Britney Spears is pregnant again – and getting candid about her prior experience with pregnancy. The pop singer, 40, announced on April 11 that she is expecting her third child. In the lengthy Instagram post, which has been liked more than 2.1 million times, she explained her confusion regarding recent changes in her body weight, while also opening up about her mental health struggles during a previous pregnancy. “It’s hard because when I was pregnant I had perinatal depression … I have to say it is absolutely horrible,” Spears wrote. “Women didn’t talk about it back then … some people considered it dangerous if a woman complained like that with a baby inside her … but now women talk about it everyday.” According to the US Preventive Services Task Force, perinatal depression is one of the most common complications of pregnancy and after childbirth, affecting as many as one in seven women. But what exactly is perinatal depression? How Chrissy Teigen inspired a platform for women’s health Unlike post-partum depression , which refers to depression after the birth of the baby, perinatal depression occurs during pregnancy and the first year after delivery. Common symptoms include: Loss of interest and energy Depressed mood Fluctuations in sleep or eating patterns Reduced ability to think or concentrate Feelings of worthlessness Recurring thoughts of suicide Experts caution that this is different from the common “ baby blues ”. While both refer to mood disturbances that can manifest as crying, irritability, fatigue and anxiety, perinatal depression lasts for more than two weeks while “baby blues” are usually gone within 10 days of delivery. In addition to common symptoms of depressive disorders, such as hopelessness or social isolation, “women who experience symptoms of depression during the perinatal period often experience enormous guilt (and) shame that they are feeling this way”, explains Karen Kleiman, the founding director of The Postpartum Stress Centre in the US state of Pennsylvania, and author of several books on post-partum depression and anxiety. “While some degree of emotional upheaval is expected, women should be encouraged to seek help if the level of distress feels too high or if it interferes with their ability to function the way they normally do.” How to prevent perinatal depression Treatment for perinatal depression is crucial for the health of both the mother and baby. A 2019 report published in the Journal of the American Medical Association (JAMA) found that it can result in premature birth and low birthweight. Let others know what your concerns are, what you may need, how they might help Karen Kleiman founding director of The Postpartum Stress Centre In addition, children of mothers who had perinatal depression showed more behaviour problems, lower cognitive functioning and increased risk of developing psychiatric disorders. Common prevention methods for perinatal depression include physical activity, medication, infant sleep training , education and yoga. However, the JAMA report found that counselling was most effective, reducing risks by 39 per cent. In particular, cognitive behavioural therapy and interpersonal therapy were favoured: Cognitive behavioural therapy addresses an individual’s patterns of thought and behaviour, while interpersonal therapy focuses on a person’s relationships and actions with others. Kleiman also suggests taking advantage of your social support network. “Let others know what your concerns are, what you may need, how they might help,” she says. “A strong support system has been shown to make a significant difference in how women recover if they do develop symptoms of depression and anxiety.” Since there is no standard screening tool for medical professionals to check for perinatal depression, it is “more complex to perform a risk assessment” and accurately determine if a woman is at-risk, Harvard Medical School psychiatrist Marlene P. Freeman wrote in an editorial accompanying the JAMA recommendations. Is online therapy the right thing for you? 8 ways to optimise your sessions Those looking for treatment for perinatal or post-partum depression should seek a women’s health specialist with perinatal psychology training. If you are having suicidal thoughts, or you know someone who is, help is available. For Hong Kong, dial +852 2896 0000 for The Samaritans or +852 2382 0000 for Suicide Prevention Services. In the US, call The National Suicide Prevention Lifeline on +1 800 273 8255. For a list of other nations’ helplines, see this page . Like what you read? Follow SCMP Lifestyle on Facebook , Twitter and Instagram . You can also sign up for our eNewsletter here .