There’s no reason to hide postpartum depression if you think you’re suffering from it. Expats, in particular, are presented with a unique set of challenges that makes new motherhood even tougher. Expats and experts share their experiences and tips when dealing with such issues.
“I often swung between being moody, sad and numb, and forcing myself to ‘be happy’ for the sake of my relationship and new family,” reminisces Elisha Tomkiewicz, a stay-at-home mum from Canada, who had her first child in Sydney in 2012, and has since moved to Singapore.
Fellow Canadian expat Noor Damji says she found it hardest when she saw other new mothers at the mall in Singapore or on Facebook. “Everyone looked so happy and relaxed, which was the complete opposite of how I felt. ‘Why was this so hard for me?’” she remembers asking herself. “I really wanted to be happy and enjoy this time, but I could not snap out of it.”
While it’s not uncommon to feel “a bit tearful or anxious in the first week after giving birth,” says Dr. Kelly Loi, a gynaecologist, obstetrician and IVF specialist at the Health & Fertility Centre for Women, “these ‘baby blues’ do not usually last for more than two weeks.”
In contrast, women like Elisha and Noor may have been experiencing postpartum depression, a mood disorder that typically starts two weeks post-birth and often has an impact on the mother, her care of the baby and the family dynamic, says Dr. Loi.
According to SingHealth, PPD affects about 10 to 15 percent of women here after childbirth.
The symptoms experienced may vary, and typically include a persistent feeling of sadness, lack of enjoyment and loss of interest, lethargy and lack of energy, including trouble sleeping at night and feeling sleepy during the day, and problems with concentration and decision-making. It affects a new mom’s social and family life as well – difficulty bonding with your baby, social withdrawal, withdrawing from other people, and even having frightening thoughts such as hurting yourself or your baby.
Dr. Vanessa von Auer, a clinical psychologist with VA Psychology Center warns that expats can be more susceptible to PPD because of their circumstances. In particular, lack of social support, especially from family, which can cause feelings of loneliness, isolation and anxiety.
That was the case for Italian expat Sabrina Candeloro Zuber, who was diagnosed with PPD after giving birth to her first child in 1998. “I would have regular phone calls with my parents in Italy, and they tried to be close to me,” she says. “But how do you explain the reality of everyday life, the disturbing feelings you experience when you live so far away? Everyone tells you it will get better. But you do not see it at that moment.”
Not having people around who understood what she was going through also plagued Dutch expat Conny Jamieson, whose parents had passed and whose mother-in-law did not fly. “Other women had their mothers come out or hired maternity nurses,” she recalls. “They had spent months researching everything and had a huge list of things to do. I felt quite alone and alienated and was unable to relate to other mothers.”
Spousal support is key, too, but some women – whether expats or not – don’t have that. Elisha says candidly that PPD contributed to the breakdown of her marriage. “My then-husband simply did not take proactive steps to help me seek treatment. While I’m not blaming him, and must take responsibility for my own mental health, I believe I would be in a different place now if he did.”
In addition to this sense of isolation, battling the negative perceptions and misconceptions of PPD can prevent some women from speaking up or seeking treatment.
But those who’ve been through it, like Elisha, stress, “It won’t go away without treatment.”
She encourages, “If you suspect something is off, then reach out and speak to someone.” Her sentiment is echoed by experts like Dr. Vanessa. She says that getting help for PPD can come in many forms: seeing a therapist, getting medical advice from a psychiatrist or hiring a confinement nanny or domestic helper to take some of the load off.
“Research shows that PPD is most effectively treated through counselling,” says Dr. Vanessa, who adds: “Medication can bring the quickest relief, and choosing medication does not necessarily mean you need to give up breastfeeding, as there are a wide range of options that are safe to consume during this period.”
Dr. Loi suggests joining support groups and new mother networks like Mother & Child. Other support services include National University Hospital’s Women’s Emotional Health Service as well as KKH Women’s and Children’s Hospital’s Postnatal Depression Intervention Programme.
In addition to social and medical support, you should do what feels good for you. “This could mean joining a yoga or Zumba class or even trying acupuncture,” says Dr. Vanessa.
“It is essential that moms eat healthy, nutritious meals and try to get good quality sleep.” American expat Ashley Johnson, a part-time yoga teacher and full-time mother, says she relied on exercise to manage her PPD, as the resultant endorphins seemed to help.
“Self-care is vital to recovery,” she says, recommending, “Find time to do things just for yourself.”
Some mothers also seek out alternative therapies such as placenta tablets, created from the placenta material collected at birth. This method, which has roots in traditional Chinese medicine (TCM), is purported to give relief from PPD, although there is no clinical evidence to back it up.
If you’re interested in placenta tablets, inform your doula, midwife or nurse in advance so that she can store your placenta properly after birth. There are placenta encapsulation specialists like Four Trimesters and A Caring Mum that can pick up the stored placenta and deliver the capsules to your doorstep (from $300 for 50-100 capsules).
Holistic practitioners claim that fish oil that’s filled with Omega-3 fatty acids, can help with PPD, too.
Whatever method you choose, Dr. Vanessa says, “The most important thing is to acknowledge that something’s wrong and that there’s nothing wrong with acknowledging it.”
Expat Ashley agrees: “As soon as you start talking about it, you learn many women have experienced it to some degree. So, reach out and don’t keep it all inside.”
And both experts and women who have gone through PPD assure, there’s no need to fear having another baby. Says Conny, “I knew what I was getting into, and I had more confidence doing so.”
By Andrea McKenna Brankin, The Finder Kids (Vol. 20), September 2017
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