Perinatal Mental Health - Anxiety/Depression

Evidence  

https://pubmed.ncbi.nlm.nih.gov/24140480/ 

Michael W O'Hara, Katherine L Wisner  

Perinatal mental illness is a significant complication of pregnancy and the postpartum period. These disorders include depression, anxiety disorders, and postpartum psychosis, which usually manifests as bipolar disorder. Perinatal depression and anxiety are common, with prevalence rates for major and minor depression up to almost 20% during pregnancy and the first 3 months postpartum. Postpartum blues are a common but lesser manifestation of postpartum affective disturbance. Perinatal psychiatric disorders impair a woman's function and are associated with suboptimal development of her offspring. Risk factors include past history of depression, anxiety, or bipolar disorder, as well psychosocial factors, such as ongoing conflict with the partner, poor social support, and ongoing stressful life events. Early symptoms of depression, anxiety, and mania can be detected through screening in pregnancy and the postpartum period. Early detection and effective management of perinatal psychiatric disorders are critical for the welfare of women and their offspring. 

https://www.cope.org.au/wp-content/uploads/2023/06/COPE_2023_Perinatal_Mental_Health_Practice_Guideline.pdf

Education  

While some degree of stress is normal as you begin to adjust to the current and impending changes of being pregnant, if you find that negative or apprehensive thoughts and feelings are starting to take over, dominate your thinking and feeling, and are beginning to impact on your ability to function from day to day, this could be a sign that you are experiencing a mental health condition.  It is important to be informed and aware of mental health conditions in pregnancy and seek appropriate help early. 

There are several types of mental health conditions that can occur in pregnancy.  The most common of these are anxiety and depression. 

Perinatal anxiety and depression happen around the time a person has a baby, either during pregnancy or after the baby is born. These conditions can affect mums, dads and non-birth parents. Perinatal anxiety and depression are really common; every year in Australia, almost 100,000 expecting or new parents experience perinatal anxiety and depression. 

You might have heard many different words used to describe perinatal anxiety and depression. Antenatal anxiety and depression can happen during pregnancy, while postnatal or postpartum anxiety and depression happen after birth. When we say perinatal anxiety and depression, we’re talking about the whole journey of pregnancy and the time after birth, too. 

Everyone will experience perinatal anxiety and depression a little differently; there’s no wrong or right way to feel when it comes to these things. It’s important to remember that some people might only experience symptoms of anxiety and not depression, or the other way around, while others might experience symptoms of both anxiety and depression. 

Symptoms of perinatal anxiety and depression can include: 

How you’re feeling emotionally:

• overwhelmed                    
• guilty 
• irritable 
• frustrated 
• lacking in confidence 

• unhappy 
• indecisive 
• miserable 
• sad 
• tense 
• wound up
• edgy

How you’re feeling physically: 

• having panic attacks
• hot and cold flushes 
• racing heart
• tight chest 
• quick breathing 
• feeling restless 
• feeling tense 
• tired all the time 
• sick or run down 
• headaches or muscle pains 
• trouble sleeping 
• churning or upset stomach 
• loss or change in appetite

What you're doing:

• not enjoying activities you used to like
• avoiding situations or activities that make you feel anxious or worried 
• having trouble concentrating 
• relying on alcohol and sedatives 
• not getting everyday tasks done (when reasonable – if you’ve just had a baby, the dishes might not get done every night and that’s okay!) 
• withdrawing from family and friends 
• not socialising when there is the opportunity

Empowerment  

Adjusting to parenthood and life with a newborn brings many changes and challenges. 

Even if you have other children, every baby is different and will change your life in different ways. As well as a new person coming into your family, changes in your body, such as shifting hormone levels, lack of sleep, discomfort or pain if you’ve given birth, and different exercise, eating and resting patterns can all also affect your mental wellbeing. 

New parenthood is a time when life can feel overwhelming. You may have moments when things feel out of control. It’s normal, too, to experience fleeting doubts as you find yourself constantly learning and adapting in these first weeks.  

Just like on an aeroplane when they tell you to put on your own oxygen mask before you help anyone else, making your own health a priority will be good for your baby, too.  

Seeking support to move through perinatal anxiety or depression is an important way to look after your own health that will benefit your whole family. 

The important thing to remember, is that you are not alone and that there are safe and effective treatments available. There’s no need to suffer in silence – and no shame in speaking up. 

The faster you get help for anxiety and/or depression, the sooner you can get these thoughts and feelings under control, so that you can get on with enjoying your pregnancy.  

There are a range of professionals and services with expertise in providing support for perinatal mental health conditions.  

Useful Links 

Special thanks for Cope – Centre for Perinatal Excellence for content sharing and providing support for families. 

COPE – Centre for Perinatal Excellence  

https://www.cope.org.au/getting-help/e-cope-directory/ 

Through the Unexpected – Perinatal Diagnosis 

https://throughtheunexpected.org.au/ 

Panda - Perinatal Mental Health 

https://panda.org.au/ 

Beyond Blue - Mental Health Support  

https://www.beyondblue.org.au/ 

Black Dog Institute - Mental Health Support 

www.blackdoginstitute.org.au 

For When – Perinatal Mental Health and Wellbeing 

https://forwhenhelpline.org.au