While society often romanticises motherhood, the reality for many new mothers is far from idyllic, especially when postpartum depression arises. Recent tragedies highlight the urgent need for greater awareness and support.
Motherhood is often portrayed as a blissful journey filled with tender moments and unconditional love. However, for many women, the reality is starkly different. The hormonal changes, sleep deprivation, and overwhelming responsibility of caring for a newborn can lead to significant mental health challenges.
Postpartum depression (PPD) is a serious condition that affects many new mothers. It is more than just the ‘baby blues’; it is a persistent and debilitating mood disorder that can interfere with a woman’s ability to care for herself and her baby. Symptoms of PPD can include persistent sadness, anxiety, irritability, difficulty sleeping, changes in appetite, and feelings of hopelessness or worthlessness.
However, it can be difficult for mothers to recognise these symptoms in themselves, as they may attribute them to the normal stresses of new parenthood or feel too overwhelmed to seek help. This is why partners, family members, and friends must be vigilant and supportive—often, those closest are the first to notice changes such as frequent crying, withdrawal from social contact, or a loss of interest in daily activities.
By gently raising concerns and encouraging open conversations, loved ones can help new mothers become aware of what they are experiencing and support them in seeking professional help. Early recognition and intervention, with the support of those around them, can make a significant difference in recovery and well-being
The tragedy of a mother taking her own life together with her baby while grappling with undiagnosed PPD in December 2023, as reported by The Straits Times, has sparked a much-needed conversation about the hidden struggles of new motherhood. This incident is a stark reminder that the transition to motherhood is not always a bed of roses. It is a complex and often overwhelming experience that requires compassion, understanding, and support.
The silent struggle of postpartum depression
PPD is often misunderstood and stigmatised, leading many women to suffer in silence. They may feel ashamed to admit they are struggling, fearing judgment or criticism. This silence can have devastating consequences, underscoring the critical need for better screening and support systems for new mothers.
Another key trigger is the unavailability of breast milk. Given that most, if not all, maternity divisions of hospitals encourage breastfeeding right after birth, if the new mother can’t express breast milk, she would start to feel inadequate, and that feeling grows worse every time she can’t express it. This was one of the affects leading to the mother in the tragedy reported.
Breaking the stigma
The stigma surrounding PPD often prevents mothers from seeking help. Many women feel isolated and alone, believing that they are the only ones struggling. It is crucial to create a supportive environment where mothers feel comfortable discussing their challenges and seeking help.
Healthcare providers, family members, and society as a whole must work together to break the stigma and provide the necessary support. This includes educating new mothers about the signs and symptoms of PPD, offering routine screening during and after pregnancy, and providing access to mental health resources.
Understanding the symptoms and causes
Postpartum depression is linked to chemical, social, and psychological changes that happen when having a baby. The term describes a range of physical and emotional changes that many new mothers experience. PPD can be treated with medication and counselling.
The chemical changes involve a rapid drop in hormones after delivery. The actual link between this drop and depression is still not clear, but what is known is that the levels of estrogen and progesterone, the female reproductive hormones, increase tenfold during pregnancy.
During pregnancy, levels of hormones such as estrogen and progesterone rise dramatically to support the developing baby. Then, they drop sharply after delivery. This sudden hormonal withdrawal is believed to play a significant role in triggering postpartum depression in some women. Both estrogen and progesterone influence brain chemistry, particularly the regulation of neurotransmitters like serotonin, which affect mood and emotional stability.
When these hormone levels fall rapidly, it can disrupt the brain’s normal balance, leading to symptoms such as sadness, anxiety, and irritability. Some women are especially sensitive to these hormonal changes, making them more vulnerable to developing PPD. Additionally, the drop in estrogen and progesterone can affect the stress response and neurogenesis in the brain, further increasing the risk of mood disturbances after childbirth.
This is why the period immediately following delivery is a particularly high-risk time for the onset of postpartum depression. By 3 days after a woman gives birth, the levels of these hormones drop back to what they were before pregnancy. In addition to these chemical changes, the social and psychological changes of having a baby create an increased risk of depression.
Most new mothers experience the ‘baby blues’ after delivery. About one out of every 10 of these women will develop a more severe and longer-lasting depression after delivery. About 1 in 1,000 women develop a more serious condition called postpartum psychosis.
Hidden safety risk
Postpartum depression doesn’t just affect mood and emotional well-being. It can also impair a mother’s ability to safely perform everyday tasks, including driving. Symptoms such as severe fatigue, difficulty concentrating, slowed thinking, and intrusive or anxious thoughts can all compromise reaction times and decision-making behind the wheel.
In some cases, mothers with PPD may be prescribed medications like which carry specific warnings about decreased alertness and the risk of impaired driving ability. The U.S. Food and Drug Administration advises that patients taking such medications should not drive or operate heavy machinery for at least 12 hours after each dose, as they may not be able to accurately judge their level of impairment.
Even without medication, untreated PPD can lead to lapses in attention, poor judgment, and slower reflexes, all of which increase the risk of accidents. For these reasons, new mothers experiencing significant symptoms of PPD—or those starting new medications for it—should consult their healthcare provider before driving. Prioritising safety, both for themselves and their children, may mean arranging alternative transportation until symptoms are well-managed and any medication side effects are understood.
Treatment options
PPD is often treated with psychotherapy, also called talk therapy or mental health counselling, medicine, or both. Psychotherapy may help to talk through concerns with a psychiatrist, psychologist or other mental health professional. Through therapy, one can find better ways to cope with one’s feelings, solve problems, set realistic goals, and respond to situations in a positive way. Sometimes, family or relationship therapy also helps. Examples of therapies used for PPD include cognitive-behavioural therapy (CBT) and interpersonal psychotherapy.
A healthcare provider may recommend antidepressants as part of the treatment for postpartum depression. If you are breastfeeding, it is important to be open and let your doctor know, as some medications can pass into breast milk. By sharing this information, your doctor can carefully weigh the potential risks and benefits of different treatment options, helping you make a clear and informed decision that supports both your well-being and your baby’s health. When needed, other medicines may be added to the treatment. With appropriate treatment, PPD symptoms usually improve. In some cases, PPD can continue and become long-term, which is called chronic depression.
Moving Forward
The journey of motherhood is unique for every woman, and it is essential to recognise and respect this diversity. While some mothers may experience joy and fulfilment, others may struggle with depression and anxiety. It is vital to prioritise the mental health of new mothers, regardless of their individual experiences.
As the recent article indicates, early detection and intervention are key to preventing tragic outcomes. This includes providing access to mental health resources, offering nonjudgmental support, and fostering a culture of understanding and compassion. By addressing the challenges of motherhood with empathy and care, we can help ensure that no mother feels alone in her struggles.
The journey of motherhood is far from perfect, and the struggles many new mothers face, particularly with PPD, should not be overlooked. The recent tragic case serves as a stark reminder of the importance of awareness, support, and early intervention. By shedding light on these challenges and offering help, we can create a more compassionate and understanding society for all mothers.
