IT is normal for new mothers to experience bouts of emotions, tears and anxieties, particularly when it comes to caring for baby.

But when the blues stay longer than two weeks, then the new mother may have post-natal depression (PND).

It is thought to affect at least one in 14 women in Singapore after the birth of a child. But experts believe that the numbers may be much higher, 'as much as 50 per cent', according to Dr Simon Siew, a psychiatrist in private practice.

Many women are diagnosed late and, in many cases, not at all, he said.

Symptoms

Women suffering from PND often report symptoms such as low mood, irritability, loss of interest in activities that previously gave them pleasure or satisfaction, disturbed sleep and appetite, difficulty concentrating, lack of energy.

According to Dr Helen Chen, head and consultant psychiatrist with the Women's Mental Wellness Service at KK Women's and Children's Hospital (KKH), there is often excessive self-blame and guilt - usually related to baby.

'Those with severe PND may also have thoughts that life is meaningless, or have thoughts of dying, killing themselves, or even have the impulse to hurt the baby,' she added.

Along with these symptoms, afflicted mothers often report difficulty in bonding with their child.

The tragedy of post-natal depression is that women often do not seek help as they may not realise that what they are feeling is not normal and can be helped.

And if left untreated, the condition can last for years.

While there is no evidence that hormonal changes in a new mum can cause depression, Dr Chen said they make the woman vulnerable. Coupled with other stressors, they could tip her over into clinical depression.

'Depression, whether related to pregnancy or not, is usually caused by the interplay of various factors, either genetic - where the woman has a family history of post-natal depression or severe mood disorders - social, or medical, if the pregnancy or delivery has been complicated,' she explained.

Women who are at risk are those who have suffered from depression previously. Those who are young, have medical problems, little social support or marital problems, and have sick babies are also at risk.

Dr Chen said the risk of PND recurring in a subsequent pregnancy is estimated to be between 25 and 55 per cent - with the risk being higher for those who had a severe episode.

'The reasons for this really vary. If the stressors that contributed to the first episode are still existing and not resolved, then it is likely with baby No. 2 that PND will recur,' she explained.

What to do

The most important thing is for the sufferer to realise and admit that she has a problem. Having someone to talk to can be a huge step towards recovery. The mother can finally feel she is not alone.

It is also important for her to take physical care of herself, by eating well and having enough rest.

Husbands should also share the responsibility for some night-time or early-morning feeds, leaving her to catch up on sleep.

Having time to herself - like taking a long bath while someone else takes care of baby - can also be beneficial.

Some doctors may prescribe medication, such as anti-depressants like Prozac or Seroxat. While this is helpful in many cases, mothers should think carefully before taking them, especially if they are breastfeeding.

If you think you are suffering from PND and need help, call these helplines from KKH:

• KK-Ask-A-Nurse Service, 1900-556-8773 (8am to midnight, daily. There is a charge for this service.)

• KKH Perinatal Depression and Anxiety Support Group, 6394-3739 (alternate Tuesday afternoons, 2 to 3pm)