Motherhood is often portrayed as a blissful, love-filled chapter. And while that might be true for some, there are also some new mothers whose reality is much more complex than that.
Postpartum depression (PPD) is a real issue that some mothers might face, and coupled with having to return to the workplace like nothing has changed, it can add another heavy layer of stress to an already overwhelming time.
But what exactly is PPD, and are all new mothers at risk?
Speaking to AsiaOne, Voon Yen Sing, deputy director for clinical services at the Singapore Association for Mental Health (SAMH) describes it as a mood disorder that affects some women after childbirth.
“It goes beyond the short-lived ‘baby blues’ and can include persistent and prolonged feelings of sadness, anxiety and fatigue that can interfere with daily life and bonding with the baby,” she continued.
“Mothers may feel overwhelmed, especially when juggling newborn care by themselves and managing other stressors such as taking care of older children, worrying about family’s well-being and other real-life pressures.”
As for who is more prone to the mood disorder, experts explained that there are several factors that come into play.
“Women who have a history of mental health challenges, limited social support, financial stress, marital or relationship dissatisfaction or a difficult pregnancy or birth may be more vulnerable. First-time mothers can also experience added pressure,” Yen Sing stated.
Dr Gillian Lim, consultant and chief of the central region at the Institute of Mental Health (IMH), echoes this, also adding that while mothers with these risk factors are prone to PPD, it can also affect those without.
She explained to AsiaOne: “People who are most prone to getting PPD will be, for example, mummies with a past history of depression or mental health problems before. It could also be mummies with very poor social support, low income, [are] very stretched financially, maybe [facing] unemployment, [and] families where perhaps there’s also issues with domestic violence. So those tend to be the ones who will be at higher risk.”
“But of course, mummies with good support, who have no history of mental illness may also be at risk of getting postpartum depression,” the psychiatrist added.
Baby blues vs PPD
So how do we differentiate between the more common ‘baby blues’ and PPD?
According to the experts, the main difference lies in the intensity and longevity of symptoms.
For those suffering from PPD, decreased mood and other negative feelings are much more chronic.
Explaining to AsiaOne about the key differences, obstetrician-gynecologist (OBGYN) Dr Lee Wai Yen from the Singapore Women’s and Children’s Medical Group shared that it’s not uncommon for many new mothers to experience postpartum (or baby) blues.
And in those cases, symptoms typically resolve within a month on their own, and mothers can still experience moments of happiness in between, unlike PPD, she added.
“The symptoms of women with postpartum depression are more severe, exist almost all the time, last longer than two weeks or start later any time in the first year after giving birth. It does not resolve spontaneously without any help and therapy,” the OBGYN stated.
Additionally, PPD can also adversely affect a mother’s daily function and ability to carry out her responsibilities.
“The ‘baby blues’ usually pass quite quickly after childbirth and without help. PPD lasts longer and comes with more intense symptoms that disrupt a mother’s ability to function or care for her baby,” explained Yen Sing.
According to Dr Lee, some symptoms of PPD include:
- Feelings of sadness or crying often
- Lack of enjoyment and loss of interest in activities
- Isolation
- Irritability and anger towards the baby and family members
- Trouble bonding with the baby
- Trouble sleeping at night
- Fatigue
- Being unable to concentrate and make decisions
- Negative talk about life being hopeless or meaningless
- Thoughts of harming the baby
“Besides low mood and exhaustion, other symptoms may include a surge of dread at specific times of the day, such as nightfall when the newborn wakes up and needs to be fed. In more severe cases, there may be thoughts of self-harm,” added Yen Sing.
Returning to the workplace with PPD
Going back into the office might be tough enough as is for most new mothers, and for those suffering from PPD, it can be extra difficult.
Returning to the workplace means wearing another hat — which according to experts, is an additional stressor.
“When you go back to a workplace, there’s a lot of additional roles that you take on. You are then someone who maybe potentially supervises a team. You have your own tasks. You report to your superiors, and on top of the load that you have as a mum, as a wife, and as a new family, that’s the additional load that comes on,” said Dr Lim while explaining that the burden might be too much to bear for those suffering from PPD.
“That’s when their symptoms may worsen, or that’s where maybe we find that they are unable to fulfil some of their duties as a mother because they’re crying, or they feel like they have no energy to do this. And [in the] worst case, of course, we worry about the risks.”
“When they feel as if there’s no escape from some of the stresses they have, and then they have thoughts of not waking up, or wanting to run away or wanting to harm themselves,” she added.
“In very rare instances, there are some mothers who feel like perhaps they may want to harm the baby as well. Those are really rare instances, but very dangerous.”
On top of the added responsibilities, another struggle that mothers with PPD might face in the workplace is judgement due to a lack of understanding.
“There is a lack of awareness of postpartum depression in the local culture. Not just among work colleagues, even among family. Women might be judged as being ‘incapable’ when depression is affecting their work outcome or ability to look after the newborn,” explained Dr Lee.
Speaking to AsiaOne, Linda Teo, country manager for ManpowerGroup Singapore (a recruitment agency) also agrees with this, stating that while there are guidelines in place to prevent discrimination at work, “a lack of understanding of mental health conditions could inadvertently contribute to biases” and these biases “might manifest in various ways, potentially affecting career progression or opportunities”.
But not all hope is lost.
According to the experts, there are certain measures that workplaces can take to help offer more support — such as more fluid work arrangements and increasing awareness.
“Flexible work arrangements, supportive leave policies, and creating an open culture around mental health can make a difference. A simple check-in from the manager who listens without judgement is already a step towards greater mental health support,” Yen Sing stated.
In addition to flexible work arrangements, IMH’s Dr Lim also suggested that child care leave, family care leave and the implementation of nursing booths or quiet spaces for breastfeeding mums to pump would also be a good touch to help mothers feel more supported.
“A mum who is better supported and who’s worrying less about her child who’s in school or at home while she’s at work then focuses better at work, and productivity will also increase,” she explained.
Creating a more inclusive company insurance package can also be beneficial.
“Including mental health coverage in company insurance can also encourage employees to seek help. Health screenings should also cover mental health to identify issues early,” said Dr Lee.
Seeking help
And for mothers who are suffering from PPD, experts emphasised that it’s important to reach out.
“Mothers need to extend compassion to themselves instead of demanding perfection. It’s okay to struggle and not have everything together all the time. Though they may feel alone, they are not alone in their struggles. Reaching out for support is not a sign of weakness, it’s a courageous and powerful step towards healing,” stated Yen Sing.
Dr Lee also adds that seeking professional advice is crucial for recovery.
“Some women are too shy to seek professional help, such as seeing a psychologist or psychiatrist, either due to lack of awareness of postpartum depression, or that they do not know where to seek help or do not want to be labelled as ‘incapable’. Perhaps speak to an obstetrician, someone [that] they are familiar with, may provide the initial guidance to the appropriate assessment and intervention,” she said.
Early intervention and support, such as talk therapy, counselling or sometimes medication are key to overcoming postpartum depression,” Dr Lee added.
Dr Lim also suggests that being aware even before the baby is born might help.
“My first advice would be to people who are pregnant, even to those who have not even given birth. I think it’s about understanding the resources that are available, understanding that there’s no such thing as a perfect mum, being willing to ask for help and to get help,” the psychiatrist encouraged, adding that she has also shared resources and more information on PPD on Clarity Singapore’s The Birth of a Mother podcast.
[[nid:713331]]
Read the full article here
