A 36-year-old mother’s postpartum depression: ‘I felt like I was in a dark box with no windows’

Just four days after giving birth to her son in September 2020, Ethel Yap found herself in the emergency department.

“I had chest tightness. I felt like I couldn’t breathe. I had heart palpitations. Every time I attempted to drift off to sleep my body would jerk itself back awake. The feeling was almost like, as you’re falling asleep, your body forgets how to breathe, and it desperately wakes itself up to say, ‘breathe, breathe, breathe’, if not, you’re going to die.

“Every time my body jerked itself awake, I was gasping for breath, like I was suffocating, choking, breathing in water,” said the 36-year-old singer-songwriter and theatre actress.

It was so bad that doctors feared she might have heart failure and admitted her.

“My physical symptoms were actually consistent with this heart condition called peripartum cardiomyopathy that newly postpartum mums can suddenly develop… get a heart attack and die,” Yap told CNA Women.

At that time, the pandemic was ongoing and because some of her symptoms were similar to COVID-19, the new mother was placed in an isolation ward, and cut off from her newborn, husband and family.

There, while fighting for breath and sleep, she continued to pump breast milk, which her husband shuttled back daily for their infant.

Throughout, a constant stream of doctors and nurses in full personal protective equipment ran MRI scans, heart ultrasounds, X-rays and other scans on her.  

A week later, doctors ruled out heart and lung problems, and referred her to a psychiatrist. She was diagnosed with postpartum depression.

HER POSTPARTUM SPIRAL

Yap was aware of postpartum depression. “But I did not think it would happen to me. Or even if it did, I didn’t realise how bad it would be,” she said.

She recalled how after a painful 20-hour labour, she was overjoyed to deliver her son.

“The moment he came out, I burst into tears. I couldn’t stop sobbing for a very long time. They put him on me for the first time for skin-to-skin. I was very, very happy,” she said.

The feeling was very different after her postpartum depression diagnosis, when she returned from her week-long hospitalisation armed with mild, breastfeeding-safe medication for her insomnia.

“I was completely exhausted,” she said. “At that point, I hadn’t slept properly in pretty much a whole week and physically, I was still recovering from the labour.”

“Having to adjust to the new routine of caring for a baby that hardly sleeps and feeds round-the-clock, no day, no night, doesn’t matter if it’s 2pm, 2am – all that coming at me non-stop was just incredibly overwhelming.

“All the things that hit you in the first few months of new parenthood – the baby crying all the time, not knowing how to soothe him – it was a really difficult time,” she recalled.

Sleep continued to elude her, and the medication her psychiatrist had prescribed did little to help. Yap admitted that she was also not taking it consistently enough.

“At that point, I was still trying to grit my teeth and muscle it out, and willing myself through sheer willpower to get better.

“You’re afraid to be dependent on medication. You’re afraid if you take it, it means that you’re weak… all these misconceptions that people have when it comes to mental health medication,” she said. “Obviously, in hindsight, I know it was a very stupid decision.”

Yap’s husband, a lawyer, took over the night feeds along with the couple’s confinement nanny, to give Yap more rest, but it did not help.

“I would go whole nights where my eyes are closed, but I was awake. I was either tossing and turning, or trying desperately to keep still so that I could attempt to drift off.

“The whole night passed and eventually I started to see the light coming into my room, I heard the birds chirping, and I knew it’s morning. I’d completely failed to sleep,” she said.

Yap only slept two to three nights each week, and only for two to three hours on such nights.

“It’s very torturous. The feeling is like, I should be dead, but I’m still alive,” she said.

ANXIETY, IRRITABILITY AND PARANOIA

Her insomnia became more intermittent after the first three months of motherhood, and other symptoms of palpitations, chest tightness and breathlessness also abated after six months.

However, she continued to experience anxiety, irritability and paranoia. “I felt incredibly fragmented. I couldn’t recognise myself in the mirror,” she said.

“My whole life, I’ve always been a cheerful, optimistic and joyful person. But I felt a foreboding sense of dread. I felt like I was in a dark box with no windows, no light. I couldn’t see,” she said.

Her condition took a deep dive when her son was about to turn one. Due to COVID-19 group size restrictions, Yap had to plan a series of birthday events for her son to accommodate their immediate family.

The stress triggered a major relapse. The insomnia, anxiety and heart palpitations returned along with vivid self-harm thoughts.

“I never actually considered taking my own life, thankfully, because I knew that I did not want to leave my husband and son,” she told CNA Women.

“But I was in so much emotional and mental pain that I felt the need to physicalise that in some way. I had thoughts of banging my head against the wall, or stabbing myself with something sharp. That’s when I knew it was really bad,” she added.

THE ROAD TO RECOVERY

Since Yap had started to wean her son off breast milk by then, she asked her psychiatrist for stronger medication to ease her anxiety and insomnia. She also began to go for counselling twice a week.

“It was a turning point,” she said. The therapist provided an unbiased listening ear, and also helped her to frame thoughts and experiences that she had been struggling to put into words.

After six months, when her son was 18 months old, Yap gradually got better. She has since been able to wean off her medication and now only takes it when severe symptoms recur.

She confided that when she was experiencing the worst of her postpartum depression, there were moments when she felt resentful towards her son.

“Rationally, I knew that he was not to blame. Nevertheless, I was still very frustrated that I was in this situation. Thankfully, the resentment did not take too much root in my heart,” she said.

During the period, her husband took on a significant share of the childcare duties and became their son’s “preferred parent”, Yap said.

“I have never been resentful about that. I was very thankful that my husband is so good with our son. Even to this day, the two of them are incredibly close. The irritating part is comments from other people who say, ‘Wow, he doesn’t want Mummy!’ That is very unhelpful.”

Over the past year, Yap has been able to embrace her role as a mother, and said she has a great relationship with her now four-year-old son. “Nothing has taught me how to put someone else’s needs before my own like being a mother.”

Her relationship with her husband has also grown because of the struggles they have been through. The family enjoys picnicking, singing songs, playing music, reading books and playing together.

Yap returned to work in June 2022 when her son was almost two years old, starring in a play and several musicals, such as Pangdemonium’s recent Dear Evan Hansen, where she played a mother. 

Last year, she wrote the song Pills to raise awareness for postpartum depression, and is working on releasing an album next year.   

Her message to other women struggling with postpartum anxiety and depression: “Don’t hesitate to get help.”

Medical help, medication, and the support of family, friends and the community were vital in her recovery journey, said Yap.

“There is no shame in admitting that you’re having a difficult time or that you don’t particularly enjoy your role as a mother. It does not make you a bad parent. It doesn’t mean you don’t love your child.”

Even without depression, Yap said parenting is “incredibly hard”.

“As a society, we have to acknowledge that, so that parents don’t feel like they can’t talk about their experiences and have to suffer alone. I wanted to share my story to create a safe space for that,” she said.

“Mentally, I am in a good place where I feel like myself again,” Yap said. “Depending on what I go through, the anxiety may relapse, the insomnia may relapse, the depression may relapse. If that happens, I still have to choose to mother my son with intention and to the best of my ability.”

If you suspect you may have postpartum depression, seek help from your general practitioner, gynaecologist, or any polyclinic or medical health professional.

You can also call these helplines:

• Institute of Mental Health’s Helpline (24 hours): 6389 2222
• Samaritans of Singapore’s 24-Hour Hotline: 1767
• Singapore Association for Mental Health Helpline: 1800 283 7019