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.

Photos: iStock

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