Postnatal depression: its causes, symptoms and consequences, and how to overcome it

Lisa Wong (not her real name) should have been over the moon when she gave birth to her first child 10 years ago. Instead, the now-42-year-old was overcome with anxiety at the thought of being a mother and regretted even going through with the pregnancy.

“It should’ve been a joyous moment but it actually felt like the worst day of my life,” Wong shares. “I suddenly felt helpless and inadequate. Over the next few weeks I grew increasingly anxious and depressed. And that mother-child bond that new mums always talk about? I didn’t experience it. When my baby arrived, he felt like a stranger to me.”

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Wong, who describes herself as highly strung, assumed that the connection between her and her son would form in the weeks after he was born, but it didn’t – and that made her feel guilty and ashamed. She cried a lot, mostly in secret because she didn’t want her husband to know that she was falling apart emotionally. Physically, she felt “broken and run-down”.

“My husband and I were expats living in Hong Kong at the time,” says Wong, who is originally from Singapore and is now based in Jakarta. “He worked a lot so I was home with our son most of the time and felt like I had no support.

“At the same time, I didn’t want to worry my husband so I kept my feelings to myself. I didn’t tell my parents what I was going through, either, because I was afraid that they would think I was an unfit mother.”

Wong suffered from what’s commonly known as postnatal depression – a depression in women that occurs after childbirth. According to Dr Jackie Chan, a psychologist at Hong Kong Psychological Counselling Centre, it’s hard to say what causes the condition, although it’s believed that genetics plays a role.

In addition, doctors say, a woman may be at risk of developing postnatal depression if she has mood disorders; a history of alcohol or substance abuse; a history of depression; lacks family or social support; is experiencing grief as a result of the death of a family member or the end of a relationship; is fearful about giving birth; has difficulty adjusting to motherhood; or has problems with breastfeeding.

Typical symptoms of postnatal depression include low self-esteem, feelings of inadequacy and guilt, negative thoughts, feeling unable to cope, irritability, anxiety, low sex drive, difficulty sleeping, difficulty concentrating, and feeling that life is meaningless or hopeless. If the symptoms continue for at least two weeks, a woman is considered to have postnatal depression.

Chan says three to six per cent of new mothers experience such symptoms. “The symptoms usually last three to six months, although 25 per cent of mums may experience them for up to one year.”

And it’s not just the mother’s mental and emotional health that are affected; a recent University of Kent study revealed that postnatal depression has a lifelong impact on mother-child relations, too. The research, published in PeerJ in February 2018, found that women who had postnatal depression reported a poorer-quality relationship with their children, lasting into their adult life, and that the worse their condition had been, the worse the quality of their later relationship was.

However, Chan says the study doesn’t tell the whole story. “I don’t disagree that postnatal depression may affect a woman’s relationship with her child after the child has grown, but I don’t think it’s the only contributing factor to a poor-quality mother-child relationship,” he says.

“Therefore, if you experienced postnatal depression after giving birth to your child, it doesn’t mean that your long-term relationship with him is doomed.”

Nevertheless, if you have postnatal depression, are worried about how it might affect your relationship with your child and want to feel closer to him or her now, you may want to address your symptoms as soon as possible.

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Depending on the severity of your condition, your doctor may suggest a combination of cognitive behavioural therapy, mindfulness-based interventions and medication. But you also shouldn’t underestimate the importance of self-care.

“When you take care of yourself and are kind to yourself, you’ll find it easier to have a quality relationship with your child,” says Chan. “So, make your emotional health a priority and do whatever you can to improve your mood.”

For starters, Chan suggests getting sufficient rest, eating healthy and regular meals, exercising a few times a week to increase the production of serotonin (mood-boosting substances) in your body, spending quality time with your spouse, and avoiding the use of stimulants such as caffeine, alcohol and drugs.

If help is offered to you, do not refuse it, and do not be afraid to ask for help, either.

“If a relative offers to assist with the housework or babysitting so that you can rest, take it,” says Chan. “It may also help to talk to other women who are experiencing the same symptoms or to share your feelings with a trusted friend or family member. Reading books about postnatal depression and engaging in comforting spiritual or religious rituals may give you an emotional lift, too.”

Wong says that prioritising her emotional health eased her symptoms significantly, and when her son was 14 months old she felt like she was back to normal.

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“I eventually spoke to a counsellor because I felt so isolated. We talked about the expectations I had for myself as a mother, my fears about being a good mother and the pressure I was experiencing from having to juggle being a wife and a parent.

“I realised how hard I was being on myself. I had to learn to de-stress and accept that it was OK to feel anxious and make mistakes sometimes. I also learned the importance of opening up to my husband.”

In time, she noticed that she was happier and more present when she was with her son. And with that came the connection she’d been longing to feel.

“Today, my son and I are closer than I ever imagined,” says Wong. “We have a great relationship that I’m sure will continue well into his adult years.”