Perinatal anxiety and depression, not just after giving birth

Most of us have heard of postnatal depression, but feelings of anxiety and depression aren’t only experienced after a baby is born.

Men, and women at any stage throughout their pregnancy, and up to a year after birth – this being the perinatal period, can face anxiety and depression.

Research shows those who experience problems with anxiety and depression early on in their pregnancy are more likely to struggle with their mental wellbeing after their baby is born.

If left undiagnosed or untreated, anxiety and depression can have long-term impacts on the wellbeing of both parents and their baby.

But a new wider focus on ‘perinatal’ anxiety and depression aims to help new and expecting parents recognise the signs and symptoms so they can seek help and support much earlier.

What is perinatal anxiety and depression?

The perinatal period begins at the start of pregnancy and extends to one year after a baby is born.

The term ‘perinatal’ is used by medical professionals to describe a woman’s physical health during pregnancy and beyond, but professional support group Perinatal Anxiety and Depression Australia (PANDA) says it’s also vital both parents are aware of their mental health during this time.

Research shows antenatal anxiety and depression (before the baby is born), is a strong risk factor in developing postnatal anxiety and depression (after the baby is born). 

How common is it?

According to PANDA more than 100,000 Australian parents per year are affected by perinatal depression. Postnatal anxiety and depression being experienced by up to  1 in 7 new mums and 1 in 10 new dads.

PANDA CEO Terri Smith says 1 in 10 women experience anxiety or depression during their pregnancy, with data suggesting many more are experiencing anxiety.

“We know that anxiety is even more common than depression,” says Smith. “While there is a degree of familiarisation with postnatal depression, many [women] aren’t identifying symptoms of anxiety.”

“People very commonly think about the period after birth and aren’t aware that the period during pregnancy is also a very significant time for emotional health issues,” she says.

Smith says many women don’t connect their feelings of anxiety to their pregnancy or the early days of motherhood, which can lead to confusion about what is causing the problem.

“The frustrating thing for us at PANDA is that there is a missed opportunity for us to intervene early because if anxiety or depression has been untreated during pregnancy then the chances are higher that it will continue after the pregnancy,” says Smith.

What are the warning signs?

Smith says anxiety and depression are two very different feelings, but they can in some cases go hand in hand.

“There is a trigger we talk about that if feelings of anxiety or depression persist for over two weeks and is inhibiting our capacity to get on with life then it’s really worth talking to someone,” says Smith.

For friends and family members it’s important to look for a change in behaviour.

“If someone is different to how they were before, then look at the duration of the symptoms,” says Smith.

“You’ve got to allow for new mums and dads to have a few bad days here and there as they make the transition [to parenthood], but if the symptoms persist for a couple of weeks that would be a concern.”

“It could be that someone has been really close to their sister and mum and [now] they consistently don’t want to be having the social contact when they would have liked that in the past,” says Smith.

“It is really important to ask the question of mum and dad - how they’re going? And you can’t just ask the question you have to listen to the answer,” says Smith.

Accessing help

Smith says callers to PANDA’s national helpline commonly say they haven’t told anyone else.

“It depends on what you’re comfortable with,” says Smith. “Sometimes people who call the PANDA helpline are looking for reassurance.”

“We have these conversations all day every day, so we’re familiar with the issues and the feelings that people have, and callers can certainly rely on a sympathetic and informed response when they call the helpline.”

Smith says others may benefit from talking to someone close to them.

“I would encourage people to think about whether that’s something they are able to do.”

There is a range of ways to access help, whether it’s through web-based resources, PANDA’s National Helpline, your GP, local support groups or counselling.

For some people counselling, or talking therapy is enough but others may require medication.

“Often women are very wary of medications either during pregnancy or if they’re breast feeding but there are some really good medications available now that are perfectly compatible with [both pregnancy and] breast feeding.”

In some extreme cases some parents require hospitalisation.

“It is important for people to know that it very rarely goes away without some support or treatment,” says Smith.

“We talk regularly with people who are profoundly unwell and feel they are either a risk to themselves or their babies, so it’s important people realise perinatal mental illness can escalate to being a very serious matter.”

Why me?

Smith says many people who experience perinatal anxiety and depression struggle to understand why it happened to them.

“One of the things we know from the data is that it’s across the board, it doesn’t discriminate, and anyone in the community can be impacted throughout the perinatal time.”

“I don’t think we can say enough about the juxtaposition of what’s meant to be a really happy and exciting time bringing home a new baby where people’s expectations are so high,” says Smith. “To suddenly face feelings of anxiety or depression is something people are not expecting to happen.”

Smith says as many couples are choosing to have babies later, they sometimes have to work hard for their pregnancy and try for a long time, or need to get help with their fertility. This can for some, be a risk factor for perinatal anxiety or depression.

Smith says it’s a phenomenal period of change where some have concerns about financial security, leaving their job, and how their relationship and family is going to change.

“It’s a complex experience and suddenly you’re not in control,” Smith says.

“It’s about honest conversations and acknowledging that mental health is as important as physical health. We know that no one is immune, but equally we no one needs to go through it alone” 

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