Postpartum depression: Dos and don'ts, and how to support someone who's experiencing this
Motherhood is a life-altering experience—one that's addled with hormones, plenty of emotions, and even anxiety that comes with giving birth to a baby. For some mothers, the "baby blues" that they experience after giving birth may not merely be a two-week dip in emotions—it could very well be postpartum depression, a treatable condition can happen to anyone, be it a woman who is a few months into her pregnancy or a mother of four.
In light of Maternal Mental Health Month, we speak to Dr Wong Yen Shi from Sunway Medical Centre on what to look out for if someone is experiencing postpartum depression:
What are some misconceptions about postpartum depression that you would like to address?
Myth 1 - It’s just baby blues and it will resolve soon.
Yes, up to 80% of women may have baby blues within days of delivery and it would usually go away just as quickly. Symptoms of postpartum depression are typically longer lasting, more severe and can occur anytime up to a year after childbirth. Postpartum depression requires medical attention and is a treatable condition.
Myth 2 - I am not crying, hence I am okay.
Though constant tearing maybe a sign of depression, mothers may manifest other symptoms such as poor concentration, insomnia, loss of appetite, lack of motivation or feelings of worthlessness. These symptoms can intensify especially when mothers try to cope with the demands of a newborn.
Myth 3 - I did not have postpartum depression in my first pregnancy, so it will not occur in my next pregnancy.
While having a history of mental health disorder in previous pregnancy increases the likelihood of recurrence in subsequent pregnancies, postpartum depression can actually occur in any pregnancy.
Myth 4 - I am on antidepressants, hence I cannot breastfeed
The exposure of the infant to antidepressants through breastmilk is generally low, and the benefits of breastfeeding outweighs the risks. It is best to speak to your healthcare provider and also, it is not advisable to skip your medication.
Myth 5 - Only women suffer from postpartum depression
This is not true—around 1 in 10 fathers experience paternal postpartum depression.
What are the signs to look out for if a parent thinks that she is suffering from postpartum depression?
New mothers may be embarrassed to speak up about their feelings as people around them are expect them to be in high spirits after giving birth. If you are worried someone you know could be suffering form postpartum depression, these are the symptoms and signs to watch out for:
- Feeling restless, moody, or hopeless
- Lack of motivation
- Loss of appetite or eating too much
- Lack of or excessive sleep
- Constant tearfulness
- Feeling worthless or guilt
- Lack of interest in activities that were previously enjoyed
- Withdrawal from family and friends
- Physical pain and aches that do not subside
- Having no interest in the newborn
- Thoughts of hurting oneself or the baby
Is there a typical period that postpartum depression lasts? When does it typically begin?
Symptoms can start as early as during the pregnancy up to the first year after childbirth. If not addressed, postpartum depression can prolong for months and affect the quality of life along with a negative impact to the infant.
Is postpartum anxiety disorder different from postpartum depression? What are the differences between both?
Postpartum depression tends to manifest generally as sadness, while postpartum anxiety is expressed through constant worrying. Postpartum anxiety can affect up to 10% of new mothers, and symptoms include excessive worrying, feelings of dread, lack of concentration, dizziness, palpitations or panic attacks. There may also be changes to eating and sleeping patterns.
How can pregnancy and being a new mother affect the mental well-being of a woman?
Expectations and anxieties are at a high at this time. During pregnancy, changes in body image, poor weight gain, dissatisfaction with marital relationships, perceived lacked of psychosocial support, previous unfavourable pregnancy outcomes, unplanned pregnancy or the presence of underlying medical conditions can all take a toll on mental health.
Upon delivery, a traumatic birth experience, pain, lack of rest and sleep with the increasing demands of a newborn too contribute to mental health problems in postpartum periods. There are a lot of factors that may attribute to a deteriorating emotional well-being of a new mother.
While attempting to help a parent who has postpartum depression, what are dos and don’ts that people should be aware of?
What you should say:
- Do allow the mother to take her own time to recuperate post delivery
- Do allow her to grasp and learn how to be a new mum at her own pace
- Offer to help her with the newborn, older children and house chores
- Provide some time for her to carry out activities that she enjoyed pre-pregnancy
- If visiting, ask about the mother’s well being, not just the baby
- Accompany her for a doctor’s appointment
What you should NOT say:
- Don’t invalidate her feelings and tell her “ You need to get over it.”
- Don’t brush her off when she is confiding in you
- Don’t humiliate or guilt trip her by saying “ Stop feeling sorry for yourself.”
- Don’t compare her with other new mothers
With the MCO being enforced now amid this pandemic, new mums are struggling even more with postpartum depression. What advice can you give to help mothers, new parents in this trying time?
In this pandemic, new parents and their newborns are faced with new challenges. New parents may find themselves lacking psychosocial support as family members are not able to visit, deliveries are lonely as spouses are not allowed to be present, and also problems accessing healthcare or daily needs due to the MCO. Some also have fears of contracting the disease and passing it to their newborns.
For many, pay cuts, job loss and financial woes are rife during this pandemic. All these can be overwhelming and are triggering factors of psychosocial stress. Though reports are scarce, it isn't surprising that mental health issues amongst pregnant and postpartum mothers and fathers are on the rise.
The physical and mental health of the family is of utmost importance. It is important for one to identify any triggering factors or stressful events that can result to psychosocial stress and address them accordingly. Speak to your healthcare provider if you think that you may be suffering form symptoms of postpartum depression.
On that note, a reminder that public health advice should also be adhered during these times such as wearing a mask outdoors, practising social distancing and avoiding crowded places. However, a new mother and her baby should attend all postnatal or vaccination appointments.
What are the support groups that offer maternal mental health support here in Malaysia?
How important is post-pregnancy recovery care and what steps do you recommend families and new parents take?
Post-pregnancy care is incredibly important. Amongst others, having a balanced, healthy diet and getting sufficient sleep is essential to maintain mental well-being.
Reach out to your spouse, older children, or other family members to help out with house chores and taking care of your newborn. Find time to rest, recuperate and do what you enjoy as these will help improve your mood. Don't forget to exercise, though it may have to be done within your house compound amid the MCO.
Dr Wong specialises in Obstetrics & Gynaecology at Sunway Medical Centre.