We've all read a great deal about the baby blues and post-natal depression - conditions that affect women in the weeks after they have given birth.
But perinatal depression, which affects women while they are pregnant, has had less exposure and is thus relatively little known.
According to Dr Helen Chen, senior consultant of the Mental Wellness Service at KK Women's and Children's Hospital (KKH), about one in five pregnant women in Singapore is likely to have depressive symptoms and about one in 10 will have clinical depression.
Over the past two years, Dr Chen has seen about 150 perinatal cases.
Because the symptoms are rather common, it is easy to dismiss them as pregnancy symptoms. They include the loss of appetite, poor sleep and forgetfulness.
While it may be convenient to attribute perinatal depression to the change in hormonal levels, its causes go beyond that.
Mums-to-be, you're not alone
The Perinatal Depression and Anxiety Support Group provides support for women who experience depression during pregnancy and follows up on their progress after delivery.
Members meet every other Tuesday afternoon in KK Women's and Children's Hospital.
Since its launch in August 2006, 58patients have participated in the support group which conducts sessions in English and is headed by a psychiatrist and case manager.
For more information, please call 6394-3739.
And the condition usually comes about due to several interacting causes.
Dr Chen said that previous episodes of depression, marital difficulties and financial problems are but some of the factors that can contribute to perinatal depression.
In fact, a woman can go through various phases of depression during her pregnancy.
'Depression during pregnancy is particularly prevalent during the first three months, in part due to the initial adjustments to pregnancy,' said Dr Chen.
In contrast, the middle trimester is a more emotionally stable period as the physical discomforts are minimal, she added.
She said that during the third trimester, physical discomforts such as abdominal pain return. Coupled with anxiety about the labour process and the responsibility of motherhood, women at this stage are more vulnerable to suffer from depression again.
However, Dr Chen said that the good news about perinatal depression is that it can be cured through medication and counselling.
A common mistaken notion is that the health of the foetus can be endangered if the mother takes medication.
However, Dr Chen assures that while not all medication is recommended for pregnant women, safe options are available. But these are used only when the depression is severe.
As she feels that perinatal depression is largely due to inner unresolved conflicts, she recommends counselling and therapy to sort out some of these issues.
'Group support is also beneficial as women derive much help from the sharing of experiences,' she said.
At KKH, women who suffer from perinatal depression can join the Perinatal Depression And Anxiety Support Group.
The group meets twice a month and women can share their experiences about how they cope with their condition.
Ms Ch'ng Ying Chia, case manager and team leader of the support group, said that the group has motivated some mothers to stay on board even after they have recovered so they can support other women who are receiving treatment.
'They offer hope to new patients by showing how well they have coped and how well cared for their babies are,' she said.
This article was first published in Mind Your Body, The Straits Times on June 18, 2008.
