Understanding and Managing Peri Natal Depression and Anxiety

Just ‘the baby blues’ or something more?woman thinking

The peri natal period describes the period from conception to 1 year after the birth. In the past we have tended to just focus on depression in the period after the birth (PND – Post Natal Depression.) However 1 in 10 expectant mums and 1 in 20 expectant dads experience depression during the pregnancy and may also need some support at this time.

Some mood changes and anxieties are expected with any normal pregnancy but where symptoms persist or are not manageable with the support of family and friends, you may need to reach out for further support from a caring professional.

This article outlines the various ways in which anxiety and depression may affect a person across the peri natal period.

The Baby Blues
In the days, weeks and months after giving birth there are three accepted mood disorders that a mother can experience. If placed on a spectrum, at one end is the baby blues. In the first week after giving birth, up to 80% of mothers will experience what is known as the baby blues.

Symptoms include: mood swings, anxiety, tearful-ness and irritability. The baby blues are thought to occur as a result of the stress associated with the birth process and the hormonal changes that occur after childbirth.  The baby blues is not an illness and symptoms should pass within a few days with rest, understanding and support.

However, if symptoms last for longer than two weeks, it is important that you seek advice from your maternal and health nurse or GP, as this may indicate the beginning of peri natal depression and anxiety.

Postnatal Psychosis
At the far end of the spectrum is postnatal psychosis. It is a serious condition and affects one in 500 mothers. It occurs in the first three to four weeks after giving birth. Symptoms include; severe mood swings (marked by elation or depression or fluctuating between both), disturbance in thought process, insomnia, inappropriate response to the baby and ones grasp on reality is affected. If you or a loved one recognises these symptoms, a medical assessment should be sought immediately, as if left untreated there may be a risk to you and your baby. Postnatal psychosis is treated by a psychiatrist and usually requires a hospital stay.

Peri Natal Depression and Anxiety (PNDA)
Between the baby blues and postnatal psychosis sits peri natal depression and anxiety. PNDA affects one in seven to ten mums. Unlike the baby blues, PNDA is an illness. It can begin in pregnancy or within the first 12 months of giving birth. It can come on slowly or suddenly and can range from mild and transient to severe and lingering. It occurs in all cultures and it can happen after miscarriage, stillbirth, normal or traumatic delivery or caesarean. PNDA is most common after the first pregnancy and can occur after subsequent pregnancies.

Risk Factors

Although PNDA can happen to any woman, some are more at risk than others. Some risk factors are:
• Previous experience of PNDA
• Family history of psychiatric disorders
• Stressful life events
• History of pre-menstrual tension
• Difficult marital or family relationships

Causes of PNDA

A combination of factors may be involved.

Biological factors:
• Genetic predisposition to developing depression
• The sudden drop in pregnancy hormones after delivery can affect the brain chemistry.

Psychological factors:
• Difficult pregnancy
• Difficult or traumatic birth
• Relationship difficulties with partner and parents
• Past unresolved grief and loss such as previous miscarriage, stillbirth or abortion.
• Traumatic/abusive childhood
• Low self-esteem

Social factors:
• Lack of support from partner, family and community
• Social isolation

Symptoms include:
• Sleep disturbances unrelated to baby’s needs
• Appetite disturbances
• Crying
• Feeling unable to cope
• Irritability
• Anxiety
• Fear of being alone
• Memory difficulties
• Feeling guilty and inadequate
• Loss of confidence and self-esteem

As well as emotional and practical support from your friends and family, treatment options for women with PNDA include counselling, antidepressant medication or a combination of both, depending on the severity of the condition. A GP or psychiatrist can best assess your medical needs.

Counselling can help support you during this time and assist recovery. Regular appointments may provide you with a safe and caring environment in which to tell your story and be heard and understood by an attentive and empathic listener. It may give you time and space to focus on your needs and explore your concerns and issues.

Fathers and PNDA
It should be acknowledged that men may also suffer from PNDA. The pregnancy of a partner and the birth of a new baby bring with them many challenges and stressors for men as they transition to fatherhood. This can lead to depression and anxiety in men in the same way as it does in women.

Men with partners suffering from antenatal and postnatal depression are most at risk. As is the case with women suffering PNDA, it is equally important for men experiencing symptoms to seek the appropriate help as early diagnosis and intervention will control symptoms and assist recovery.

In conclusion
If you or your partner are experiencing any of the symptoms described in this article, you should contact your maternal health nurse or GP. Many women and men do not realise that they are suffering from PNDA and think that the way they are feeling is normal. They may try and tough it out because they do not want to be seen as not coping or failures as mothers or fathers. Thus treatment is delayed and symptoms may worsen.

It is important for both women and men to understand that PNDA is an illness and that help is readily available and with appropriate support and professional help recovery can occur.

‘Baby & Me’ support groups – getting ahead of post natal depression.  For women and couples.  Contact Open Doors for details.

Need to talk?
If you or your partner require counselling, Open Doors can provide a skilled and empathic counsellor who will help support you during this difficult time. Low cost, unlimited sessions are available.

5 Greenwood Ave Ringwood Vic 3134 Australia
03 9870 7044
Freecall outside Melbourne: 1800 647 995
or use our Contact Form to request an appointment or a call back, or to ask a question

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