Prenatal depression is nothing to be ashamed of.
When people offered their congratulations to Ms Annabel Chow when she said she was pregnant, she felt “lousy”. She had suffered depression during her pregnancy – known as antenatal or prenatal depression – during which she experienced insomnia, anxiety and fatigue while carrying her first child more than nine years ago.
But she says it was also frustrating “when others kept telling me that I should be happy, that I was lucky to be having a child”.
“It added to the guilt I felt that I was not happy,” says Ms Chow, 40.
This incongruence between the reality of women’s mental health and common beliefs about pregnancy and maternity is one reason prenatal depression is not easy to diagnose, says Dr Chan Herng Nieng, a senior consultant in the department of psychiatry at Singapore General Hospital.
There is also “an overlap of symptoms between depression and normal pregnancy, such as fatigue, loss of energy and changes in appetite and sleep”, says Dr Chan.
Whether it is antenatal depression or postpartum depression, which is better known, there is a taboo against a mother expressing strong negative feelings amid a wider backdrop of stigma against mental illness in general, says Mrs Silvia Wetherell, a counsellor specialising in maternal mental health at a private obstetric clinic.
“The mothers feel ashamed and think, ‘What’s wrong with me, why am I feeling this way?’ People around the woman often tend to dismiss such feelings as hormonal changes during pregnancy,” says Mrs Wetherell, who also runs a support group for mums at Mother & Child, a prenatal and postnatal education centre.
Dr Cornelia Chee, director of the Women’s Emotional Health Service at National University Hospital, estimates the prevalence of prenatal depression in Singapore at about 12 per cent, even though many women do not come forward to seek help.
SGH’s Dr Chan says: “The focus during pregnancy is usually on the physical health of the mother and the foetus, rather than the mental health of the mother.”
Ms Chow knew, however, that what she was experiencing went beyond the emotional and physical changes one may experience in pregnancy. It felt like something had “snapped” in her mind, especially when she tossed and turned till 3am before waking near 6am to prepare to go to work.
She even had suicidal thoughts.
She went to her doctor and took medication for her condition from the ninth week of her first pregnancy to the seventh month.
Now a stay-at-home mother, she is married to a doctor and they have three children, aged between six and nine.