Perinatal Depression & Anxiety

"Depression and anxiety can happen at any time — but we know women are more likely to experience these conditions during pregnancy and the year following the birth of a baby."

It is important to understand these conditions so you can learn to recognise the signs and seek help early.

Mental health problems during pregnancy and the year following birth (the perinatal period)

Pregnancy and adjusting to a new baby is rewarding, but also brings changes and challenges. While some days will be better than others, for some women who experience mental health problems each day is a struggle.

Just like physical health problems experienced during pregnancy, birth or early parenthood (e.g. high blood pressure), mental health problems can happen to anyone. It’s important to recognise the signs and seek help early.

While depression and anxiety disorders are the most common type of mental health problems in the perinatal period, there are other serious mental health problems that can also occur at this time (see 'Other mental health conditions').

Depression

"I felt nothing…just numb, emotionally dead/flat."

Perinatal depression affects up to one in 10 women during pregnancy, and almost one in seven women in the first year after the birth. Unlike the ‘baby blues’, which is temporary, depression does not go away on its own. Women with depression describe feeling sad, down, numb and empty, with no interest in their baby, other people or things they used to enjoy.

Anxiety disorders

"I’m just so worried about everything."

"I can’t stop feeling that something will go wrong with this pregnancy."

While we all experience some anxiety from time to time, for some people, these feelings keep going and can have an impact on their ability to function from day to day. Anxiety conditions are likely to be at least as common as depression during pregnancy and the year following, and many women experience both anxiety and depression at the same time. Symptoms of anxiety disorders include feelings of worry, panic or fear that are difficult to stop or control.

Getting Help

Talking to your general practitioner (GP) or other health professional is a good first step in getting help. By discussing your experiences with you and assessing your answers to the questions in the Edinburgh Postnatal Depression Scale (EPDS) a health professional can help you to work out if you may be experiencing depression or anxiety and whether you could benefit from some additional advice or help.

Depending on your symptoms, you may be referred to a specialist (e.g. psychologist, psychiatrist).

When is urgent assistance needed?

If you or someone you care about is in crisis, contact your GP or local health care provider.

Thoughts of suicide, harming yourself or your baby can accompany mental health conditions.

If you think your partner or baby would be better off without you, or you are having thoughts of suicide or thoughts of harming the baby, seek emergency assistance by calling 000 or go to your local hospital emergency department.

Treating perinatal depression and anxiety

"I knew I needed help, it was just a matter of finding the right combination of help for me."

The type of treatment varies according to the individual and the severity of the illness. Often a combination of treatments is most effective for depression and/or anxiety.

• Psychological therapy, often referred to as ‘talking therapy’, can be effective in changing negative thoughts and feelings, stopping symptoms from getting serious and helping recovery.
• Medication can also play an important role in reducing the impact of depression or anxiety on the mother, baby and other family members. Research has shown that certain medications are effective and can be used safely during pregnancy and breastfeeding.

Medicare rebates are available for a range of mental health services. For more information, phone the beyondblue info line 1300 22 4636.

Other mental health conditions

There are other less common mental health conditions that can occur during pregnancy or in the year following birth.

• Bipolar disorder affects a small number of women in the perinatal period and involves periods of feeling low (depressed) and high (mania). Medication and extra support are required to treat and manage this biological condition.
• Puerperal (postpartum) psychosis is a serious but rare condition that occurs in the first weeks after the birth. It involves marked changes in moods, thoughts, perceptions and behaviour. Women with puerperal psychosis can become very confused and may be at risk of harming themselves or others. This is a medical emergency and a doctor should be contacted immediately.

Women who have had bipolar disorder or puerperal psychosis before have a high risk of relapse in the perinatal period.

Tips for looking after yourself

"Talking with others who really do understand has helped me not to worry about the birth and being a mother."

• Develop a support network of friends, family and/or health professionals and organise extra help in the first few weeks after the birth.
• Involve your partner and family in day-to-day care of your baby and household chores from the beginning.
• Organise your routine so you get some time for yourself — use the time to relax or do something you enjoy.
• Talk to someone you trust about your feelings. Sharing your concerns can be really helpful.

Tips for partners

"My husband was fantastic… he spent as much time as he could at home helping with the children."

• Become involved in day-to-day tasks related to caring for the new baby and the household.
• Accept offers of help from friends or family members or organise someone to help with meals, housework and the child/ren.
• Plan some time as a couple and try to do something you both enjoy.
• Be aware of your own health and wellbeing. Make sure you exercise, relax and set aside time for yourself.

Tips for family and friends

"My mother stayed over as much as possible and a neighbour and other friends cooked meals."

• Spend time listening, without needing to offer solutions and advice unless it is requested.
• Offer to look after the baby or older children, help with cooking and cleaning or whatever else is needed.
• Encourage the mother and/or father/partner to seek professional help if necessary.

Information resources for women and their families

Download the full version of Understanding perinatal depression and anxiety.

For information on the common emotional challenges faced by new and expectant parents, including practical tips and strategies, see The beyond babyblues guide to emotional health and wellbeing during pregnancy and early parenthood.

For more information about depression, anxiety disorders, bipolar disorder and puerperal psychosis, see the beyond babyblues booklet Managing mental health problems during pregnancy and early parenthood: A guide for women and their 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/

Reproduced with permission, Beyond Blue LTD. BL/0940_0612