[{"@context":"https:\/\/schema.org\/","@type":"NewsArticle","@id":"https:\/\/thehomeground.asia\/destinations\/singapore\/a-mothers-journey-of-postnatal-depression\/#NewsArticle","mainEntityOfPage":"https:\/\/thehomeground.asia\/destinations\/singapore\/a-mothers-journey-of-postnatal-depression\/","headline":"A mother\u2019s journey of postnatal depression","name":"A mother\u2019s journey of postnatal depression","description":"(Content warning: Depression and suicide)\u00a0 Shubhra Shastry had just put her six-month-old daughter to bed, but in the brief moments of peace that followed, she found that she was unable to settle her mind. While her daughter slept on, blissfully unaware, Ms Shubhra found herself lost in a downward spiral of emotions. \u201cI couldn\u2019t hold […]","datePublished":"2021-07-29","dateModified":"2022-04-15","author":{"@type":"Person","@id":"https:\/\/thehomeground.asia\/author\/Ming%20En%20Liew\/#Person","name":"Ming En Liew","url":"https:\/\/thehomeground.asia\/author\/Ming%20En%20Liew\/","identifier":132,"image":{"@type":"ImageObject","@id":"https:\/\/secure.gravatar.com\/avatar\/8fe7a89455a989038349633329a6e4ad6299388f5e1e3ea83c28126090b2314f?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/8fe7a89455a989038349633329a6e4ad6299388f5e1e3ea83c28126090b2314f?s=96&d=mm&r=g","height":96,"width":96}},"publisher":{"@type":"Organization","name":"TheHomeGround Asia","logo":{"@type":"ImageObject","@id":"https:\/\/thehomeground.asia\/wp-content\/uploads\/photo_2021-07-22-222533.jpeg","url":"https:\/\/thehomeground.asia\/wp-content\/uploads\/photo_2021-07-22-222533.jpeg","width":640,"height":640}},"image":{"@type":"ImageObject","@id":"https:\/\/thehomeground.asia\/wp-content\/uploads\/1627526547830_1280X626_285229.jpg","url":"https:\/\/thehomeground.asia\/wp-content\/uploads\/1627526547830_1280X626_285229.jpg","height":626,"width":1280},"url":"https:\/\/thehomeground.asia\/destinations\/singapore\/a-mothers-journey-of-postnatal-depression\/","about":["Community","Health & Wellness","Local","Sex & Gender","Singapore"],"wordCount":2355,"articleBody":"(Content warning: Depression and suicide)\u00a0Shubhra Shastry had just put her six-month-old daughter to bed, but in the brief moments of peace that followed, she found that she was unable to settle her mind. While her daughter slept on, blissfully unaware, Ms Shubhra found herself lost in a downward spiral of emotions.\u201cI couldn\u2019t hold myself together,\u201d she recounts. \u201cI felt so all over the place in terms of my thoughts, and my energy. I was physically shaking to the point that I had to sit down. And then, it became this unleashing kind of crying.\u201dWhat followed was a barrage of thoughts that she was unable to control: \u201cI was [thinking], what if I just jumped off the building? But then, I thought, no one could help her [her daughter]. So should I just take her with me?\u201d\u00a0\u201cYour mind goes into this weird sort of dark place of self-loathing and sabotage,\u201d she explains. \u201cIt is thinking, \u2018I need to end the pain now, and what\u2019s the fastest way to end pain now?\u2019 And because it doesn\u2019t know where the pain is, it\u2019s all over \u2013 the mind, the body, the body shaking, the tears, the breathing, everything. It\u2019s going, \u2018You need to do something to stop the pain\u2019, and the first thought goes towards suicide.\u201dAnd that, she recalls, \u201cscared the living bejesus\u201d out of her.\u00a0\u201cWhat if the thoughts get so bad that they overtake all reasoning?… I may lose my mind because another part of my brain that I have no control over may take over, and I better stop that before it does,\u201d she says.\u00a0In that brief glimmer of rationality, Ms Shubhra called her husband, who rushed home from work to be with her, as well as her parents, who were living abroad at the time, but booked a plane ticket to Singapore. It was only then that she could take a breath, safe in the knowledge that her loved ones would be around to keep her and her daughter safe.\u00a0While this one moment was Ms Shubhra\u2019s breaking point, the incident did not arise out of the blue. Instead, it had been born from multiple factors converging.\u00a0The spiral into postnatal depressionMs Shubhra\u2019s breakdown had come after months of broken sleep and poor eating habits, and the neverending pressure of being a mother, topped with biological factors such as hormonal changes, and a past history of depression.\u00a0Having suffered from severe reflux during her pregnancy, Ms Shubhra was already having trouble sleeping before the birth of her daughter. This only worsened after her daughter was born: \u201cThe sleep was so bad, to the point that I was only getting two hours in a 24-hour period. I would only sleep from four to six [in the morning], when [Rahul, my husband,] would take the baby in a carrier and go for a walk.\u201d\u00a0\u201cIt was a cascade of processes,\u201d she explains. \u201cDepression hits even stronger the more your body is under-rested. And because the balance of hormones is already out of whack [from pregnancy and breastfeeding], it\u2019s just a domino effect.\u201d\u00a0Ms Shubhra\u2019s story is not reflective of all mothers who go through postnatal depression (PND, also referred to as postpartum depression).\u00a0Senior Consultant and Head of the Women\u2019s Mental Wellness Service at KK Women\u2019s and Children\u2019s Hospital Dr Chua Tze-Ern highlights that what Ms Shubhra experienced are potential risk factors for PND, and that many factors can play a role in contributing to the condition.\u00a0Dr Chua Tze-Ern highlights that postnatal depression can arise due to a multitude of risk factors, such as psychiatric history, interpersonal problems, and obstetric complications. (Photo courtesy of KK Women’s and Children’s Hospital)In particular, Dr Chua points out that a past psychiatric history is a significant risk factor, as is the presence of obstetric complications. Young mothers under 21 years of age and mature mothers are also at a higher risk of developing PND. Other stressors can include \u201cmarital difficulties, interpersonal problems, financial and workplace problems, and having insufficient support, which may accumulate to increase the risk of the development of PND.\u201d\u00a0Risk factors can also vary depending on the individual, Dr Chua explains. For instance, some may find breastfeeding a stressful experience, while others may relish the experience as a way to bond with their newborns.\u00a0But while risk factors are aplenty, with some being outside of a mother\u2019s control, there are measures that mothers can take to protect themselves.\u00a0Protecting oneself from postnatal depressionDr Chua recommends three approaches to cultivate a healthy outlook towards motherhood.The first is to appreciate the fact that life will be different once the baby arrives. She explains that this will help to \u201ctemper feelings like guilt, dismay, and self-blame during stressful periods,\u201d which were the emotions Ms Shubhra experienced the moment she found out she was pregnant.\u00a0Despite being overjoyed by the news, she also says, \u201cIt felt like the pressure was on straight away. From this moment [pregnancy], I\u2019m no longer for myself [only]. Even after she comes out, even until she\u2019s 18, this is it. My [life of just being Shubhra] has ended, and that was quite overwhelming.\u201d\u00a0The next approach to prioritise personal well-being is also vital in preventing PND, emphasises Dr Chua. She highlights that while a mother may think she is duty-bound to achieve success in and outside her home, the need to ensure she is physically and mentally well should not be forsaken. This includes having a balanced diet, getting adequate rest, as well as being kind and nurturing to herself.\u00a0Finally, Dr Chua underscores the importance of developing awareness and acceptance of one\u2019s emotions. While societal expectation may dictate that having a baby is a happy and fulfilling affair, she points out that parenting is hard work, which entails struggle, stress and sacrifice. Thus, mothers should be able to express their tiredness, worry, and frustration, without being judged. Nor should they be blamed for not automatically knowing how to handle a baby, or for experiencing negative emotions.\u00a0Ms Shubhra adds that getting sufficient rest is of utmost importance, citing the lack of it as a key factor contributing to her PND. She shares that even though her daughter was sleeping well, she struggled with insomnia after months of broken sleep.\u00a0\u201cI was still breaking down because my body didn\u2019t know how to sleep anymore, so I was still rattled\u2026 I was jumping every single time [my daughter] made any sound,\u201d she shares. \u201cThat\u2019s not healthy, because your brain is not able to shut down.\u201d\u00a0Caregivers surrounding the mother should also be attentive to warning signs and indicators that something might be wrong, and to get them help when possible.\u00a0Warning signs that Dr Chua urges the people surrounding the mother be attentive of.\u00a0They should also be cognisant of symptoms that can indicate severe depression, including confusion, auditory hallucinations, the presence of irrational beliefs, thoughts of harming the baby, or suicidal thoughts.\u00a0In such scenarios, Dr Chua emphasises that removing the baby from the mother should not be the automatic response. She clarifies, \u201cAlthough severe depression increases the risk of suicide and infanticide, this outcome is fortunately rare. Most mothers with depression love their children deeply. In fact, their sadness, guilt and negativity often stem from the fear of\u00a0 not being a good mother.\u201dShe continues, \u201cWe should do our best to improve, and not remove, the mother-child bond. Simply taking her child away will reinforce to a mother that she is indeed a bad parent, which will probably worsen her depressive symptoms.\u201dAnd while mothers have primarily been in the spotlight when it comes to discussions on postnatal depression, Dr Chua points out that fathers, too, can be susceptible, and should not be left out of the conversation.\u00a0In fact, she says that approximately one in 25 new fathers may experience some form of psychological problem, with depression being one of them.\u00a0Should fathers begin to experience symptoms that affect their well-being, functioning, emotionality, and ability to relate to others, Dr Chua encourages them to seek help as well. In the case of paternal depression, she clarifies that psychological support and therapy is the mainstay of management, similar to PND. In severe cases, medication may also be recommended.\u00a0Finding a supportive communityHaving a support system is essential too, highlights Ms Shubhra: \u201cChoose the most reliable person that you feel you can tell 100 per cent [of things to]\u2026The last thing you need is to feel unsupported by the people around you,\u201d she says.\u00a0It is a point reiterated by her husband, Rahul Shastry, who emphasises the need to be understanding of the mother\u2019s emotions and potential fragility: \u201cIt\u2019s a very sensitive period for the mother, [and so] it\u2019s important for the family to understand what the mother really wants.\u201dMs Shubhra agrees, citing instances of family members who would give unwelcome feedback or comments on how she was raising her daughter, which only served to increase the stress she felt.\u00a0\u201cIf you have family members that are not very supportive of anything you do, because they think it is going against what they did for you, and you\u2019re [having to] manage their emotions rather than attend to the baby…that can be really, really tough,\u201d she shares.\u00a0Adds Mr Rahul, \u201cIt\u2019s all in good intentions, but maybe it\u2019s not the right time and setting to bring up [your past experiences]. It doesn\u2019t matter what experience you have, if the [mother] is not in a position to receive it, you\u2019re just adding more chaos.\u201d\u00a0Rather than offer unsolicited advice, he instead recommends \u201creading what is needed for the hour, so that they [mothers] get the support that is essential.\u201d\u00a0Shubhra Shastry (left) and Rahul Shastry (right) believe that having the right support system is pivotal in managing and preventing postnatal depression. (Photo courtesy of Shubhra Shastry)He also suggests that partners be actively involved in childcare: \u201cIf both parents can equally spend time [with the child], it makes a world of difference in terms of connecting. Over time, it also helps in the relationship to showcase that you\u2019re an equal partner in terms of caring for the baby.\u201dIt also helps if mothers could lead as normal lives as possible: \u201cIt shouldn\u2019t become that they are stuck, cooped up in a room,\u201d he says. \u201cIt\u2019s important that they can get back to normalcy, so that they can feel like a normal human being, and connect with a social self outside.\u201cOtherwise, you end up living in your own little bubble,\u201d he cautions.\u00a0A need to talk about the downsidesFurther, Mr Rahul opines that postnatal depression is not being addressed enough when talking about parenting, and hopes that all pre- and post-natal classes especially will cover such topics \u2013 on support systems for mothers, or who to reach out to when there is an emergency.\u00a0\u201cNo one talks about it, because it comes down to how society perceives [postnatal depression],\u201d he says. \u201cBut if it could be normalised, it allows more people to speak a lot more openly about it.\u201dMr Rahul also emphasises the importance of partners being open to each other, and healthcare providers, of their medical history, including psychiatric conditions: \u201cThat\u2019s very useful because the gynae did speak to me about her history of depression, so she informed me separately to pay attention to her,\u201d he says.\u201c[This] gave me some level of comfort and guidance on what sort of indicators I needed to look out for, and that really helps,\u201d he adds.\u00a0Ultimately, he believes that while parenthood can be a celebratory affair, it is essential to speak about the struggles and reality too: \u201cThey can be caught up in a celebratory party, but at the same time, it\u2019s good to provide a reality check that this [postnatal depression] can also happen, so just be prepared.\u201d\u00a0\u00a0Moving forward, and seeking helpIn the end, when a safe space can be created for a mother to learn how to care for her child, and the mother is receiving adequate support (and medical care, if necessary), Dr Chua says, \u201cThe prognosis for maternal depression is excellent.\u201d\u00a0\u00a0The prognosis of maternal depression is excellent when mothers have a safe space to learn how to care for her child, and have an adequate support system, according to Dr Chua. (Photo source: Canva)For Ms Shubhra, her lowest point was also the beginning of her recovery. After calling Mr Rahul during her breakdown, she contacted her cousin, who is a doctor in Australia. He had recommended that she reach out to her gynaecologist, who was then able to refer her to a psychiatrist, who put her on medication to manage her condition.The road to recovery might have been a long and arduous one, but with the support of her family and professional help, she has managed to rise above being depressed, after more than a year.\u00a0\u201cNow, I see it as a blessing, because it made me wake up about a lot of things,\u201d muses Ms Shubhra. \u201cLooking back, [I realised] I put so much pressure on myself because I had these beliefs that I needed to live up to expectations [of being a good mother].\u201dShe adds, \u201cI\u2019m really grateful for [the experience], because I know now what not to do.\u201d\u00a0Resources and helplines if you need supportIf you are, or someone you know is struggling, or just need someone to talk to, resources are available:\u00a0Care Corner Counselling: 1800 353 5800 (Mandarin)CHAT webCHAT ServiceFei Yue\u2019s Online Counselling ServiceInstitute of Mental Health\u2019s Mental Health Helpline: 6389-2222KK Women’s and Children’s Hospital’s Women\u2019s Mental Wellness Service: pnd@kkh.com.sgNational Care Hotline: 1800-202-6868Singapore Association for Mental Health: 1800-283-7019Samaritans of Singapore: 1800-221-4444\u00a0Silver Ribbon Singapore : 6385 3714TOUCHline: 1800 377 2252Join the conversations on TheHomeGround Asia’s\u00a0Facebook\u00a0and\u00a0Instagram, and get the latest updates via\u00a0Telegram."},{"@context":"https:\/\/schema.org\/","@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"name":"Destinations","item":"https:\/\/thehomeground.asia\/destinations\/#breadcrumbitem"},{"@type":"ListItem","position":2,"name":"Singapore","item":"https:\/\/thehomeground.asia\/destinations\/\/singapore\/#breadcrumbitem"},{"@type":"ListItem","position":3,"name":"A mother\u2019s journey of postnatal depression","item":"https:\/\/thehomeground.asia\/destinations\/singapore\/a-mothers-journey-of-postnatal-depression\/#breadcrumbitem"}]}]