Perinatal Anxiety and Depression
For many people the period of pregnancy and following the birth of a child can bring a range of strong emotions, from joy and excitement to concern and anxiety. This period presents a range of challenges and adjustments, and there are many changes experienced by parents in all areas of their lives at this time. New parents can experience changes including physical, psychological, social, and financial. It is natural that new parents will encounter some difficulties in adjusting to these changes, and will experience some variability their usual mood state and perception of coping. In particular, the ‘baby blues’ can occur in a high proportion of new mothers (up to 80%), in which they will experience symptoms such as mood swings, anxiety, crying, irritability, difficulty sleeping, and feeling unhappy or overwhelmed. The baby blues tend to occur in the first few days after giving birth, and typically last between 2 and 10 days. They are strongly influenced by changes in hormones (and the enzyme MAO-A) shortly after giving birth. If you do experience the baby blues, it is important to understand that this commonly occurs for a brief period, and to accept support from your partner, family, and/or friends during this time.
When substantial mood changes and difficulty coping worsen and/or persist for a longer period (including during pregnancy), it is important to discuss this with your treating medical professional (e.g. General Practitioner (GP) and/or Obstetrician, Maternal Child Health Nurse), as it may indicate the development of perinatal anxiety or depression.
Symptoms
Perinatal anxiety or depression can occur quite suddenly or develop over time in the weeks or months following birth. The severity of symptoms can be mild to severe, and the range of symptoms that a person experiences can vary. These can include persistent:
- Mood swings
- Crying for no apparent reason
- Feeling low, flat, sad, or numb
- Feeling overwhelmed
- Worried, fearful and/or negative thoughts
- Feeling panicked
- Feeling detached
- Rapid heart rate or heart palpitations; tightness in the chest
- Shortness of breath, or rapid and/or shallow breathing
- Shakiness
- Feeling wound up or on edge
- Sleep problems (e.g. not being able to sleep, or sleeping too much)
- Significant change in weight or appetite
- Feeling easily angered / annoyed / irritated / frustrated
- Excessive worry about the baby
- Loss of interest in the things that you usually enjoy
- Difficulties with concentration, attention and/or memory
- Muscle tension or headaches
- Feeling constantly tired / lack of energy
- Feelings of worthlessness, guilt, inadequacy, failure, or hopelessness
- Not feeling attached or bonded with your baby
- Obsessive or intrusive thoughts or behaviours
- Struggling with everyday tasks
- Withdrawing from friends and/or family
- Poor self-care
- Thoughts of harming yourself (may include suicidal thoughts) or your baby
Although more common in women, men can also experience postnatal anxiety or depression.
Risk Factors
- Complicated, traumatic, or high-risk pregnancy or birth
- Family or personal history of depression, anxiety, or other mental health diagnosis
- Previous trauma
- Excessive stress
- Lack of support (emotional or practical) and/or isolation
- Relationship problems
- Health problems or illness
- Having a baby with health problems or other special needs
- Difficulties with feeding or settling
- Age (e.g. being an adolescent or older parent)
- Unplanned pregnancy
- Multiple births (e.g. twins or triplets)
- Previous pregnancy loss
- History of drug or alcohol dependence
- Changes in hormone levels associated with pregnancy and birth can also contribute to mood and mental health difficulties.
Postnatal psychosis is another, less common but very serious mental health condition that can occur in new mothers – see https://www.panda.org.au/info-support/postnatal-psychosis for further information. If you think that you have symptoms of postnatal psychosis, please seek help immediately (e.g. call 000, or present to your local hospital emergency department).
Treatment
It is important to seek help and accept support. A GP or trained mental health professional such as a Psychologist can diagnose anxiety, depression and other mental health conditions, and provide treatment and support.
There are effective treatments for perinatal anxiety and/or depression. Psychological therapy can help you to understand and address symptoms and improve your mood and wellbeing. Therapy can also help you to put practical strategies in place for support, and assist you to adjust to the challenges and changes that occur with pregnancy and parenting. Your doctor may also discuss options for medication with you, where appropriate.
If you identify symptoms that have continued for more than a couple of weeks, and are interfering with your ability to function in daily life, see your treating medical professional. Addressing symptoms early can reduce the severity and duration of perinatal anxiety and depression.
Psychologists and other trained mental health professionals can also assist with Infant Mental Health (birth and early years of life), which supports children’s development and their ability to express, experience, and learn to regulate their emotions, form close and secure relationships, and learn and explore their environment.
Some general strategies that can alleviate the stress and overwhelm experienced by new parents include:
- Prioritise rest and take some time for yourself – it’s important to have some small breaks, do some things that you enjoy, and engage in self-care activities.
- Look after your health by eating well and doing some gentle exercise, when able.
- Be kind to yourself – parenting is Nobody is a perfect parent, so let go of unrealistic or unachievable expectations. Sleep when you can – the housework can wait. Allow yourself some down time without feeling guilty - it is important both for yourself and your child(ren) that you have some balance in life.
- Accept help, and where possible delegate tasks that can be done by others.
- Talk to a trusted family member or friend.
- Seek out company or enjoyable activities when experiencing a drop in mood.
- Join a group such as a parenting or mother’s group or support group.
At The Hummingbird Centre we have a dedicated Perinatal Mental Health Clinic with Psychologists and Accredited Mental Health Social Workers who are highly skilled and experienced in working with expectant and new parents to address a range of issues such as:
- Perinatal Depression
- Perinatal Anxiety
- Childbirth Preparation
- Birth Trauma
- Sleep-Related Anxiety
- Perinatal Loss
- Couples Conflict
- Infant Attachment and Bonding
- Parenting
- Enhanced Child Development
We also run a range of perinatal group programs.
Further Resources
PANDA provides information to expecting and new parents, and also has a National Helpline dedicated to perinatal mental health. You can call from Monday to Friday, 9:00am to 7:30pm on 1300 726 306. The helpline can also provide an interpreter service and assistance for people with a hearing or speech impairment.
https://www.pregnancybirthbaby.org.au/baby-blues
Pregnancy, Birth and Baby offers support during pregnancy and parenting if you’re feeling anxious or overwhelmed, including telephone support (1800 882 436) or video call 7 days a week (including public holidays) from 7am to midnight (AET).
The Parent-Infant Research Institute (PIRI) provide information and resources for pregnant and new mothers, including MumSpace (https://www.mumspace.com.au/).
Centre of Perinatal Excellence (COPE) provides support and information for the challenges of becoming a parent.
https://raisingchildren.net.au/
The raising children network also provides helpful information and resources through from pregnancy throughout the life stages until adulthood.
Beyond Blue also has some resources for pregnant and new parents, including information for fathers https://healthyfamilies.beyondblue.org.au/pregnancy-and-new-parents/dadvice-for-new-dads
https://gidgetfoundation.org.au/
Gidget Foundation Australia provides support for the emotional wellbeing of expectant and new parents.
https://www.whatwerewethinking.org.au/
What Were We Thinking! also provides information and resources for new parents, and have developed an app for support https://www.whatwerewethinking.org.au/app#.YFQj2JMzbOc
