7 Best Tips To Manage Prenatal and Postpartum Depression By A Psychotherapist

Motherhood is a transformative experience, encompassing immense joy alongside significant emotional challenges. Recent data reported on Channel News Asia and The Straits Times highlighted a trend of a concerning increase in perinatal depression, encompassing both prenatal and postpartum depression, among Singaporean mothers.

In this article, I will be sharing my views on this growing trend of perinatal depression in Singapore, based on my experiences of working with new parents and my personal journey of being a mother of two young daughters. I will provide tips and other practical strategies to help expectant and new mothers navigate the emotional rollercoaster of pregnancy and early parenthood. I hope that this article will serve as a resource for all expectant and new mothers to empower you to embark on a fulfilling and joyful journey into motherhood.

Understanding Prenatal and Postpartum Depression in Singapore

We are more familiar with the term “postpartum depression” as it has traditionally been used to describe maternal depression. However, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) by the American Psychiatric Association (2022) now utilises the term “peripartum depression.” This shift reflects growing evidence that roughly 50% of maternal depression actually occurs during pregnancy, rather than after delivery as postpartum depression suggests

The symptoms of peripartum depression mirror those of major depressive disorder, with the key difference being onset during pregnancy or within the first 4 weeks postpartum. Recent research suggests peripartum depression can also occur later in the first year, with a peak around 2 to 3 months after delivery.

Symptoms of Peripartum Depression

The symptoms of peripartum depression can be significant and require attention. Here are some common signs:

  • Feeling of hopelessness
  • Consistently low mood
  • Feeling like you can’t enjoy anything
  • No connection with your baby
  • Overwhelming stress and anxiety about your baby
  • Panic attacks
  • Insomnia
  • Suicidal thoughts

 

Causes of Peripartum Depression

The journey of pregnancy and childbirth is a transformative experience, encompassing significant physical, physiological, and psychological changes for women. Throughout pregnancy and after delivery, a cascade of hormonal fluctuations occurs. For instance, our oestrogen levels plummet by over 100 times in the days following delivery. 

These dramatic shifts, combined with other chemical changes, can contribute to a temporary dip in mood known as the “baby blues”, which is very common among new mothers and affects up to 75% of women shortly after childbirth. 

In addition, the arrival of a newborn ushers in a major life change. New mothers face the immense responsibility of caring for their child, mastering breastfeeding or bottle-feeding, coping with disrupted sleep patterns, and navigating physical recovery after delivery. These challenges can leave many women feeling overwhelmed and struggling to regain a sense of normalcy.

The cumulative effect of these physical, physiological, and psychological changes, along with the immense responsibility of caring for a newborn, can contribute to peripartum depression.

Prevalence in Singapore

KK Women’s and Children’s Hospital (KKH) reports concerning statistics. Their initial screening of 1,300 patients identified signs of prenatal depression in approximately 8% of expectant mothers. Additionally, KKH documented a 47% increase in patients screening positive for postnatal depression between April 2021 and March 2022 compared to the previous year. These figures highlight the growing need to address peripartum depression in Singapore.

 

Reasons For Increase in Depression Amongst Mums in Singapore

While the recent reports do not delve into specific causes, here are three factors contributing to the increase in maternal depression in Singapore from my perspective:

Shifting Family Dynamics

A potential factor contributing to the rise of peripartum depression in Singapore is the changing landscape of family structures. In our parents’ generation, they had an extensive support network within the extended family and close-knit communities in kampongs (villages) to rely on. These networks often provided crucial assistance with childcare and emotional well-being for new parents and fostered a sense of shared responsibility over child-rearing. 

In contrast, modern Singaporean society is characterised by smaller, nuclear family units. This shift can lead to increased feelings of isolation for new parents, as the immense responsibility of caring for a newborn falls primarily on them. The lack of readily available support from extended family can exacerbate the stress and emotional challenges associated with this crucial life stage.

Increased Societal Pressures

The high cost of living in Singapore could also be a potential factor for the rise in peripartum depression as it creates a unique set of challenges for new parents. With expenses like childcare and housing often requiring dual incomes, the pressure to maintain a certain lifestyle can feel immense. For many families, relying on a single income simply is not feasible, placing significant pressure on new mothers to return back to work as quickly as possible even before they are physically and emotionally ready.

The traditional expectation for women to excel in both their careers and motherhood can contribute to feelings of guilt and inadequacy. Often, new mothers feel guilty for not spending enough time with their children, while struggling with having to perform at the same pace at work. The lack of time for self-care and the constant struggle to achieve an unrealistic work-life balance can lead to exhaustion and increased vulnerability to peripartum depression.

Pervasiveness of Social Media

The ubiquitous presence of social media has added a significant new layer to the pressures faced by new mothers in Singapore. Social media platforms are often filled with carefully curated portrayals of parenthood and these “highlight reels” showcase seemingly perfect families and flawless parenting moments, rarely reflecting the messy realities and everyday struggles that new parents encounter.

Constant exposure to these unrealistic portrayals can fuel an expectation of “perfect parenting” for new mothers. Often, we may unconsciously compare our own experiences and feel like we are falling short of the idealised image presented. This relentless comparison can exacerbate feelings of anxiety and inadequacy, leading mothers to question their own abilities and judgement. The emotional toll of this constant comparison can significantly contribute to the risk of developing peripartum depression.

Tips to Manage Prenatal and Postpartum Depression For Mothers

Prenatal and postpartum depression can be challenging, but there are steps you can take to manage it and feel better. Here are 7 tips for mothers:

Tip #1: Educate Yourself

The first step towards managing perinatal depression is empowering yourself with knowledge. Learning about the condition can significantly reduce your anxiety around the pregnancy and postpartum experience and to recognise signs of perinatal depression in yourself and advocate for your needs. 

It would also be helpful to learn about the various treatment options available, which will allow you to have informed discussions with your doctor and choose the approach that best suits you, whether it is joining a support group, psychotherapy, or medication. 

 

Tip #2: Build a Support Network

New mothers can often feel lonely and overwhelmed by their new role. Research suggests that loneliness can be quite detrimental to our mental well-being, leading to painful feelings of isolation.

Social and emotional support from others can be a powerful tool for managing the complex challenges of motherhood. You do not require an extensive network to benefit from social and emotional support – meaningful connections can be found with just a few people you trust, such as your partner, close friends, family members, or other new mothers. 

If you are struggling to find a support network, try not to give up! Consider exploring baby and toddler classes, or joining support groups for new mothers that are available on different platforms such as Facebook, WhatsApp and Telegram.

Here are some local support groups for new mothers in Singapore:  

Tip #3: Maintain a Healthy Lifestyle

A balanced diet, regular exercise, and adequate sleep are the cornerstones of a healthy lifestyle that can significantly improve your mental well-being during pregnancy and postpartum. Here are some specific ways to incorporate these lifestyle behaviours:

Eat nourishing foods: Consider incorporating foods rich in omega-3 fatty acids, such as oily fish like salmon and herring, as studies suggest that these may lower the risk of postpartum depression.

Get as much sleep as possible: While consistent sleep schedules might seem like a distant dream with a newborn, sleep is crucial for your mental health. Utilise any help available from your partner, close friends or family members to catch a nap when your baby sleeps. The phrase “sleep when the baby sleeps” is valuable advice, even if it is not achievable in perfect chunks.

Get out in the sunshine: Sunlight exposure has a mood-boosting effect. Aim for at least 10-15 minutes of sunlight exposure every day through gentle activities such as taking a walk around the block with your baby in the stroller.

Tip #4: Prioritise Self-Care

The transition to motherhood can sometimes lead you to feel that you are losing your identity and sense of self. Taking care of yourself extends beyond just physical needs. Schedule time, even if it is just a small break each day, for activities you used to enjoy or that bring you a sense of peace and fulfilment. This could be reading, taking a relaxing bath, spending time in nature, or journaling. Specific journals, such as anxiety journals, can help to target and manage certain emotions.

Remember, prioritising self-care is not selfish; it allows you to better care for your baby. 

Tip #5: Build Strong Communication

The arrival of a baby brings immense joy, but it can also be a time of immense stress for both parents. Open and honest communication with your partner becomes even more crucial during this period. Be open and specific about your needs, whether it’s needing help with chores, wanting time for self-care, or simply feeling overwhelmed. For example, you could say, “I’m feeling a bit burnt out. Would you be able to take over bath time tonight?”

Open communication with family members is also important. Set clear boundaries as needed, but also be open about what kind of help would be most beneficial. For example, you could say, “I appreciate your offer to help with the baby. Right now, what would be most helpful would be if you could watch the baby in the mornings so that I can get myself ready for the day.”

Tip #6: Set Realistic Expectations

Social media often portrays a picture of seemingly perfect families and flawless parenting moments. It is important to let go of these idealised expectations and embrace the messy realities of parenthood, which would significantly reduce stress and foster a more positive experience. 

It is perfectly okay not to be calm as a parent all the time and not to maintain a spotless house. Instead, focus on creating a loving and nurturing environment for your baby, one step at a time.

Tip #7: Seek Professional Help

If you notice the feelings of ‘baby blues’ persisting beyond a few weeks or worsening over time, reach out for professional help. Share your concerns with your primary care physician or gynaecologist and they can connect you with appropriate treatment options.

Our counsellors at Sofia Wellness Clinic can also provide valuable support and guidance towards helping you to feel better and enjoying this special time in your life through counselling for anxiety and depression. 

FAQs about Prenatal and Postpartum Depression

What are the potential consequences of untreated prenatal or postpartum depression?

Untreated prenatal or postpartum depression can have significant consequences for both mother and baby. Mothers experiencing untreated depression may struggle to bond with their babies, leading to feelings of guilt and inadequacy. This can impact their ability to care for themselves and their newborn properly. Additionally, untreated depression can increase the risk of self-harm and suicidal thoughts. 

Furthermore, early childhood is a critical time whereby the formation of secure attachment and bonding between mother and baby forms the foundations of a child’s emotional and social development. Hence, exposure to maternal depression may cause delays in reaching developmental milestones for the baby, particularly in areas such as social and emotional development.

How can I support a loved one who is experiencing prenatal or postpartum depression?

There are many ways to support a loved one who is experiencing prenatal or postpartum depression. One of the key ways is to provide a listening ear and offer a safe space for your loved one to express their feelings without judgement. This can be a very helpful process for them to make sense of the new and confusing experience of motherhood. 

Other ways would be to offer practical help with errands, childcare or housework to ease their burden and for them to give them time and space to practise self-care for themselves. You can also gently encourage your loved one to seek professional help through depression counselling. It could be helpful to also assist with researching different treatment options or offer to accompany them to the appointment. 

Is it possible for prenatal depression to continue after childbirth?

Yes, prenatal depression can continue after childbirth and transition into postpartum depression. While some women experience a temporary improvement in mood after delivery, for others, the symptoms of prenatal depression persist or even worsen after the baby arrives. This can be due to several factors, such as hormonal shifts that occur postpartum, the stress and exhaustion of caring for a newborn, and the potential disappointment of childbirth not leading to the automatic emotional relief some women expect. 

If you experienced prenatal depression and continue to struggle with symptoms after giving birth, it is important to reach out to your doctor or a mental health professional for evaluation and treatment.

How can I differentiate between normal pregnancy mood swings and prenatal depression?

It can be tricky to differentiate between normal pregnancy mood swings and prenatal depression. However, key factors to consider are:

Intensity and duration of the symptoms: Pregnancy mood swings are usually temporary and mild. They might involve feeling irritable, tearful, or anxious for a short period. Prenatal depression, however, involves more intense and persistent feelings of sadness, hopelessness, and anxiety that last for at least two weeks.

Impact on daily life: Normal mood swings might cause some frustration, but generally do not significantly disrupt your daily life. Prenatal depression, on the other hand, can make it difficult to complete daily tasks, find enjoyment in activities, or care for oneself and the baby.

How can I differentiate between baby blues and postpartum depression?

Peripartum depression is different from baby blues, which is very common among new mothers and affects up to 75% of women shortly after childbirth. Symptoms of baby blues are mood swings, tearfulness, anxiety, insomnia, irritability and feelings of guilt over being unhappy that you are not happy. Baby blues generally appear within 3 to 4 days after delivery, peak on the postpartum day 7, and disappear within 2 weeks.

Because the symptoms of baby blues are milder and transient, generally no treatment is usually required. However, baby blues can sometimes be the early signs of peripartum depression or puerperal psychosis so it is definitely still important to keep a watch out on the symptoms.

Seek Help From A Professional

Speak to one of our counsellors here at Sofia Wellness Clinic. Book an appointment here.

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Written by Sophia Goh, Senior Counsellor at Sofia Wellness Clinic.

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