Prenatal Anxiety - 938NOW Radio Interview


9 ways parents encourage bratty behaviour in kids - Smart Parents

If junior is always throwing tantrums and being rude, are you guilty of parenting no-nos that make them behave badly?

 

PUBLISHED: MAY 28, 2018 BY REBECCA WONG LINK TO ARTICLE

 

One of its most challenging aspects of raising children for any parent is managing their behaviour and ensuring that they are well-disciplined.

 

And when our children behave badly, we may blame it on the child’s difficult personality, external circumstances (they had a bad day at school), or simply the fact, that junior is too young to tell right from wrong.

 

But if your child is constantly behaving like a brat, it might be time to examine your own actions.

As difficult as it is to acknowledge that what you do might be fuelling junior’s misbehaviour, it’s important to address the issue if you want to raise a well-mannered child.

 

“Parents need to understand how everything they do influences their children’s development, behaviour and actions,” explains Silvia Wetherell, psychotherapist at

The Choolani Clinic and a mother of two. “You can explain why they shouldn’t act in a certain way, but that’s not going to stick. You need to show them.”

 

But before you show them the right way to behave, start by identifying your own negative actions. Here are ways you may be inadvertently raising a brat.

 

1. Setting a bad example

Yes, it’s possible to be a bad role model without realising it. As the saying goes ― monkey see, monkey do.

“A classic example is how parents snatch their kids’ toys when playtime is over, thus teaching them how to snatch and be possessive,” Wetherell points out. “If you want your children to share, snatching is not a great way to go about it.”

“Consistency across all caregivers is the key to successful parenting. An inconsistent approach will only make children confused about rules and expectations.”

Another area where parents potentially set bad examples is phone usage, Wetherell stresses. Constantly bemoaning the fact that your kid is disengaged and addicted to his device? Take a look at your own phone habits, and you might understand why.

“We need to teach kids boundaries around technology usage, but that can’t happen if you’re always glued to your phone,” Wetherell says. “Limit your screen time if you want to raise an attentive child.”

 

2. Being inconsistent

“Consistency across all caregivers is the key to successful parenting,” notes Vyda S Chai, a clinical psychologist at Think Psychological Services. “An inconsistent approach will only make children confused about rules and expectations.”

Consistency ensures junior learns the right way to behave, no matter the environment.

You may expect your child to behave well in public, but if you let him throw tantrums at home, this will certainly be giving him mixed signals.

“If different adults are using conflicting approaches, this further confuses children and makes it hard to control challenging behaviours,” Chai adds. “Start early and discuss with all your child’s caregivers the appropriate disciplinary methods.”  

 

3. Making empty threats

Ever threatened junior with punishment and not followed up afterward? Time to stick to your word!

“Empty threats only encourage your child not to take you seriously, eventually ignoring you,” notes Chai. “Without consequences for misbehaviour, there’s no incentive to listen or behave.”

If you want to prevent your little ones from walking all over you, be sure to spell out exactly how they’ll be disciplined and follow your terms to the letter.  

Told them you’ll be removing TV privileges for a week? Be firm and don’t let them get away with turning it on after two days. Said you’ll confiscate their toys if they don’t apologise for hitting their sibling? Follow through no matter how sulky or sad they get. 

 

4. Hitting them

Whilst a smack or the cane might work in the short run, Wetherell has a cautionary word for parents who hit their offspring regularly.

“The way a parent handles anger has a huge impact on a child,” she observes. “When parents smack, this aggressive act shows children that it’s okay to do this when one’s frustrated.”

In fact, children who are frequently beaten are more likely to act out in aggressive waystowards others, and may eventually abuse their own offspring.

Wetherell points out, “All that hitting achieves is conditioning kids out of fear, rather than helping them learn intrinsically what is right and wrong.”

So, if you’re hoping to teach your children to be kind, show kindness to them while you set firm boundaries in ways that don’t involve physical punishment.  

 

5. Yelling and shouting

Like hitting, shouting may be a convenient solution for dealing with bad behaviour, but is extremely detrimental in the long run.

“Children learn through modelling ― if you’re constantly shouting at your child, he or she may assume that they need to yell back in order to get what they want or be heard,” Chai warns. “Eventually, your child may lose respect for you, and will yell in return every time you’re trying to teach him something new.”

Instead, be calm but firm, explaining to junior how and why his behaviour is unacceptable, Chai advises.

Lower your expectations, bearing in mind that your child’s brain is still in development. Accept that he will act up on various occasions and can’t always self-regulate the way grown-ups do.

 

6. Overreacting

Ignoring misbehavior may be a definite no-no, but so is harping on every single mistake your little one makes.

“As parents don’t wish to be perceived as bad caregivers, they are more likely to overreact when children misbehave in public,” Wetherell observes. “Hoping to project an image of being in control, parents tend to jump on slips-ups that are normal for toddlers ― like making loud noises, running around, and forgetting to say please and thank you.”

Lower your expectations, bearing in mind that your child’s brain is still in development. Accept that he will act up on various occasions and can’t always self-regulate the way grown-ups do.

“Being very reactive can also backfire,” Wetherell warns. “Giving negative behavior too much attention can ironically reinforce it. Your child learns that if he acts this way, he gets you to take notice.”

 

7. Laughing at misbehaviour

At the other end of the spectrum, some parents may find bad behaviour amusing, and respond by laughing or simply brushing it off.

“Don’t laugh at misbehaviour ― it is not funny and your child needs to understand that,” Chai stresses. “Laughing will only further encourage the behaviour.”

Once bad behavioural patterns are established, it will be difficult for your child to modify or change it, she cautions.

So, no matter how young or adorable your child is, be clear that you will never approve bad behavior from them.

 

8. Making excuses

Another way to trivialise bratty behavior is when you make excuses for your child.

Explaining that they’re “too young”, “too tired” or “too sick” to understand the right way to behave simply gives them licence to act out and not take responsibility for their actions.

Wetherell suggests that you figure out the most important values you want to pass on, and not compromising, no matter the circumstances.

 “For me, kindness is an essential value,” she states. “I’m more likely to pick it up on behaviour that is hurtful to others. For instance, if my 3-year old toddler hits me or says something unkind, I won’t hesitate to let him know how upset and sad it’s made me.”

 

9. Telling lies

If you want to raise honest children, be open and transparent with them.

Of course, this is sometimes easier said than done, especially with difficult subjects like marital conflicts or an illness in the family.

You don’t have to explain every single detail ― but bear in mind that your children are highly intelligent. They pick up on things easily, and leaving them in the dark may do more harm than good.

“You lie to your kids, they’re going to start lying eventually,” says Wetherell. “I'm a big fan of transparency in the family, and want a close family unit where my kids can come to me if they're having problems.”

 


Pregnant and depressed - Straits Times

The prenatal condition is less known than postnatal depression and expectant mothers are often unwilling or hesitant to express their negative feelings for fear of being judged

 

PUBLISHED: OCT 1, 2017 BY VENESSA LEE LINK TO ARTICLE

 

When people offered their congratulations to Ms Annabel Chow when she said she was pregnant, she felt "lousy".

 

She had suffered depression during her pregnancy - known as antenatal or prenatal depression - during which she experienced insomnia, anxiety and fatigue while carrying her first child more than nine years ago.

But she says it was also frustrating "when others kept telling me that I should be happy, that I was lucky to be having a child".

"It added to the guilt I felt that I was not happy," says Ms Chow, 40.

 

This incongruence between the reality of women's mental health and common beliefs about pregnancy and maternity is one reason prenatal depression is not easy to diagnose, says Dr Chan Herng Nieng, a senior consultant in the department of psychiatry at Singapore General Hospital.

There is also "an overlap of symptoms between depression and normal pregnancy, such as fatigue, loss of energy and changes in appetite and sleep", says Dr Chan.

 

Whether it is antenatal depression or postpartum depression, which is better known, there is a taboo against a mother expressing strong negative feelings amid a wider backdrop of stigma against mental illness in general, says Mrs Silvia Wetherell, a counsellor specialising in maternal mental health at a private obstetric clinic.

 

"The mothers feel ashamed and think, 'What's wrong with me, why am I feeling this way?' People around the woman often tend to dismiss such feelings as hormonal changes during pregnancy," says Mrs Wetherell, who also runs a support group for mums at Mother & Child, a prenatal and postnatal education centre.

 

Dr Cornelia Chee, director of the Women's Emotional Health Service at National University Hospital, estimates the prevalence of prenatal depression in Singapore at about 12 per cent, even though many women do not come forward to seek help.

 

SGH's Dr Chan says: "The focus during pregnancy is usually on the physical health of the mother and the foetus, rather than the mental health of the mother."

 

Ms Chow knew, however, that what she was experiencing went beyond the emotional and physical changes one may experience in pregnancy.

 

It felt like something had "snapped" in her mind, especially when she tossed and turned till 3am before waking near 6am to prepare to go to work. She even had suicidal thoughts.

 

She went to her doctor and took medication for her condition from the ninth week of her first pregnancy to the seventh month.

Now a stay-at-home mother, she is married to a doctor and they have three children, aged between six and nine.

 

Doctors stress the importance of seeking professional help for depression. Screening for antenatal and postnatal depression is offered for free to all mothers at National University Hospital and Singapore General Hospital.

Dr Chee says: "There is mounting evidence that women with untreated antenatal depression have poorer obstetric outcomes, such as having smaller or premature babies, as their moods affect the level of cortisol and other stress hormones that can cross over into foetal circulation.

 

"Depressed mothers are also more likely to have children who are diagnosed with anxiety and depressive disorders later on."

 

Risk factors for antenatal depression include an unwanted or complicated pregnancy, financial or marital difficulties, a lack of social support, substance abuse or a past history of depression, says Dr Chan.

 

Associate Professor Tan Lay Kok, senior consultant, department of obstetrics and gynaecology at Singapore General Hospital, adds: "Focusing on depression alone misses out on a greater problem. There has been increasing attention given to the growing importance of mental health and its role in maternal health.

 

"Mental health problems may have several multiple morbidities, as well as complex social factors, including possible substance abuse and domestic abuse."

 

Coping mechanisms that women might ordinarily use to deal with stress and anxiety may not apply in pregnancy, says Mrs Wetherell.

For instance, a pregnant woman may no longer wish to have a few drinks with friends, or she could be prescribed bed rest when she might usually have a jog.

 

Emma, a stay-at-home mother in her 30s, is an active person who cycles and walks a lot.

"I did yoga during my first pregnancy, which helped in terms of being able to relax. But it could go only so far," she says.

Now a mother of two children, aged two months and four years old, she says that even with exercise, she got no respite from her antenatal depression, which took the form of anxiety and obsessive-compulsive disorder.

"I got very anxious about germs. I was not able to press the traffic light button to cross the road. I didn't want to hold on to the bars while using public transport. I couldn't control it," says Emma, who did not want to be named in full.

 

She was prescribed anti-depressant medicine and got therapy.

She did not want to tell anyone except her husband what she was going through - not because she could be judged as a less-than-joyous pregnant woman, but more as a reaction against the intrusiveness that an expectant mother can be subjected to.

 

She wanted to keep private the full experience of having her first child.

"When you're pregnant, there are so many people trying to give you advice, tell you what to do or touch your belly," says Emma.

 

Part of the anxiety she felt while pregnant was a fear that her first child would be born with disabilities, but this feeling vanished during her second pregnancy after her first child was born healthy.

 

Postnatal depression is more widely known than antenatal depression, probably because of greater media exposure, experts say.

 

But the symptoms are similar. These include persistent low mood, excessive feelings of self-blame, tearfulness, irritability and a sense of worthlessness.

 

Ms Chow recognised the feelings that frightened her during her first pregnancy when they surfaced again after her third child was born.

 

She suffered postnatal depression when she was feeling overwhelmed caring for three children who were all under four years old then.

"There was no cut-off point, it just carries on," she says.

When her third child was two months old, she took medication for her depression again and she is still taking a low dose of this medication now.

 

She still feels uncomfortable with the term "mental illness".

 

"But you feel useful when you tell your story. You make the other mums feel better."

 


5 factors that'll increase your risk of postnatal depression

Almost 6 months after giving birth to her baby, Lindy Soh, 26, felt blindsided when she was told that she might have postnatal depression (PND). In fact, the young mum, who thought it was a bad case of the baby blues, decided to get a second opinion just to prove her doctor wrong.

“It was my baby’s paed who brought up the topic and I thought he was overreacting. Yes, I was struggling with being a new mum ― who wasn’t ― but that didn’t mean I was depressed,” recalls Soh.

However, after an hour-long sit-down with a counsellor, Soh was told the same thing ― she had a mild case of PND. “I was in shock because I thought only women who had a negative experience with motherhood or a bad pregnancy got post-partum depression,” adds Soh. “I had a drama-free pregnancy and birth and was very happy to have a baby. How did I end up getting postnatal depression?”

PND can hit anyone, at any time and it usually happens within the first year of childbirth. It’s very often confused with the baby blues, which is a more common and milder form of depression that usually disappears after the first few weeks of baby’s birth.

PND can begin slowly, with symptoms varying from person to person. The most common signs to look out for are: Mood swings; anxiety; crying for no reason; lack of energy; and losing interest in everything, including baby.  

Left untreated, PND won’t just interfere with a mum’s ability to care for and bond with her baby, but can also end with her taking her own life out of sheer hopelessness. Sadly, many mums who choose this path also take their babies with them in the process.

The good news is that we live in a time where mental health, especially maternal mental health, is getting more awareness. While no one know what exactly causes PND, there are certain factors that can increase a woman’s risk of falling victim to this disease. Here are five to keep in mind…

“A woman who has a loving mother helping her, looking after her needs…will feel very differently from a woman who has no family support or troublesome family members.”

#1 Bad pre-menstrual symptoms

Hormones definitely play a big factor in PND, notes counsellor Silvia Wetherell, who specialises in maternal mental health. You will experience a dramatic drop in oestrogen, progesterone and endorphins right after birth and this can trigger depression the same way premenstrual (PMS) changes produce mood swings. No single hormonal factor has been medically proven to distinguish those who develop PND and those who don’t. However, if you’re more sensitive to hormonal changes, you may be at higher risk. “So, if you are someone who has experienced a lot of hormonal fluctuations before becoming a mother, like really bad PMS, you’re more likely to suffer from PND that’s related to hormones later on,” points out Wetherell. By the way, hormonal sensitivity can also differ from woman to woman. Some will experience an almost immediate onset of depression which will crash down on them after childbirth, while others will feel their mood worsening as motherhood and childbirth recovery overwhelms them. Then, there are also womens who carry their untreated pregnancy depression into the post-partum phase.

#2 Experiencing stressful life events   

Environmental factors can also contribute to a woman’s state of mind, and they can manifest in a variety of scenarios. “A difficult pregnancy, difficulty in conceiving, taking a long time to have a baby, difficulties in the relationship ― like if the couple is arguing a lot and the marriage is unstable ― can all play a part in causing PND,” Wetherell states. In her line of work, Wetherell also counsels women who lack practical and emotional support, plus, those who get the wrong kind of support. “A woman who has a loving mother helping her, looking after her needs and guiding her with the baby will feel very differently from a woman who has no family support or troublesome family members,” says Wetherell. Drowning in debt or worrying about making ends meet with a new mouth to feed can also trigger maternal depression. So can experiencing the recent death of someone close, even if it’s the passing of a beloved family dog.

#3 Breastfeeding

Breastfeeding is a huge one and can often be the first trigger,” warns Wetherell. The message that Breast is Best and that the World Health Organization supports it makes every woman feel pressured to breastfeed. So, when a mum is unable to do so exclusively for medical reasons or simply because she doesn’t want to, she is made to feel like a failure when she bottle-feeds her little one. “Also, you are told that everyone can do it [breastfeed]and it’s very easy and it will be fine. But it’s not, it’s really difficult,” says Wetherell. “You’re trying to build confidence as a mum, but then you encounter so many problems with breastfeeding and a crying baby that you can’t console ― it’s a very high trigger for PND.”

#4 Childhood trauma from the past

During her sessions, Wetherell not only touches on the factors that are affecting her patient’s present mental state, but also what from their past could have contributed to it. “Often, we will explore their childhood, and sometimes, there will be early childhood trauma,” notes Wetherell. One common trauma that Wetherell often has to tackle is dealing with new mums whose own mothers had postnatal depression and never really recovered from that. “Women who didn’t receive attuned empathetic caregiving as babies because their mothers were not emotionally available, will struggle a lot more as mothers themselves,” explains Wetherell. “Especially since now this mum is expected to know how to be a good mother when she didn’t have that role model.” It’s a hard pill to swallow, but the good news is that PND has more awareness these days and women are stepping up to get the help they need. This means they don’t end up passing on their baggage to the next generation and allowing history to repeat itself.

“Women who didn’t receive attuned empathetic caregiving as babies because their mothers were not emotionally available, will struggle a lot more as mothers themselves.”

#5 A history of mental disorders

In 2016, a study done by the University of Newcastle and Hunter Medical Research Institute, revealed that women with a history of mental health problems are overwhelmingly more likely to suffer PND than women who didn’t. The findings reinforce the need for early intervention for mental health problems in adolescence and young adults. “This would result in more positive maternal and infant outcomes while helping to tackle the cycle of poor mental health across the lifespan,” notes Dr Catherine Chojenta in the study that she spearheaded.

Between 15 and 20 percent of women who give birth will suffer from PND. While new mums make up the majority of these numbers, a woman’s chance of suffering recurring PND is also quite high. “First-time mothers tend to have the hardest time ever, but if a mother has had PND and goes on to have more children, she is more likely to get it again with every pregnancy,” Wetherell explains. However, there are always exceptions, she adds. She has treated women who two problem-free pregnancies, but struggle with depression with their third child. The reason behind this is still unclear as it could be a combination of factors, such as hormones or something more physiological. “There’s no guarantee and no one is immune. It can strike any woman, from any socio-economic status and country. But the good thing is that we are better at screening for it now,” Wetherell adds.  


6 postnatal depression “facts” you should ignore

When you give birth, you don’t just bring a new life into the world, you’re also opening a floodgate of feelings. First, there is pure love, joy and excitement as you meet your new baby. Next to kick in is the sheer exhaustion from being in labour for that many hours. To top it all, there’s also some anxiety about the unknown now that baby is here. 

This cocktail of emotions, coupled with the post-partum bodily injuries you’re recovering from can easily trigger another kind of emotion as well ― postnatal depression (PND).

While not much is known on how and why some women suffer from PND, one thing is certain ― as many as 20 per cent of mothers are at risk of this particular type of depression.

If undetected, PND can result in mothers who never fully bond with their children or who allow their unresolved feelings to affect their daily life and relationships with others. PND is also a very lonely and isolating experience for a woman, which can cause her to literally lose her grip and take her own life, or worse, her baby’s.

PND is real, but the facts that surround it are not always straightforward. To create a culture of acceptance, we first need to separate fact from fiction. This way, we’ll know exactly how how to help someone who is dealing with this disorder.

Here’s how to respond the next time you hear one of these misconceptions about PND.

This is why it’s [PND] often called the smiling depression, because you simply plaster a positive look on your face and get on with your mummy duties.

Myth #1 : PND looks like normal depression

Very often, PND does look like normal depression ― the signs and symptoms are similar as well. These include feeling low and numb, crying constantly, not finding pleasure in things you used to enjoy and feeling disconnected from the baby.

However, there are specific differences between normal depression and PND. The biggest is that a woman with PND often looks like she’s coping. This is why it’s often called the smiling depression, because you simply plaster a positive look on your face and get on with your mummy duties.

“You have a baby to breastfeed, you have to take care of baby’s needs and be active. So, it doesn’t look like a normal depression where you have this idea of a woman crying under the covers and not going to work,” explains counsellor Silvia Wetherell, who specialises in maternal mental health. “On the outside, a new mother with PND may look like she’s fine and she’s coping and this is why it makes it harder to diagnose as well.”

Myth #2 : If you ignore PND, it will go away

“This is the biggest myth!” Wetherell exclaims. “And people around you will rather blame it on the hormones and feeling tired.” When a woman’s feelings get discounted, it doesn’t make her problems go away ― it only exacerbates it.

What makes it even worse, according to Wetherell, is how other women around this PND-plagued mum ignore her feelings with their own “survival stories.” “This woman’s mum, her mother-in-law or aunt may say things like, ‘Oh I got through it with 5 kids, so you will get through it. You need to be stronger and suffer through it’.”

While it comes off as well-meaning tough love, Wetherell points out that these women are dealing with their own unresolved feelings regarding motherhood and how difficult it was for them. So, instead of being a listening ear or a shoulder to cry on, they think the best way to help is to perpetuate an “I survived and so should you, it’s just the way it is” attitude.  

“It’s good to see things are changing slowly in Singapore, but unfortunately, there isn’t much space for acceptance or family support when it comes to postpartum depression, notes Wetherell. “For a woman to want to get help in itself takes courage, so when she has to deal with all this, it makes things even worse.”

Myth #3: PND is a sign of weakness

The sad truth is that most people consider mental health as a “mind over matter” situation. In other words, all you have to do is toughen up and you will get through depression. This means that if you don’t just that, you’re seen as weak.

Wetherell couldn’t disagree more about this popular way of thinking and shares a convincing analogy to counter this notion. “You wouldn’t say that to someone who’s broken their leg. That you just need to get up and be strong. Why are you complaining for? The thing about mental health is that you can’t see it, so you can’t take it seriously ― there’s no broken leg, so it’s not real,” she points out.

Myth #4: You only get PND in the early weeks after giving birth 

The mood swings and weepiness you feel in the initial weeks after childbirth is called the baby blues. It’s something almost every woman experiences as it’s due to hormonal changes, intense fatigue or trying to adjust to the changes that a baby brings.

For many women, these feelings pass. However, if they persist for more than two weeks, then it is more likely to be postnatal depression. “The difference between baby blues and PND is quite a continuum. It’s not like you have one or the other,” Wetherell explains.

PND often starts within the first two months after birth, but it can also start after several months. Sometimes, the symptoms may have also begun during pregnancy and if not picked up earlier, will continue after the baby is born. “You can have PND anytime up to the first year and even a bit after that, usually up to 18 months,” she notes.

“About 10 per cent of husbands get postnatal depression and they are more likely to suffer from it if their wives have it.”

Myth #5 PND is caused solely by hormones

“Hormones are more associated with the baby blues, but if it persists, then it’s more likely PND,” notes Wetherell. “So, while hormones play a big part, we shouldn’t just blame this  and think it will pass. Sometimes it doesn’t just pass. That’s when we need to dig a little deeper.”

There are so many factors at play here, but a big one could be the woman’s shift in identity. They can no longer do the things they used to during their pre-baby days and sometimes they can end up resenting bub for it and immediately feel guilty about doing so. This tug-of-war over their feelings contributes greatly to the depression they are already feeling.

“Also, since their lifestyle has changed, all the coping strategies the used when they were stressed in their pre-baby days, they probably can’t use it now,” points out Wetherell. Before you became a mum, you may have blown off steam by exercising, having a drink, or going to the movies with your girlfriends. But since your baby who has taken over your life and schedule, you can’t use several of these coping mechanisms anymore, which makes it even more challenging to deal with your depression.

Another contributing factor is your relationship with your body, which changes a lot during pregnancy. “How you look now changes your bodily perspective and how you see yourself as well,” points out Wetherell. “Women who have had issues with body image prior to having a baby tend to struggle as well.”

Sometimes your post-baby body ― which might encounter issues such as incontinence and prolapse ― could affect your sex life. Speaking of sex, getting jiggy might have been a stress reliever during your post-baby days, but it might not be an option anymore. “Sex may feel different now or you’re not in the mood anymore,” says Wetherell. Plus, you might not be getting any action even if you wanted to because your husband sleeps in a separate room when you’re with baby. You may no longer feel desired and it can feel lonely and isolating, which can call contribute to the decline of your mental health.

Myth #6 Men don’t get PND

“About 10 per cent of husbands get postnatal depression and they are more likely to suffer from it if their wives have it,” notes Wetherell. The reason for this is straightforward ― men can feel really useless around a new mum and baby. They don’t know what to do and even when they try, they don’t know how to help.

Since these dads are at work all day, they don’t have the same opportunity to bond with baby, nor do they know how to pacify them when they’re crying. Once they feel like they are failing at home, these dads start avoiding baby altogether. “They might start being on their gadgets a lot or working longer hours. All of a sudden, they have a lot more work drinks,” says Wetherell.

Some dads really do want to make things better ― but even when they do try to help, their idea of helping is trying to fix things or going into problem-solving mode, though this doesn’t always work. Other times, they snap and go into tough-love mode, which also doesn’t work.

So, what should they do? “Men need to be quiet, listen and give feedback to their wife on what do they think she’s feeling, not going straight into problem solving, not giving her tough love,” suggests Wetherell.

So, husbands should take the initiative with the baby and get involved. Look at how your wife handles the baby and mimic that to the best of your abilities. Support your wife practically and emotionally. Sometimes, this also means looking out for signs of PND and encouraging your wife to talk to someone about it.

6 ways to spot postnatal depression - SmartParents

The first few month following baby’s birth will be one of the most challenging times a new mother has to face. It makes sense why many people refer to it as the 100 days of darkness.

Your body is reeling from shock from a severe lack of sleep; you are petrified that you’re now solely responsible for a new life, plus, your hormones are going wild. And this is just the tip of the iceberg!

Babies are a handful, but they are also a blessing. Mums and dads are full of joy when they bring home their little bundles. This is usually followed by several parties to celebrate the newest addition to the family and visits from friends and families who want to take a peek at the new arrival.

During a time when you’re supposed to be bursting with pride, some women may feel the opposite. This is known as the baby blues and many mums go through it during the initial postpartum weeks. 

“Baby blues occurs because of the huge hormonal change that happens in your body after giving birth, which is a huge change,” points out counsellor Silvia Wetherell, who specialises in maternal mental health. “However, if those symptoms prolong for more than two weeks, then it’s probably postnatal depression.”

According to Singhealth, 10 to 15 per cent of women in Singapore get postnatal depression (PND) after childbirth. If it’s not detected early, PND can cause a woman to lose her sense of self, wrecking her marriage and even harm her baby. This was indeed the case back in November 2016, when a 29-year-old Singaporean mum fell to her death with her newborn from the 12th-story of her Bukit Panjang flat.

 

 “That’s why it’s [postnatal depression] sometimes called the smiling depression, because the mother looks like she’s coping well from the outside.”

Several factors contribute to a mother’s PND. To some extent, hormones play a part, but so do external factors such as breastfeeding struggles, existing problems in the marriage or lack of support. Very often, getting the wrong kind of support can also contribute to a woman’s mental health issues. This can be anything from having a hands-off husband or helicopter in-laws and parents.

Whatever the case, maternal mental health should be taken seriously as it’s not just a hormonal issue that will pass with time. Nor should a woman who has had the courage to talk about her depression be seen as weak and told to toughen up.

“You wouldn’t say that to someone who’s broken their leg. That they just need to get up and be strong and not complain about it,” says Wetherell. “The thing about mental health is that you can’t see it so you can’t take it seriously.”

Another reason why PND is hard to take seriously or even detect is that most mothers are so good at hiding it. One of the big differences between normal depression and PND is that a woman with the latter often looks like she’s coping.  

“That’s why it’s [postnatal depression] sometimes called the smiling depression, because the mother looks like she’s coping well from the outside, and she has to because she has a baby to take care of and she’s getting on with her duties,” explains Wetherell. “It won’t look like a normal depression where you have this idea of a woman crying under the covers and not going to work.”

PND can be tricky to diagnose, but it’s not impossible to do so. A mother who is battling depression internally will demonstrate some outward signs and symptoms that can be picked up by anyone who is keeping an eye out for it.

It’s important that you look out for these six of the most common symptoms ― because you could end up saving lives.

 

#1 Withdrawing contact  

Mothers with PND will have difficulty bonding with their baby. This is quite often the case even when a mum is able to meet her newborn’s physical needs, such as feeding himchanging his diapers and putting him to bed.

“Look out for someone who doesn’t show interest in her baby and keeps passing the baby to someone else. Or they get busy with other things and avoid spending time with the baby,” says Wetherell. “They often do it because they have difficulty bonding and are feeling disconnected from the baby. Sometimes, it could also be because they are terrified of hurting the baby.”

Some mothers also withdraw contact with their friends and family because they don’t want others to see how much they are struggling with motherhood. Other times, a mother is forced to stay home alone with bub during the first few months, which can contribute to her PND as well.

“I’ve had women who come to my support group who never left the house for three or four months. Their first outing would have been to come to the support group and they would sit there and sob and sob and sob,” adds Wetherell.

 

#2 Unresponsive

A mother who is feeling inadequate and emotionally overwhelmed can sometimes just “check out” mentally, which leads to numbness. While the mum may physically go about her daily babycaring duties, she is not really present, mentally or emotionally, for her peewee. “She feels like it’s all too much and she can’t take it anymore,” says Wetherell. “This is not the best thing, especially when you have a newborn and you have to be very present.” The downside of this is that the mum will be unable to meet her little one’s emotional needs, such as cuddling bubba and cooing over him, which is important if you want to raise an emotionally stable child.

 

#3 Frequent crying

As mentioned earlier, the first few weeks after baby arrives are the hardest. So, if a woman is feeling tearful it could be because of exhaustion and feeling overwhelmed. It doesn’t automatically mean she is experiencing PND though. “If she’s crying for just a few days and it goes away on its own, then it’s probably hormonal. But if it persists for more than two weeks, then it could be postnatal depression and they should seek treatment,” advises Wetherell.

With postnatal anxiety, mums experience lots of intrusive thoughts about something bad happening to their baby. They also worry about something happening to themselves or their husbands.

 #4 Anger and negativity

Some women may be good at hiding their emotions, but their depression can be detected from the things they say. “I see a lot of very angry mums, they may just be overwhelmed but it comes out as anger and frustration,” notes Wetherell. Look out for a mum who is continuously saying negative things about baby or motherhood. She can also look quite angry at the baby or whatever that’s happening around her. It’s also not usual for her to yell at her newborn.

#5 Anxiety

Of the 25 to 30 patients a week Wetherell sees, some 80 per cent have PND while the remaining 20 percent are struggling with pregnancy, fertility or a pregnancy loss. “Within that 80 per cent, I think I see more postnatal anxiety than I do depression. For some women, quite a few, they have both,” adds the counsellor. With postnatal anxiety, mums experience lots of intrusive thoughts about something bad happening to their baby. They also worry about something happening to themselves or their husbands. “This could lead them to check on baby 10 times a night to make sure he’s really alive and this anxiety can trickle into everything they do,” adds Wetherell.

#6 Scary thoughts

The most severe form of PND is postpartum psychosis (PPP), where the woman breaks away from reality. “They hear things, they see things, they complain that their baby is evil or there’s something seriously wrong with baby and that they are doing the baby a favour by killing it,” explains Wetherell. Interestingly enough PPP is also the most treatable form of depression, since the mum is instantly put on medication and sedatives. which will make he feel better at once.

In its not so severe form, PND can also make a mum feel that committing suicide might be the easiest way out. This is because she is suffering so much, yet keeping it all inside ― so, she might feel that things will never get better and it makes more sense to just end it all. She may not talk about it often though, but during the rare times that she does broach the topic of suicide, it’s important that those around her take what she says seriously instead of labelling her as a drama queen. It could end up saving her life and that of her baby’s.


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Why new mums struggle at work: A guide to surviving the huge shift - Asian Parent

 

BY Nasreen Majid, May 2017 Read Full Article here

 

Back to work after maternity leave? Are you struggling? On the verge of breaking down? Read on to find out the reasons returning to work after having a baby is just so tough, and what you can do to make things a little easier.

 

Four months of maternity leave have gone by in the blink of an eye. The time has come. You are returning to work after having a baby. 

 

You look through that long-abandoned section of your wardrobe – crisp work shirts, silk blouses, high-waisted pencil skirts. There is a tinge of excitement growing within you at the thought of getting out of the sweatpants and messy bun that have plagued your appearance for the most part of the last few months.

 

Then your thoughts are interrupted by the sound of your baby crying. Reality hits and it hits hard. You stare at your ashen-faced reflection in the mirror. It dawns on you that when tomorrow comes, you will be away from your baby for most of the day.

 

An unexpected wave of guilt sweeps over you. As your baby’s cries get louder, you start to realise that perhaps returning to work after having a baby is harder than you expected. Panic starts to engulf you.

 

Sounds familiar?

 

Returning to work after having a baby is no walk in the park. Many mothers struggle to adapt to the drastic change in their lives. Some even find themselves gravitating towards postnatal anxiety or depression.

In order to help mums to deal with this situation, we spoke to Silvia Wetherell, lead counsellor, The Choolani Clinic, Mount Elizabeth Novena Medical Centre. She provides a detailed explanation of the challenges of returning to work after having a baby and offers some solutions to facilitate the transition.

Why is the transition so hard? 

 

1. Emotionally difficult transition

 

Jumping right on board after four months of being a full time mum is a huge transformation. Especially if you are a first time mum, you have just spent four months trying to be a mum.

In this short span of time you had to learn how to hold, feed, clothe, bathe, clean and care for a baby. You stayed up all night soothing an inconsolable baby suffering from colic pain. Breastfeeding is something you are barely getting the hang of.

 

You had to deal with physical recovery from childbirth. Your body has undergone a tremendous amount of change during pregnancy. After giving birth, you stare at your reflection albeit not recognising yourself. You don’t look the same. You don’t feel the same. Half your clothes don’t fit.

Then suddenly you’re expected to return to work and get right back into the swing of things. You have just set foot into your office and you are already drowning in a sea of meetings, emails and new projects. It’s like going from 0 to 100.

 

You are barely holding it together and the expectations are for things to be the same as they were before you had a baby. The same working hours, deadlines and stress levels. Many women feel overwhelmed and struggle to cope. Consequently, they start feeling useless. 

These are unrealistically high expectations of a woman says Silvia. 

 

Solution: 

 

A possible way to ease the transition would be to give new mums an adjustment period. Silvia advises employers to have realistic expectations of mums and to start them off with no more than 20% of their actual workload. Give them a few weeks to fully get back on track. 

If such arrangements are not in place for you, do not hesitate to request for them. It is best to speak to your bosses prior to going on maternity leave. Informing them of your plans way ahead of time makes it easier for them to make contingency plans. 

These days, many companies and organisations are pro-family. Do not assume that trying to request for some flexible arrangements would immediately translate to negative appraisals.

Remember mums, going on maternity leave is something you do not have to feel bad about. So do return to work with a positive mindset and pick it up from where you left. 

 

2.Hormones – Baby Brain

 

Returning to work after having a baby is exceptionally difficult due to the hormonal changes after pregnancy. Ever heard of ‘Baby Brain’?

 

You mentally prepare a long grocery list only to stare blankly at the shelves in the supermarket. You search the entire house for your sunglasses only to find them perched on your head. You just can’t seem to remember what you have on this weekend.

 

You burst into tears while watching television. Then you realise that everyone else watching the same show looks at you strangely. It wasn’t that moving a scene was it? 

 

Does this ring a bell? It’s called baby brain. Simply put, baby brain is shrinkage of the grey matter in your brain caused by a huge flood of hormones that affected your brain during pregnancy.

While some areas of your brain shrink, there is significant growth in areas of your brain relating to your baby. You find yourself more forgetful and overly sensitive. This is nature’s way of taking your focus away from logical tasks and preparing you to bond with your baby.

Silvia stresses that in order for you to shift from this huge maternal preoccupation to work mode, your brain needs time. Again, it is of cardinal importance to be realistic.  

 

Solution:

 

Write more to-do lists and reminders, diligently fill in your planners, set phone reminders. Do what you must. But remember, the idea is not to find yourself struggling to keep your head above water.

You may wish to talk to some of your colleagues about your struggles. Consider confiding in a few close friends or the person you directly report to.

Again, this is not for sympathy, or an excuse to get away with work. It is just a humble request for people around you to be a little bit patient, and a little more forgiving if you initially have trouble getting back into business.

 

3.Breastfeeding 

 

Breastfeeding was hard enough when you had your baby camping at your breasts all day. Now that you are returning to work after having a baby, you need to express milk.

 

It’s a hectic day. One meeting after another. You missed a pumping session and your breasts are engorged. You feel uncomfortable. Your breasts hurt. You are leaking milk and staining your clothes.

It’s an exceptionally busy day. 15 minutes are all you have to get lunch out of the way. 15 minutes are also all that you have to pump. Pumping while eating sounds like the only solution. But where?

 

Exactly. Where? Some mums are blessed with a nursing room or a conducive pumping environment with adequate privacy. For mums who work in a tiny, cramped office, options aren’t aplenty. Sad to say, until today, some Singaporean working mums are expressing milk in the toilet. 

 

Do we even need to start on supply issues? 

 

And the feeling of being judged. This judgment is sometimes real but often, it is simply your perception, says Silvia. The anxiety within you is acting up. You fear that people think you are slacking off work by taking time to pump. You read too much into the facial expressions of everyone around you. 

 

Please mums, do not impose such undue stress on yourselves! You are doing what you got to do. Expressing milk does not mean you are skiving.

 

Solution: 

 

Think a little less of those around you. Close your eyes and think of your baby’s face. Remind yourself that this is a necessary pocket of time that you need to set aside in order to nourish your baby. It is important that you take stress out of the equation or you might find yourself struggling to get a let-down. 

 

Communication is key once again. Let those who are working with you know that you will need to express milk every three hours or so. If someone doesn’t look too happy then remind yourself that you cannot possibly please everyone. 

If your job requires you to constantly be on your feet, you need to carefully plan how you are going to slot in your pumping sessions.

 

Your company has an event and you are going to be out of your office the entire day. What do you do? Plan ahead. Call up the location and find out if they have a nursing room or place for you to pump or store your milk. Bring your cooler bag. Think of how you will clean your pumping equipment. 

 

In a worst case scenario, you might have to pump and dump your milk. It’s tough. Undeniably. But mums have a fighting spirit that is unparalleled. I promise you that you will find a way around it if you try hard enough. 

 

4.Juggling work and home 

 

After a hard day of work you return home. You spend the entire drive home mentally going through the dinner menu. You visualise your refrigerator and try very hard to remember if that half a packet of cherry tomatoes is still there.

When you get home you rush to prepare dinner. You take thrice the usual time because you need to attend to a crying baby in between. Or worse, your crying baby and toddler. Then there’s the infamous Mt. Everest pile of laundry eagerly awaiting your attention.

 

Work in the office, chores at home, doesn’t quite end does it?

 

Silvia highlights that even in this modern society, where we speak of equality, the main responsibility of domestic affairs still falls on women. Juggling work and home is incredibly exhausting.

There is also the guilt that women are struggling with. While at work, they are weighed down by the guilt of leaving their baby. When they return home, instead of focussing on the baby they start feeling guilty about work. Silvia sheds light on how many women find themselves trapped in this vicious cycle. 

 

Solution: 

 

Support, support and more support. I cannot emphasise enough just how important support is for a mum who is returning to work after having a baby. 

Husbands need to play an active role. So daddies, please remember to change your fair share of diapers. Consider taking turns for night feeds as well. 

 

The rest of the family should also come together to assist. Ask for help mums, and free some time up. You don’t want household chores taking away whatever little time you have left with your baby. 

Don’t forget you need time just for you. That bubble bath, your favourite Netflix series, a face mask, whatever it is. You need me-time. 

 

5.Separation Anxiety 

 

For the most part of your maternity leave, you were by your baby’s side. You were the primary caregiver. Returning to work after having a baby means being separated for a good eight to twelve hours a day.

Silvia explains that it is the mums who are most likely to face separation anxiety rather than the baby. Additionally, mums may find themselves constantly worrying about the care of the baby.

 

Solution: 

 

You need a plan in place to work towards being away from your baby, advises Silvia. The change from being with your baby all day to working full-time is extreme. The transition has to be gradual to make things easy for yourself and your baby.

 

During your maternity leave itself, take some time away from home. This will help both you and baby prepare for when you return to work. The bonus is that you have some space for yourself!

 

Start planning out the arrangements early. Decide on who is going to look after your baby when you return to work. Let them start getting accustomed to handling the baby.

This will help you to trust the person and have less to worry about when you return to work. It will ease the transition. 

 

6.Intrusive family members

 

Many Singaporean mums struggle to deal with their parents, in-laws or family members constantly telling them what they should or should not feel. When returning to work after having a baby, the last thing a mum needs is for people belittling her struggles and imposing their views on her.

 

A mum also does not need to hear that it is a terrible idea for her to work, or that money is not more important than being with her child. Such things can be extremely undermining for a new mum who is already dealing with a myriad of challenges. 

 

Silvia emphasises that mums need the right kind of support. Practical support to run things and look after the baby isn’t enough. Mums need emotional support Mums need someone to confide in. They need to be heard without judgement. 

 

Solution:

 

Silvia foregrounds the importance of standing up for yourself when the need arises. Remove yourself from an environment that causes you to second guess yourself due to too much criticism. Mums need to be surrounded by people who are encouraging and supportive, not overly critical. 

 

One of the best support systems a new mum can have is to be with other mums. Silvia advises new mums to join What’s app groups, Facebook groups or whatever support groups that work. 

 

Sometimes when you are at work and you find that you are close to breaking down, just being able to rant away on What’s App to fellow mums who can empathise makes all the difference. Even if they cannot fix your problems, just being there for you goes a long way. 

 

Senior assistant executive Serena Lim shares her struggles of returning to work after having a baby. Among other things, she felt lethargic and exhausted due to breastfeeding.  Expressing milk was a challenge as she did not have a proper place to do so. Serena’s teammates were neither understanding nor supportive.

Eventually she suffered from mastitis in her left breast. She could only feed her baby from one breast and struggled to meet her baby’s demand. 

 

Serena’s husband was away and she was mostly living alone with her mother-in-law. Things got so bad that she felt like throwing her baby away. “I remember kneeling on the floor with my baby crying in my arms when no one was home. I wailed and screamed in frustration.” 

 

Over time, Serena found solace in prayer and by reading up more about the issues she faced. She moved in with her mum and gained support from Facebook support groups. Some members of the support group even paid her a home visit to help her cope. 

 

Serena has come a long way and is now a happy mum to a thriving four year old. She has since made a career switch, and is finding purpose and meaning in her new job which involves working with children. 

So mums, always listen to your needs and do what you think is best for you and your child. We hope that this article has helped you to understand the challenges of returning to work after having a baby, and how you can overcome them.

 

You need to be a happy and healthy mum to raise a happy and healthy child. Always look after yourself and never ever hesitate to seek help! 

 

Do keep a lookout for our upcoming article on red flags for working mums slipping into depression and the types of treatment and help that is available for them.


Online pressure: When social media pushes new mothers close to the edge - Interview for Channel News Asia on PPD and social media

BY Jalelah Abu Baker, May 2017 View full article here.

 

Everything Ms Malini Pravin Saivi read on social media painted a rosy picture of the pure, unconditional love a mother has for her newborn. So when she gave birth three years ago to a baby girl, she waited for that feeling.

It did not come.

“I’ve seen mothers posting (on Facebook) an hour after giving birth about how all the pain was worth it, with photos of them looking lovingly at their baby. But I didn’t feel that that the pain was worth it,” said the 33-year-old Singaporean, who is currently living in Chennai, India.

What she read online made her feel like a bad mother, but she was too embarrassed to share those feelings with anyone, she told Channel NewsAsia.

 

“New mothers usually share so much of their joy online and they don’t share the downsides. Everyone wants to post a pretty picture,” she said, adding that she believed she would have been subjected to online abuse if she had shared her emotions about not feeling love for her baby.

 

The lack of emotional connection with her new daughter, coupled with pain from lacerations from delivery and an oversupply of milk that led to engorgement, resulted in Ms Malini starting to feel extremely low. A death in her family the day she delivered also took a toll on her.

She started to imagine hurting her daughter, and the thoughts became more violent.

 

However, she did not succumb to them, and things took a turn for the better when she had a routine check-up at the six-week mark at KK Women’s and Children’s Hospital. She opened up about her feelings, and was referred to a psychologist, who in turn referred her to a psychiatrist who diagnosed her with post-natal depression. With the right medicines, and support from her family, Ms Malini was able to recover, she said.

While social media shaped an idealistic image of what kind of a mother she should be, she also found comfort in other groups on Facebook where she could ask questions and immediately receive a flood of answers from concerned fellow mothers.

 

Psychologists and counsellors said that while social media and online support groups may be a source of help for new mothers, they can often also make mothers insecure about themselves.

 

SOCIAL MEDIA LEADS TO COMPARISON: EXPERTS

 

Counsellor Silvia Wetherell, who specialises in maternal mental health, said that one of the biggest perils of social media for new mothers is comparison. “They are comparing themselves at their worst to a filtered snapshot of a person at their best, when they feel like sharing,” she said.

Photos of mothers who look like they have it all together can make those who are already struggling feel inadequate, giving them a sense of isolation and that they are the only ones not coping, she said. In reality, these well-adjusted mothers may just be very good at hiding their emotions, she said.

 

And the Internet can provide other unrealistic comparison points for emotionally vulnerable mums.

“Now, they don’t only compare themselves to their peers, but to celebrities, who are in bikinis a week after giving birth, going on dates, making it look like motherhood is not a big deal,” she said. They feel like they are failures, and terrible mothers, she added.

 

Ms Wetherell, who every week sees around 20 mothers going through postnatal depression or anxiety, said that pressure to breastfeed is a “huge” contributing factor. “Research shows breastfeeding is very good for the baby, and there is a lot of pressure to breastfeed. Sometimes when it doesn’t work despite the mother's best efforts, it can trigger postnatal depression.”

 

She added that when there is anxiety and pain surrounding breastfeeding attempts, it could hinder a mother’s attachment to her baby.

 

One mother, a 30-year-old civil servant who did not want to be named, knows the pitfalls of using social media all too well. The worst thing for her, she said, was the pressure to breastfeed. She was in several groups with others who gave birth at around the same time as her, and she would see photos of the amount of milk they were able to express.

“I didn’t have as much supply, so I would think: ‘Am I an incompetent mother who is not feeding her child enough?‘” she said. These led to feelings of insecurity, and combined with a lack of sleep, leaving her job and her loss of independence, she would cry for hours at a time.

 

In these support groups, some would also post photos of their text exchanges with their husbands showing how appreciative they were of the new mother breastfeeding. Up alone at night while feeding her baby, she would feel frustrated that her husband would be sound asleep beside her. She also found herself drawn to pictures of attractive mothers on Instagram, loathing herself for being a “blob of fat” months after giving birth.

It was also social media and support sites that led her to create an “idealistic” birth plan which did not go well when it came to the actual delivery.

 

She did not want to take any pain-relief drugs and she wanted delayed cord clamping, which she had read was good for the baby. But these did not happen, and she felt despair at her perceived inability to live up to the ideal birthing and motherhood experience that she had seen online.

Six months after giving birth, she sought counselling help from a family service centre near her, in order to make sense of her constant anger against everyone, and it helped her.

 

DIGITAL DETOX

 

However, postnatal depression, if unchecked, can lead to suicide - as it did in the case of 29-year-old Koh Suan Ping, who jumped to her death from a block of flats in Bukit Panjang with her two-month-old daughter in her arms.

Five days before, she had searched online for “what to do when there is no way out”. Her husband and colleagues said she was upset she could not produce enough breast milk to feed her daughter, stressed at having to find a replacement domestic helper, and concerned that her company, where she was a sales manager, was not doing well.

 

While seeking help, whether online or in person, is encouraged, centre manager of Care Counselling Centre Jonathan Siew said that even positive, empowering information may have a negative effect on mothers who are already struggling. 

"At the centre, we usually have mothers coming in a year or two after giving birth, finally deciding to seek help. Social media is a new thing mothers grapple with and it has a great impact on mental wellbeing," he said.

 

Ms Wetherell agreed, saying that mothers may have too much information, some of which could be conflicting. “Instead of trying to get to know their baby, they are trying to get information online on the average child, she said.

She added that she has had her clients go through a digital detox, with access to their social media accounts only on a computer, instead of on their mobile phones, and her clients found that they felt much better after they did that. 

 

"Social media can help, but mothers should set boundaries. For example, 20 minutes in the morning, 20 minutes in the afternoon, and 20 minutes at night. One of the things I teach is to be present and mindful, because social media is distracting," she said. 

 

While the 30-year-old mother that Channel NewsAsia spoke to does not have such boundaries, she recognised that the unrealistic standards social media set for her were not helping her. She did a "wipe-out" of her social contacts on both Facebook and Instagram. 

 

"I deleted toxic friends, and unfollowed the hot mums on Instagram. Even when I see mums flaunting photos online now, I take them with a pinch of salt," she said.


Family members are key to supporting new mums - Interview by TODAY newspaper on Postnatal depression

BY FARIS MOKHTAR, May 2017  

View full article here

 

"Mistaking what they are feeling for a bout of the baby blues, shame at their parental ability, and stigma are the common reasons for mothers with postnatal depression to suffer in silence, experts said.

So, people around women who have just given birth — for the first time, especially — have important roles to play, to provide support or spot red flags, experts added.

Postnatal depression is estimated to affect 6 to 8 per cent of women here, but going by anecdotal evidence, only a fraction of these women seek help. 

 

Taking the 33,000 births last year, for instance, about 1,800 women, conservatively speaking, would have suffered from postnatal depression. The Women’s Mental Wellness Service at KK Women’s and

Children’s Hospital, however, saw just about 80 new cases.

Dr Chua Tze-Ern, a consultant from the centre, said the low rate of those seeking help is partially because most people, including new mothers, assume that the emotional duress experienced post-delivery is due to hormonal changes alone. 

 

Since they do not recognise the symptoms of postnatal depression — low mood and lack of positive emotions persisting beyond two weeks, affecting one’s ability to function, among others — they might not seek professional help, she said.

 

Feeling ashamed of getting help is another significant barrier, said Ms Jolene Tan, who is the head of advocacy and research at the Association of Women for Action and Research. The mistaken thinking that parenting comes instinctively is not uncommon, but motherhood is actually a steep learning curve involving great physical and mental stress, she noted.

 

“The idea that mothers should naturally know what to do, or that caring for a newborn is always joyful, can magnify a feeling of failure when new mothers face ordinary challenges and frustrations,” Ms Tan added.

Some mothers also fear that by seeking professional help, they may be seen as unfit to care for their child.

Ms Silvia Wetherell, a counsellor at The Choolani Clinic at Mount Elizabeth Novena Hospital, added that “there is simply lack of understanding on the part of families and friends”.

About 80 per cent of her patients are expatriates, but she has seen a 10 per cent increase in the number of local patients in the last six months.

 

“Mental illness is like a broken leg. It’s not obvious, but you need to treat it. If it’s a broken leg, everyone will be saying that you need to see a doctor,” said Ms Silvia.

Experts said that people around new mothers should be careful about not flippantly dismissing cries for help as simply exhaustion or a natural state of affairs for inexperienced mothers.

They noted that, if not managed properly, postnatal depression not only affects mother and child developing a close and nurturing relationship, but also leaves husbands stressed out, and eventually, affecting marriages. 

“Depression does not just affect one person at one point in time, it impacts the family, potentially on a long-term basis,” said Dr Chua.

 

While more support could be given to new parents, such as more leave days and flexible work arrangements, family members remain the key sources of support for new mothers, said experts. 

It could be as simple as providing a listening ear, and communicating with new mothers to help them emotionally. Or helping out with household chores and caring for the child so the mother gets a break, they said."

 


Stigma, lack of awareness among reasons women don’t seek help for baby blues - Interviewed as an expert by TODAY newspaper on PPD

 BY FARIS MOKHTAR

 

View full article here

 

She was feeding her one-month-old baby girl when Susanna Nickalls had a mental image of her cutting herself and harming her child. She was feeling annoyed because her husband had overslept and missed his turn to feed their daughter.

“I felt let down. My thought process was: ‘If anything happens to me or my baby, my husband would be sorry’,” recalled the 36-year-old, of that day in April 2013.

 

After shouting at her husband and crying for an hour, Ms Nickalls confided in a good friend about her emotional distress. Persuaded to seek help at the National University Hospital’s Women’s Emotional Health Service, she was diagnosed with mild postnatal depression.

It was then that Ms Nickalls realised she had also suffered from postnatal depression for a few months after giving birth to her son two years earlier.

At that time, she was also easily annoyed, such as when she could not find her shoes and it felt like it was “the worst thing in the world”. She blamed her mood swings on a number of things, unaware that it was postnatal depression.

 

“I thought it was because of the sleep deprivation and I thought I was failing as a mother,” said Ms Nickalls, a Briton who has been living here for eight years. “I didn’t think that uncontrollable crying was part of postnatal depression. I thought it’s just hormonal.”

Ms Nickalls’ lack of understanding of postnatal depression is not uncommon here. Experts told TODAY many women do not recognise the symptoms, and even those who do resist seeking help out of fear of how others would view them.

 

Around 6 to 8 per cent of mothers suffer from postnatal depression — this translates to at least nearly 2,000 women, using last year’s figure of 33,000 births. 

But since 2008, the Women’s Mental Wellness Service at KK Women’s and Children’s Hospital has seen only about 700 new cases of postpartum depression. The peak was in 2012, when there were almost 100 new cases. Since then, it has averaged at around 83 cases.

 

The low awareness of postnatal depression was highlighted as an issue to tackle in a coroner’s inquiry last week into the case of Koh Suan Ping, 29, and her two-month-old daughter, Jaelyn Ng, who were found dead at the foot of their Fajar Road block in November last year. 

In ruling that Koh took her own life in the fall from height with her baby because she was in postnatal depression, State Coroner Marvin Bay said it was important that new mothers — and those around them — know about the condition and how to find help.

 

Housewife Amanda (not her real name), 28, who was diagnosed with the condition several months after her second son was born in December 2015, agreed that more people need to learn about the stress of motherhood and postnatal depression.

Between caring for her six-year-old firstborn and household chores, she was tied up with her newborn, leaving her exhausted and agitated at the end of days that typically lasted 17 hours.

“I would cry with my baby and ask, ‘What do you want?’” she said.

 

Amanda took her frustration out on her husband and they quarrelled nearly every week.

“When I got into a heated argument with my husband, I think of ending my life because it’s so tiring,” she said. “But I kept thinking of my kids, and I can’t just leave them behind. That held me back.”

Amanda said her mother was the one who sensed that something was amiss. “My mom said it might be good for me and my children if I get medical help, rather than wait for things to turn ugly,” she added.

Although she was afraid that she would be judged by others as being mentally ill, Amanda saw a psychiatrist but has kept it a secret from friends.

 

“I don’t want people to think that I’m not a good mother. And I don’t want my friends to keep their distance away from me, and say, ‘Is she going to go crazy or something?’” she said.

Sharing similar sentiments, Jamie (not her real name), a 31-year-old teacher who also slipped into depression after giving birth to her daughter last August, said the stigma weighs on mothers struggling with the condition.

 

“The fact that I am uncomfortable to give my name reflects this. I don’t want my parents or my in-laws to get comments from their friends about it,” she added.

Healthcare professionals, these women said, ought to educate parents-to-be on postnatal depression during prenatal check-ups, and share resources, such as information on the different help centres. But it still takes support and vigilance from loved ones after baby is born to ensure mothers who need professional help get it promptly, they added.

 

Ms Nickalls noted: “Mothers-to-be should not just plan about getting those cute socks, but plan for their mental health care as well.”


Interview for Motherhood Magazine, May 2017

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Full Interview with Low Lai Chow for Motherhood Magazine, May 2017
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Coping with child loss: Advice from the experts - Article for TODAY Newspaper on Pregnancy Loss

By ALISON JENNER, December 2016

 

The loss of a child, whatever stage it happens, is one of the most profoundly painful and inconsolable experiences for parents to deal with, experts TODAY spoke to said.

 

“It violates the natural order of things — as children are not supposed to die before their parents. It evokes rage at the injustice of it all — it is not fair for an innocent child to lose his potential and fail to see his dreams fulfilled,” said Ms Majella Irudayam, Principal Medical Social Worker and Chairperson, Bereavement Support Committee, KK Women’s And Children’s Hospital (KKH).

 

When it does happen, parents can sometimes try to rush through or even skip the important grieving process because they want to avoid those painful emotions. But it is important that the parent allows him or herself to grieve and reaches out for support from family and friends, said Ms Silvia Wetherell, Counsellor at The Choolani Clinic at Mount Elizabeth Novena Medical Centre.

Shock, confusion and feelings of extreme suffering and pain are all normal, and parents should not feel pressured to rush the healing process.

 

“It may take weeks or even months to come to terms with the pain of their loss ... Bereaved parents need to know that the pain of the loss will never disappear. With time, they will find ways to cope with the pain,” said Ms Irudayam.

 

Some parents, the experts said, have found that spiritual, religious or symbolic rituals can help with coming to terms with a loss. Writing can also be very therapeutic and parents are at times encouraged in counselling sessions to write a goodbye letter to the child, said Ms Wetherell.

 

They also recommend creating a memory box of their child with tangible items such as photographs, journals, handprints and footprints. This can provide comfort and healing as they act as meaningful reminders of their child’s existence and a physical go-to when they want to remember the life that was lost.

 

For friends and family of the bereaved parents, the experts advise allowing the parents to express their feelings and pain as much as and as often as they want to. Be careful, though, when trying to comfort the parent that you avoid making comments such as: “It is God’s will” or “At least you have another child”.

 

Finally, on difficult occasions such as birthdays, the death anniversary, Mother’s Day or Father’s Day, the experts said, giving the parent a telephone call, visit, or card would mean a great deal.

 

Parents who have suffered the loss of a child can seek support from among others, Child Bereavement Support Singapore at http://www.cbss.sg, Facebook group “Pregnancy and Infant Loss Support Group Singapore”, KKH’s Department of Psychological Medicine (Mental Wellness Service) and NUH’s Women’s Emotional Health Service. ALISON JENNER

 

Full Article here.

 

Video interview for Parent Town on pre and postnatal depression