Being pregnant and becoming a parent can be an amazing experience but it may also come with unexpected challenges.

Having a new baby is a time of adjustment for new parents and many find it harder than expected. For some, it can feel overwhelming and scary. Both mothers and fathers can experience mental health problems during the first year of a baby’s life (the perinatal period).

The depressive and/or anxiety disorders which are experienced at any time during pregnancy and the first 12 months after a baby is born are referred to as perinatal depression and anxiety (PNDA).

There are differences between perinatal, antenatal and postnatal depression. Depression experienced during pregnancy and after giving birth may be referred to as:

• antenatal depression- occurs during pregnancy
• postnatal depression- begins during the first 12 months after a baby is born
• perinatal depression- experienced at any time during pregnancy and the first 12 months after birth.

PNDA does not discriminate. Women and men from all ages and backgrounds can be affected. In Australia, up to 1 in 10 women and 1 in 20 men experience depression during pregnancy.  Up to 1 in 7 mothers and 1 in 10 fathers experience depression in the first year after birth[1]. Anxiety is just as common during the perinatal period, with many parents experiencing both anxiety and depression at the same time.

Factors that increase the risk for PNDA include[2][3]:

• A history of anxiety and depression
• Family history of mental illness
• Having a difficult or complex pregnancy
• Birth trauma
• Previous perinatal loss
• Having a premature or unwell baby
• Difficulties feeding and settling
• Relationship stress
• Lack of support
• Isolation
• Physical illness
• Experiencing a recent stressful life event
• Family violence
• History of trauma

What are the signs?

Signs of perinatal depression may include:

• Depressed mood, including feeling sad, hopeless or empty
• Frequent tearfulness
• Loss of interest or pleasure in activities that were enjoyed prior to pregnancy or having the baby and/or lack of interest in the baby
• Insomnia or excessive sleep
• Physical symptoms- such as increased heart rate, changes in appetite, clammy palms, headaches
• Feeling overwhelmed and exhausted
• Not feeling bonded or attached to your baby
• Feelings of worthlessness and guilt
• Feeling trapped
• Persistent negative thoughts
• Difficulties concentrating or making decisions
• Feeling very sensitive or irritable
• Thoughts of self-harm, death or suicide, or thoughts of harming the baby

Perinatal depression affects a person’s ability to function normally in their day to day and can affect their ability to care for their child/ren. Depression is identified by the presence of several symptoms experienced over at least two weeks.

Signs of perinatal anxiety may include[4]:

• Anxiety that interrupts thoughts or interferes with daily tasks
• Feeling irritable, on edge, restless
• Difficulties relaxing and/or getting to sleep
• Panic attacks
• Anxious thoughts that feel intrusive and are difficult to control
• Physical symptoms- such as heart palpitations, chest tightness and tense muscles
• Anxiety that stops a woman going out with her baby or leads her to check on the baby constantly

What are some coping strategies?

Look after your own health, it is as important as the health of your baby. Eat well and drink plenty of water (keep easy healthy snacks and bottles of water on hand), do some gentle exercise, and prioritise rest as much as possible.

Try not to have too many sources of parenting information, it can easily get overwhelming. Give yourself permission to learn through experience and remind yourself that learning takes time. Choose a few trusted sources of information (e.g., a health professional, trusted family member or friend). Be gentle with yourself- this is a major learning curve and emotionally vulnerable time.

Make sure you remain connected with support networks. Having a baby can be isolating. Options to connect with other new parents can be via mother’s groups or playgroups, other activities (such as baby rhyme time at the local library and community-run baby classes), or online support groups.

Ask for and allow people to help. This can be a difficult step for many. Identify those people and services around you who you can go to for support. Speaking up about how you are feeling does not mean you “can’t do this” or make you a “bad” or incompetent parent. In fact, reaching out when you are struggling is prioritising your baby’s wellbeing. Early intervention leads to faster recovery with less negative impact on you and your baby.

Keep your expectations realistic. Social media representations of pregnancy and parenthood do not often show “how it really is” to be pregnant or in the early stages of parenthood.  The Centre of Perinatal Excellence provides information to promote realistic expectations for the journey in becoming a parent as well as providing strategies to help cope during the challenges and difficult emotions via their free e-newsletter called “Ready to COPE”. Sign up at (www.readytocope.org.au).

 

When to seek further help and where from?

PNDA is a real and serious mental health condition. It is important to know that PNDA is treatable, and recovery is possible. Help and support is available and getting the right help early leads to a faster recovery.

If you are experiencing signs of PNDA, don’t suffer in silence.

Consult with your GP, obstetrician, midwife, or other trusted health professional. They can direct to you and/or link you with appropriate support services. 

Contact a Perinatal Psychologist or Counsellor. Psychological therapies can be subsidised under Medicare with GP referral.

Helplines:

• PANDA National Helpline (Mon to Fri, 9am- 7.30pm AEST/AEDT). Call 1300726306
• Pregnancy, Birth and Baby | Phone 1800 882 436 | Information, emotional support, 7am to midnight
• Lifeline | Phone 13 11 14 |available 24/7
• Suicide Callback Service | Phone 1300 659 467 |available 24/7

Websites for further information and resources:

• How Is Dad Going?- www.howisdadgoing.org.au
• What Were We Thinking- www.whatwerewethinking.org.au
• Mum Space website- mumspace.com.au
• Baby Steps website at babysteps.org.au.
• PANDA- www.panda.org.au
• Centre of Perinatal Excellence- www.cope.org.au

Online Programs:

• Mum2bmoodbooster is a free evidence based online program designed to help women recover from antenatal depression- www.mum2bmoodbooster
• Mumsmoodbooster is a free evidence based online programme for mums experiencing mild to moderate postnatal depression- www.mummoodbooster.com

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[1] Deloitte Access Economics. (2012). The Cost of perinatal depression in Australia. Post and Antenatal Depression Association.

[2] Leach, L. P.-s. (2017). Maternal perinatal anxiety: A review of prevalence and correlates. Clinical Psychologist.

[3] The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. (2015). Perinatal Anxiety and Depression: Health Statement and Guidelines. Retrieved from RANZCOG Excellence in Women's Health: www.https://ranzcog.edu.au/

[4] COPE: Centre of Perinatal Excellence. (2017). Perinatal Anxiety: A guide for health professionals. Retrieved from COPE: Centre of Perinatal Excellence: https://www.cope.org.au