Perinatal depression, which refers to depression occurring during pregnancy or the first year postnatally, affects up to 15 per cent of women in Singapore.
Dr Cornelia Chee, Consultant & Director of the Women’s Emotional Health Service at the Department of Psychological Medicine, National University Hospital, sees two new cases per week, and this is just the tip of the iceberg, she says.
Any woman can have perinatal depression. “I just saw a doctor with depression, who saw me early in the pregnancy. We made a decision to start antidepressant therapy and she made a good recovery. She’s really enjoying the baby now (even though she’s still very sleep-deprived) and is back to her usual lively self!” says Dr Chee.
If you think you have the blues, don’t suffer in silence. “I have met so many mothers who suffered through perinatal depression in previous pregnancies, and tell me they wish they had known, or sought help earlier,” Dr Chee recalls.
Her advice? Start with talking to a friend who has a baby too, or your husband. If you find your symptoms aren’t getting better after two weeks, seek help (see below).
Am I at risk for perinatal depression?
Anyone can get it, but especially at risk are mothers who have past histories of depression (and particularly previous perinatal depression), psychosocial stressors such as family, maid, work or economic issues.
What should I look out for?
Some of the more specific symptoms include persistent low mood, lack of interest in pleasure, feeling overwhelmed, negative or pessimistic thoughts, tearfulness, and irritability (as the other symptoms such as poor appetite and sleep and low energy levels are commonly found in pregnant or postnatal women as well).
Will I be a danger to myself or to my baby?
In a majority of cases, no. But there is a small group of women who find themselves wishing that someone else could take care of the baby because it’s too overwhelming for them, and this affects bonding with the baby.
How can this be treated? If it is by medication, will this harm the baby?
Do not keep silent. Talk to others for support, exercise if your obstetrician says it’s okay to, and work out whatever is stressing you. If necessary, medication can be prescribed. This should be done in consultation with a doctor who can weigh all the factors involved and customise treatment. The risk of medication has to be balanced against the risk of being unwell. Having said that, antidepressant therapy in pregnancy and the postpartum is safe in the right hands.
Will I suffer a relapse when I have another baby? What are the chances?
The risk of having perinatal depression is ten to 15 per cent in general, but a woman who has had previous perinatal depression will have a 35 per cent risk of having another episode. So while it is entirely possible to have a great pregnancy and postnatal period with a second or subsequent baby, it still needs to be watched out for.
Can perinatal depression can be treated with hypnosis?
I have certainly done hypnosis with some patients. It can be useful for anxiety issues, and the role transitions required in motherhood. But at a moderate level of depression, medications become increasingly of benefit compared to non-medication methods.
What can I do to help a friend if I suspect that she has perinatal depression?
Encourage her to consider that she may have it. Some women have difficulty accepting this at first. Print out educational materials on perinatal depression for her from online sites like this one or go to beyondblue.org, the Australian national website for postnatal depression.
The National University Hospital (NUH) has a Women’s Emotional Health Service. Call the hotline at 6772 2037 to book an appointment. KK Women’s and Children’s Hospital has a Mental Wellness Service specially for women with perinatal problems.
You do not need to deliver your baby at these hospitals to book an appointment.