Postnatal depression (PPD): the signs, and where to get help in Singapore

Postnatal depression, also called postpartum depression or PPD, is a common, treatable illness of low mood, anxiety and hopelessness after having a baby. HealthHub says about 1 in 10 mothers in Singapore who recently gave birth may have it. The NHS says it can begin in pregnancy or at any point up to a year after the birth. Unlike the baby blues, it lasts beyond two weeks.

Signs of postnatal depression

NUH lists the signs to watch for, and strongly encourages you to see a doctor if any have lasted or are getting worse:

• low mood or mood swings
• losing interest in things you used to enjoy
• sleeping badly, or far more than usual
• eating much more or much less
• feeling hopeless, guilty or worthless
• struggling to concentrate or to control worries
• panic attacks, or constant worry about your baby
• feeling irritated or angry with yourself or others
• disturbing thoughts about harming yourself or your baby

The NHS adds difficulty bonding with your baby. NUH is clear that it is not your fault: mood and anxiety disorders can happen to anyone.

PPD or the baby blues?

The baby blues come a few days after the birth and are mild. SingHealth says that if low mood lasts beyond two weeks, you should get professional advice. It puts postnatal depression at 10 to 15% of women after childbirth, with 3 to 5% having a moderate to severe depression that needs medical attention.

Some mothers carry more risk: SingHealth says a past psychiatric history is a major risk factor, and that mothers under 21 are at higher risk, as are older mothers whose pregnancy was unplanned or complicated. Some studies also link it to difficult deliveries, such as forceps, vacuum or caesarean births.

A rare, severe illness, postpartum psychosis, can bring confusion, hallucinations or paranoia. Mayo Clinic says to get help immediately if you have those symptoms. Our guide to postpartum psychosis explains more.

Getting checked for postnatal depression in Singapore

HealthHub has the Edinburgh Postnatal Depression Scale free online: 10 questions about how you have felt over the past 7 days. It is meant for mothers who delivered in the past six months and can be used up to a year after the birth. It is a self-check, not a diagnosis, and your score shows as soon as you submit.

If your answers point to depression, HealthHub encourages you to see your GP, a polyclinic or your obstetrician. It lists the Samaritans of Singapore on 1-767 for anyone who needs to talk now, and KKH's Women's Mental Wellness Service at pnd@kkh.com.sg, which replies within 3 to 5 working days.

Hospitals screen as well: KKH's Women's Mental Wellness Service started a postnatal depression programme in April 2008, and NUH's Women's Emotional Health Service says the earlier you seek treatment, the better the outcome. Your mood is also part of your 6-week postnatal review.

How postnatal depression is treated

Treatment depends on how severe it is, and SingHealth says mild depression may need only support and reassurance from your doctor and family. For moderate or severe depression, it says care usually combines psychological support and therapy with medicines suitable for breastfeeding.

The NHS says talking therapies such as CBT and antidepressants both help, that many antidepressants are safe while breastfeeding, and that PND usually gets better in 3 to 6 months, though it can last longer. It is more likely to improve with treatment.

If you are struggling before your next appointment, do not wait for it. KKH's doctors, writing for Families for Life, say to see your obstetrician or return to the hospital as soon as possible. Our guide to postnatal depression help in Singapore lists where to go and what it costs.

Frequently asked questions

What does PPD stand for?

Postpartum depression. The NHS uses postnatal depression (PND) and postpartum depression (PPD) for the same condition.

How long does postnatal depression last?

The NHS says it usually gets better in 3 to 6 months, though it can last much longer, and it is more likely to clear with treatment.

Can I take antidepressants while breastfeeding?

Often, yes. The NHS says many antidepressants are safe while breastfeeding, and SingHealth says doctors pick medicines that suit nursing mothers, so tell your doctor you are breastfeeding.

Can fathers get postnatal depression?

Yes. The NHS says fathers and partners can also have depression after having a baby.

Related terms

• Baby Blues: Tearful, irritable, anxious days in the first week or two after birth that pass on their own.
• 6-Week Postnatal Review: Your own check-up with a doctor four to six weeks after birth, covering healing, mood, feeding and contraception.
• Confinement (Zuo Yue Zi): The traditional rest period after birth, 30 to 44 days depending on community, with food rules and extra help at home.
• Polyclinic: A public primary care clinic with subsidised fees, where Singapore families can take children for jabs and checks.

See every term in the glossary