Postpartum Depression

In a study published in March this year in  JAMA Psychiatry,  1,396 of 10,000 mothers screened positively for postpartum depression on the Edinburgh Postnatal Depression Scale (EPDS). This study sponsored by the publicly funded National Institute of Mental Health in the US shows that depression after childbirth is a significant problem. Unfortunately, postpartum depression remains underidentified and undertreated. Some of the following are common myths about Postpartum Depression.

Postpartum Depression (PPD) is the same as baby blues.

Unlike baby blues that goes away after a few days, postpartum depression lasts for weeks to months. The symptoms of PPD is the same as for a Major Depressive Episode. 

PDD is normal and ok to be sad after having a baby.

Whilst changes in mood may be normal after birth, if they are prolonged or are affecting your ability to care for your child, you should seek medical attention. If left treated, PDD can lead to:

1) Inconsistent and poor childcare
2) Avoidant or venting type of coping strategies with child
3) Insecure attachment between mother and child (may result in anxiety and depression of the child in later life)
4) Risk and danger if mother becomes agitated or suicidal with depression

PDD occurs right after birth.

It can occur right after birth or even up to a year later. Most of the time it occurs within three months.

Treatment for PDD will prevent me from breastfeeding and harm my baby.

Effective treatment is available for PDD. Antidepressants safe for pregnancy can be used to treat PDD after the risks and benefits have been discussed. Psychological therapy with techniques such as CBT is also useful.

It is unfortunate that PDD often goes unrecognised leading to tragedies such as these. Seek help today as PDD  can be treated!

Can Changes in Diet Improve ADHD Symptoms?

Parents often ask me if certain food may make the ADHD symptoms of their children worse. One of the purported culprit is sugar and the "sugar rush" phenomenon is well known. Despite a lack of studies to support these claims, anecdotal reports are aplenty. In this news article a mother reports success with diet changes such as adding vitamins and omega 3's, avoiding addatives- red dyes in particular and skipping the simple processed sugars.

Read about symptoms of ADHD here.

Most adolescent suicidal behavior preceded by mental health treatment

A recent research(1) showed that the lifetime prevalence of suicide ideation among adolescents was 12.1%, suicide plans 4%, and suicide attempts 4.1%. One-third of adolescents with suicidal ideation went on to develop a suicide plan and 33.9% made an attempt. Most adolescents (88.4%) who transitioned from planning suicide to attempting suicide did so within a year.

Most adolescents who had suicidal ideation (89.3%) and attempted suicide (96.1%) met lifetime criteria for at least one DSM-IV mental disorder, which included major depressive disorder, specific phobia, oppositional defiant disorder, substance abuse, intermittent explosive disorder and conduct disorder. Most disorders significantly predicted suicidal behaviors, and the prevalence of mental disorders generally increased with the increasing severity of suicidal behaviors.

From this study, we can see that it is important to identify and provide early treatment for these troubled youths. Unlike physical illnesses, parents tend to ignore mental health issues and to believe that such problems will go away by themselves. Otherwise, they may feel that seeking help from a mental health professional is too stigmatising and may do more harm to their children.

Such ignorance, often lead to delay in seeking treatment and may result in the youths and parents defaulting follow-ups. Today, suicidal behaviors are among the leading causes of death in Singapore and worldwide, especially among adolescents and young adults. Seek help early and contact a psychiatric clinic in Singapore.

(1) Prevalence, Correlates, and Treatment of Lifetime Suicidal Behavior Among Adolescents Results From the National Comorbidity Survey Replication Adolescent Supplement  
Matthew K. Nock, PhD; Jennifer Greif Green, PhD; Irving Hwang, MA; Katie A. McLaughlin, PhD; Nancy A. Sampson, BA; Alan M. Zaslavsky, PhD; Ronald C. Kessler, PhD
JAMA Psychiatry. 2013;():1-11. doi:10.1001/2013.jamapsychiatry.55

Natural Born Parents?

Is there such a thing as natural born parents?

You know, those people who can intuitively deal with the incessant crying of their newborns, handle those terrible (terrible) twos, effortlessly impress upon their ten year old kiddo that school is more important than XBOX or Nintendo and can communicate with the not-a-child-not-quite-an-adult adolescent without pulling their hair off from frustration.

Somehow we are made to believe that parents especially mothers have the innate ability to care for their children. I think this is partly true. There exist primitive mechanisms that parents will have to protect their younglings so as to preserve the survival of the species. However, bringing up a child in a modern society and nurturing him/her into a confident, happy and successful person is a totally different story.

In Singapore, this is made worse as most of us stay in small apartments as a nuclear family. The extended family may be living in another neighbourhood and opportunities to learn about how to be a parent is limited. The wisdom of the previous generation in handling a child is unfortunately not passed on.

We have also rapidly developed since independence. Our parents' practices may seem dated and redundant. A generation ago, disciplining children meant corporal punishments and caning. The child was expected to be seen but not heard. Today, parenting skills are all about time-outs, limit setting and star charts. Close your eyes and you can immediately see the grandparents scoffing about such "western techniques" and that if you "spare the cane, you spoil the child."

Many young parents lacking experience and guidance will find in stressful handling their newborns and dealing with parenting. Parents have asked me what IS the best way to discipline or to bring up a child. There really is no one size fits when it comes to parenting. Every child is different and has different needs and requirements. The child-parent dynamics are affected by the temperament of both the child and the parent, the bidirectional interactions between the child and parent and other external circumstances.

Unfortunately, I have seen many parents getting caught in the rat race and focusing on short term targets like music, sports and academic achievements and disregarding the emotional and psychological wellness of their children. The young child can quickly learn that the world is negative and full of struggles and trepiditions. He may develop to become an unhappy genius, never to be satisfied with his own talent.

I believe every single parent will want his or her child to blossom into a confident and happy adult. So start by being mindful that your aim as a parent is to provide a healthy environment for the child to grow, both physically and emotionally.  Once this picture is clear in the mind, the jigsaw pieces of the parenting puzzle will fall into place with nautral ease.