SingaporeMotherhood | Baby & Toddler

September 2024

Having experienced Postpartum Depression, this Mum gives voice to the condition to help other new parents

By June Wan

Four days after bringing her newborn son (now four) home from the hospital, Ethel Yap found that she could not breathe. She had no idea that it was because of postpartum depression. “It started off as a sudden tightness in my chest. Then it progressed to feeling like I couldn’t breathe properly. Every time I tried to drift off to sleep, my body would violently jerk itself back awake, and I would feel like I was suffocating, as if someone was choking me. I’d be gasping for breath,” the 35-year-old recalls.

That is when the singer-songwriter and theatre actress decided to go to the Urgent O&G Centre at KK Women’s and Children’s Hospital (KKH). “Friends who were in the medical profession had told me that KKH has a specific A&E just for Obstetrics and Gynaecology (O&G) related issues. So I thought that was probably the best place to go.

Also, when my husband and I Googled my symptoms, a heart condition came up. Peripartum cardiomyopathy is a postpartum heart condition in which a newly postpartum mother can develop sudden heart failure, even without having any heart condition prior to pregnancy or the birth. That was what made us decide to seek professional help,” she says.

Four years after, Ethel, as brand ambassador of this year’s Beyond The Label (BTL) Festival, shares her story about going through postpartum depression and anxiety.

“I was admitted to the hospital for one whole week, and they did all the physical tests on my heart function, my lung function. I was sent for a lot of CT scans, for X rays, for ultrasounds, and a cardiac ultrasound of my heart.

In the end there was no physical diagnosis. Physically, I was completely fine. I was referred to the mental wellness team for a follow up.

My diagnosis, officially on paper, is postnatal adjustment syndrome with anxiety symptoms.

The first thing that I felt when I found out was a mixture of relief, and further worry. Relief, because physically, I was fine. So there wasn’t any risk of me just dropping dead from sudden heart failure.

But there was extra worry, because I am aware that for mental health conditions the recovery journey isn’t as linear as it would typically be for a physical health condition. I didn’t know how long it would take for me to recover, or what the recovery journey would be like.

My husband was constantly in touch with me throughout the hospitalisation and my entire journey. I am very close to my family as well. So I was keeping them updated while I was in the hospital and further on, when I had my mental health diagnosis.

My mom was instrumental in helping me with vital child care support, right from my son’s birth and she continued to actually be one of my son’s primary caregivers, along with me for the first 18 months of his life before he went into preschool.

I was diagnosed with obsessive compulsive disorder (OCD) when I was a teenager…

and there is a history of OCD in my family, but not depression specifically. Throughout my late teen years and into my early adult, young adult years, I was able to manage my condition very successfully, with therapy. But I am aware that OCD tends to predispose you to anxiety. They are correlated, so I was always aware that I am perhaps more predisposed to being anxious or to having anxiety.

Once I was diagnosed, I had regular appointments with the KKH psychiatrist. Mainly, my medication was for insomnia that was caused by anxiety. I also had counselling sessions with the KKH mental illness counsellor.

Outside of that, I also had therapy counselling from a private practitioner. That may sound like overkill, but I felt that I needed it. I knew that I wasn’t in a good place yet, and that I needed extra help, so I went ahead to seek that extra help.

A very big challenge was not being able to connect emotionally with my son.

That was very discouraging and disappointing for me. I’ve always had a very close relationship with my own mother and not being able to connect emotionally with my son made me very disappointed in myself. It was frustrating that our relationship wasn’t at a place that I wanted it to be.

Another challenge was the lack of sleep. That just really reduced my ability to function normally. I mean, I could still function. In fact, a lot of people didn’t even know I was anxious and depressed, because externally, I seemed highly functional.

Internally though, I just felt very empty, very worthless. I felt like a zombie.

I felt like I was just going through the motions in a very detached way. And of course, I was just utterly exhausted, mentally, emotionally, physically, but not able to switch off, not able to rest, to recharge. I was feeling extremely worn out, extremely wrung dry, just a shell of myself. I couldn’t experience joy, and I felt like a ghost.

And it was also very hard for me to connect emotionally with my husband. I had no energy to connect with anyone, whether it was my son, my husband, the rest of my family, or my friends.

I think one of my biggest fears was not knowing when I would recover from postpartum depression, when I would feel like myself again.

I’m actually very bubbly, very cheerful, and very joyful. And I have always been a very positive, optimistic person my entire life. So when I was going through my 18-month struggle with anxiety and depression, I felt that I was completely the opposite of my usual self.

I was just like a hollow shell, and I missed myself. I missed feeling like myself and I was so afraid that I would never recover, I would never become myself again. I just felt so fragmented. I didn’t know when I would come back together again, come back to myself again.

What helped me manage was knowing that no matter how I felt, I was always loved by the people around me. I never doubted anyone’s love for me for a second — my husband, my family, my friends, my community, a lot of them close friends from my church. It really helped a lot to know that I was never alone.

I felt that I was getting better at the one year mark, but then I had a very bad relapse. My insomnia came back very aggressively, and I couldn’t sleep for almost a week. By the end of that week, I started to have thoughts of self-harm.

I would imagine hurting myself with sharp objects around the home, banging my head against the wall, things like that. I think this was the lowest point. It really felt like I was possibly on the verge of hurting myself.

What helped me get through it was community support and my faith. I’m a Christian, and I believe that God loves me, and I believe that He is greater than the struggles I’m going through, and I believe that He is with me, even in the darkness.

So clinging onto that faith, believing that even though I was in a very dark place, I was still loved and not alone, both because I have God and also because He has given me a wonderful community and a support network, was what really helped me get through it.

And I think being able to be very honest with the people closest to me and tell them that I was really struggling, I was having a relapse, please pray for me, and knowing that they were there for me, also helped me get through it.

I just felt that I was doing a bad job as a mum. It’s already been one year. Why am I still relapsing? Why am I not better yet? Am I going to be like this for the rest of my life?

I think that really affected me. It made me feel so hopeless and feel like there was no point in living if I was just going to go through life like this empty shell. What’s the point?

I’m not living abundantly or living life to the fullest. I’m not enjoying being a mum, like, what’s the point of it?

I guess the good thing about me is that I have never been afraid to ask for help. I know a lot of people are, and think that asking for help is shameful and weak. But I have never shied away from asking for help, and I think that’s why I was so intentional about seeking therapy the moment I detected that something was not right with me.

Ever since I’ve had this experience though, I am not afraid to be honest with people. I’m not afraid to say that motherhood is a complex and sometimes difficult experience for me.

That’s not what’s widely talked about when people talk about being a mother. You know, the common discourse is always, I love being a mum, it is the best thing in my life… everything’s always overwhelmingly positive.

I love my son and I will never stop loving him. Being a mother is not easy, but I don’t regret having him in my life.

As a creative person I’ve always used my art in particular, my songwriting, to express very honest and difficult thoughts and experiences that I am going through.

So I have used my songwriting as a platform for postpartum depression and anxiety, and the complexities of parenthood. I’m happy to use my voice and my art making to highlight these issues so that people who are going through the same thing won’t feel so alone, and know that it’s okay for them to have honest conversations about this.

I have also been quite intentional about seeking avenues to collaborate for mental health awareness. One of them is by partnering Beyond The Label. They selected me to be the ambassador for this year, to advocate for mental health awareness and honest conversations, to check up on your friends and to not be afraid to share your experiences with mental health struggles.

We want to normalise this so that people who are struggling and who are in need of help will not be afraid to go and get that help, and to go and voice out the fact that they do need help.

The group of people that I want to reach out to personally are parents. Not just mothers with postpartum depression, but also dads.

There are parents who are struggling with their role as parents, who find that it’s not easy but are maybe afraid to be honest about that, because they are afraid of judgement. I would like to create that safe space for them.

One big lesson I’ve learnt is that I can get through very hard times. I don’t know if I’m just being naive or foolish, but I would like to believe that if I can get through very hard things once, I can do it again. Initially, when I was in the middle of my suffering, I was like, wow, I really cannot imagine having another child. Like, this is just the worst. I’m suffering so much. This is torturous. I really can’t imagine having a second one.

But now that I am much better, I feel like I’ve survived it before, and I can survive it again. I don’t know if that’s foolishness. I don’t know if I should just enjoy the fact that I have recovered, and not put myself through — possibly — another round of suffering.

But at the same time, I really do love my son. I love the joy that we share and the relationship that we have, and I think it would be beautiful to have that with another child.

To a new mum who finds that she is struggling? I would say, firstly, you are not alone.

You are not the only mum going through this. Don’t be afraid to talk about what you’re going through. Two, getting help is not a sign of weakness, it is a sign of courage. Don’t be afraid to ask for help. Help exists on a spectrum as well. It’s not just professional help, which is incredibly important, but also community help.

We were never meant to raise our children in a vacuum. There is a reason for the phrase: it takes a village to raise a child. It’s true. It really does take an entire community of individuals to raise a child, and having my village around me has been incredibly helpful for me.

(See also: Postpartum Depression 101 – Beyond the Baby Blues)

I also want to normalise conversations about mental health conditions, especially postpartum depression. As a Beyond The Label ambassador, I want to champion people speaking up and reaching out to get the help that they need.

I also think that to a new mum who’s struggling, particularly in the age of social media, I would say that every situation is different. Every mother and every baby is different. So don’t compare yourself to other mums or other families that you see on social media who appear to be thriving and doing very well.

Everyone’s journey is different. You are on your own journey. Find what works for you and what helps you and your child, what fits you and your child the best. It may not look the same as other families.

To mums-to-be who are preparing welcome a baby into their lives, I would say, prepare your community support network.

As far as it is possible, surround yourself with people who will be there for you when you are struggling, and who will be there for your child when you are struggling.

Also, I think it is very important to be aware about what postpartum depression and anxiety look like, feel like, what the symptoms may be. This is so that if you start to experience it, you can identify the signs and get help.

Don’t just prepare the physical things for the birth, like the baby room and the milk bottles and the pump. Prepare mentally, prepare emotionally. Especially if you’re a first time mum, having a baby will rock your world. It will shape your world. It is life changing. It’s not a small thing. Is a huge thing, potentially the biggest thing in your life. It’s going to be a huge adjustment. You are going to feel a lot of feelings you wouldn’t expect, shock, maybe grief.

You may not immediately fall into affection for your child right away, and that is totally fine. That’s totally okay. You are not a bad mum for feeling that way. You are not a bad mum for having those thoughts, feelings, for feeling grief, for feeling like you don’t know this child that you just gave birth to, for feeling like that baby’s a stranger.

It does not make you a bad mother. You are adjusting to the biggest change you have ever experienced in your life. Give yourself time. Be kind to yourself. Prepare your network. Read out about signs and symptoms of postpartum depression and other mental health conditions. Arm yourself so that if it happens to you, you know how to seek help.”

Beyond the Label (BTL) is a nation-wide movement started in 2018 by National Council of Social Service (NCSS), which focuses on addressing stigma towards and promoting social inclusion of persons with mental health conditions. In 2022, then-President Halimah launched the second phase of the movement (BTL 2.0) and the BTL Collective, which comprises partners from the public, private and people sectors working together to create an empowering and inclusive environment for persons with mental health conditions. BTL 2.0 is led by NCSS and TOUCH Community Services.

Images: Ethel Yap, unless otherwise specified

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