Perinatal Depression and Anxiety22 August 2017 Newborn Sleep
From Conception to 12 months after delivery
With the news of a pregnancy and then delivery, we shower families with flowers, gifts, love and praise. But this celebration and joy can sometimes seem at odds with the emotions parents are experiencing.
For a range of reasons, from traumatic delivery to isolation and even previous mental illness, many parents experience antenatal and postnatal anxiety and depression.
In fact, antenatal depression (before birth) occurs in up to 1 in 9 women. Up to 1 in 7 women and 1 in 10 men experience depression and after the baby is born. Once known as Postnatal Depression, ‘Perinatal Depression and Anxiety’ is now the term widely used because it is reflective of the antenatal time through to 12 months after the baby is born, and it includes both parents.
Fortunately, today we can talk openly about perinatal anxiety and depression, making the stigma once associated with emotional struggles a thing of the past.
- There is no single known cause;
- It is treatable; and
- Anybody can develop perinatal anxiety or depression.
What do I do, if I’m feeling depressed or anxious?
The best way to manage perinatal anxiety and depression is to start talking to someone about it. Don’t try to manage intense feelings and thoughts alone because that has the potential to intensify the symptoms.
Tell your partner, family, maternal child and family health nurse, doctor, midwife or obstetrician … anyone! It is important to talk so the recovery process can start.
If you feel you can’t talk with your family, then talk directly with your doctor or healthcare professional, because it’s important you’re supported. The earlier you get help, the sooner you can begin to return to health.
There are also several online services who support parents with Perinatal Depression and Anxiety because it’s essential you talk to someone.
- Speak out;
- Seek support;
- Let others in, so things can begin to improve; and
- Don’t be surprised by the number of other people you meet who have had similar experiences!
What are the symptoms?
Everyone experiences perinatal depression and anxiety differently, but the following symptoms are some of the experiences parents frequently report:
- Feeling like you are ‘living in a fog’;
- Experiencing little or no joy with your baby or in life;
- Times of feeling panicked, short of breath, sweaty, heart-pounding and sometimes feeling frozen and unable to connect with the world around;
- Feeling overwhelmed that the baby is not okay;
- Worrying so much it seems to be consuming your thoughts;
- Feeling obsessive about self-care, appearances and/or cleaning;
- Teary or often feeling sad;
- Feeling flat or detached from the world around you;
- Feeling like everything is an effort because of ongoing lack of energy;
- Loss of appetite;
- Can’t sleep despite being completely exhausted;
- Forgetful or unable to concentrate;
- Reduced libido;
- Uncharacteristic mood swings and being annoyed by family and friends;
- Withdrawing from your partner and/or your baby;
- Thoughts of harming yourself or your baby; and
- Making an extraordinary effort to put on a ‘happy face’ despite feeling really quite flat and sad.
It is unlikely you will have all of these symptoms, but even two or more that persist may well be telling you that you’re not in your best headspace. If you’re noticing any of these indicators, don’t hesitate to speak to your partner, your doctor or a friend - do not stay alone in your feelings.
If you have thoughts of harm, go to your local hospital. You don’t have to work this out, let professionals support you. Or if you can’t get to the hospital, then phone one of the support lines below and talk to them or dial 911.
Exhaustion and feeling overwhelmed can be part of having a new baby and can look the same as or similar to perinatal depression and anxiety. If you feel overtired, run-down or foggy for over a week or more, it’s still a good plan to check in with your nurse or doctor to be sure all the support you need is in place to allow you to adjust to ‘normal’ exhaustion.
Is it normal?
Remember that perinatal natal depression and anxiety are widespread. It’s quite normal not to enjoy your baby if you’re feeling overwhelmed. Hence, it’s good to use the many resources available to help you focus on improving your situation, so then you can begin to enjoy parenting more.
In the antenatal period, if you feel you may have anxiety or depression symptoms, it’s important to seek professional support before the baby is born. Hence, you’re in the best emotional and mental state possible to care for yourself and your baby when they arrive.
My partner is suffering
If it’s your partner who is emotionally struggling and you are worried about their safety or the safety of your baby while in their care, take them to the nearest hospital emergency department, or call 911. You don’t have to do this alone - services are trained to support families in distress.
‘Baby blues’ is a pervasive feeling of sadness and emotional upheaval, usually around the 4th day after birth but anywhere up to 10 days post-delivery. It affects approximately 80% of mothers and is distinctly different from perinatal depression or anxiety. Dramatic hormonal swings cause these feelings to come and then go, usually within a few days without any specific treatment.
Baby blues can be really intense and is often associated with uncontrollable tears and an overwhelming sense of sadness. This is part of the body re-adjusting after birth.
For anyone who has had premenstrual swings that include spontaneous tears, it’s a similar feeling except you can’t explain why you’re crying when you also have your beautiful baby. It will pass soon enough.
The treatment is lots of tissues, lots of TLC and an understanding that it’s a normal process. Don’t try to fix it, because it’s not broken.
This is a scarce and very serious mental condition and different to perinatal depression, where the mother’s thoughts become way out of character, and she begins doing and saying things that indicate she is losing or has lost touch with reality.
It is terrifying for families because the mother cannot see what is happening, and it often happens very quickly. It can occur from almost immediately after birth to within the first few weeks of delivery.
Postnatal psychosis is considered a psychiatric crisis and needs professional intervention immediately. This is not something families should try to manage as it is a mental health emergency.
What to do if someone you know is exhibiting signs?
Do not leave the baby alone with the mother. Return the mother immediately to the delivery hospital. If you’re not sure you can safely get the mother to the hospital, then call for services to come to you:
- Crisis Assessment or Acute Treatment teams can come to you (your hospital will have your local number; also numbers are online) If there are any delays and the situation becomes unsafe call 911
- Do not try to manage this yourself. It is scary, but the mother is not thinking rationally, so you will not be able to relate to her in a way you are used to. This is rare but needs immediate attention from crisis professionals.
About the Author Helen Stevens. Registered Nurse, Midwife and Maternal Child and Family Health Nurse, with qualifications in Infant Mental Health and a range of early childhood interventions. As author, researcher, educator and clinician, she has specialised in infant sleep for over 20 years and has world recognition for her work. Go to www.helenstevens.com.au for more great information and help for parents.