Perinatal Mental Health Information
Do you know the cost of Perinatal Anxiety and Depression (PNDA) is Australia?
Antenatal and postnatal depression are common conditions. One in seven mums and one in ten dads experience depression in the first two years after having a baby. One in 10 women experience depression during pregnancy.
Pregnancy and early parenthood are times of great change. It’s normal to feel emotional or overwhelmed from time to time, but if you are experiencing any of the symptoms below, it’s important to discuss them with your doctor or another health professional. Depression is an illness, and can be treated.
It is often very difficult for the person experiencing depression to recognise that they are unwell and reach out for help, so it helps for family and friends to be aware of the signs and symptoms as well.
Some of the symptoms that you may notice are:
- feeling empty/teary/exhausted/overwhelmed
- feeling guilty and inadequate
- diminished pleasure and/or interest in activities (particularly those that you used to enjoy)
- loss of confidence and self esteem
- inabilitly to cope
- sleep disturbance unrelated to baby’s needs
- negative obsessive thoughts
- change in appetite
- fear of being alone
- worrying about harming self or children
- wanting to be alone, withdrawing from social circle
- loss of concentration and memory
- difficulty with decision making
- crying for no reason
- being irritable and moody
- feeling negative all the time
- thoughts of suicide or wanting to escape
Other helpful organisations
Anxiety can be as equally as debilitating as depression but is often not recognised as a true illness, especially by parents themselves. New and expecting parents have often heard of postnatal depression, but are less aware of the risk of anxiety during pregnancy and early parenthood. Parents may delay seeking help, believing that because they are not feeling sad, the experience they are having must just be a normal part of parenthood.
It’s true that a certain amount of stress and worry is part of life, but if you are experiencing any of these symptoms, have a chat to your doctor or other health professional:
- feelings of fear and worry which begin to ‘take over’ your thinking
- feeling irritable, restless, tense or constantly ‘on edge’
- racing heart/strong pulpatations – sometimes panic attacks
- reoccurring worrying thoughts such as that you are not doing things right and/or that something terrible will happen
- unable to sleep – even when you have the opportunity
- avoiding situations for fear something bad will happen
(Source: Centre of Perinatal Excellence)
Often depression and anxiety go hand in hand, and both conditions need attention and treatment.
Other helpful organisations
Adjusting to fatherhood
Emotional struggles during pregnancy and parenthood are not exclusive to mothers. Dads can suffer too. In fact, they can feel just as helpless, confused, angry and overwhelmed as mums do!
Acknowledging this, Peach Tree ensures that dads’ health is an integrated part of our projects. Both our PEPP Talks and our documentary Because Parenthood Isn’t Always Peachy include sections to raise awareness about dads’ experiences, provide tools to help ease the adjustment and encourage dads to get support early on if they are struggling.
- How is Dad Going? – an initiative of Perinatal Anxiety and Depression Australia (PANDA)
- Adjusting to parenthood – information for dads from the Centre of Perintal Excellence (COPE)
- “Dave’s Therapy” – an initiative of BeyondBlue
Some great organisations supporting dads
Postpartum or puerperal psychosis is a rare perinatal mood disorder about which most new mothers know very little or nothing at all. Although it only affects a small number of women (between 1 in 1000 and 2 in 1000 of new mothers) the impact it has on these women and their families makes it an illness that expecting parents and the general public must be educated about. The time of onset is variable but is generally within the first six weeks after the baby is born.
The list of symptoms which characterise this illness is extensive and variable, but may include:
- delusional thinking
- grandiose ideas
- sudden strong religious beliefs
- insomnia and a reduced need for sleep
- erratic behaviour
- rapid/pressured thoughts and speech
Some, if not all, of these symptoms may mean little to the average person. Practically, the most important things for close family members to look out for are sudden, dramatic changes in an affected woman’s mood, personality, and/or thought processes. She may look and sound as though she has lost touch with reality. She may be convinced there is nothing wrong with her, which means the decision to seek treatment must lie with a close family member or friend.
Postpartum psychosis is a psychiatric emergency. Rapid medical assessment, preferably with a psychiatrist, or a GP who will recommend referral to a psychiatrist, is essential. Treatment includes antipsychotic medication and close monitoring. Hospitalisation is almost always necessary, and ideally should be in a mother/baby unit to preserve mother-baby bonding.
In Brisbane, the Brisbane Centre for Postnatal Disorders offers a specialised mother/baby unit at Belmont Private Hospital. The direct line phone number for the centre is (07) 3398 0238. Unfortunately, the public hospital system in Brisbane has only one mother/baby bed available. If hospitalisation is required, your psychiatrist will discuss the options available to you.
Thanks to the media’s tendency to only ever publish information about postnatal psychosis when it has ended in suicide and/or infanticide, many people’s perception of this illness is that it is incurable and almost invariably fatal for the mother and baby. This is false. Suicide is rare in cases of postpartum psychosis and infanticide is even rarer, especially if the illness is diagnosed and treated quickly, appropriately, and compassionately. With treatment and appropriate support, a psychotic episode can resolve within days or weeks and most patients return to normal functioning with the bond to their baby intact.
After a psychotic episode, the woman and her family may need psychological counselling to come to terms with what has happened to them. As with all mental illnesses, people often find that connecting with others who have had a similar experience is supportive, affirming and helpful in the process of recovery.
The content in this section has been kindly provided by Anita Link, who experienced postnatal psychosis with both her children.
Bipolar disorder (known in the past as “manic depression”) is a mental health condition characterised by periods of extreme low mood and periods of extreme elevated mood or “mania”.
If you have already been diagnosed with bipolar disorder, it is important to be aware that pregnancy and early parenthood are high risk times, and to work with your doctor to make sure your illness is appropriately managed.
Some women who have not been diagnosed experience their first episode of bipolar disorder during the perinatal period. Being familiar with the symptoms of the illness will help you recognise it and get help early if you need it. This is especially important if you have a family history of bipolar disorder.
Post traumatic stress disorder
For most women, giving birth is a wonderful, empowering and joyous event, but for some women this can be a frightening and anxious experience. Fortunately, most women are able to overcome their traumatic experience with minimal impact, and within a short time-frame, however, for some women it can be more difficult to recover from the emotional impact this may have and this is referred to as birth trauma.
Birth trauma is a reaction in response to a real or perceived traumatic event during child birth. It can be experienced by both women and men and needs to be discussed and acknowledged by your health professionals, GPs, midwives, obstetricians, lactation consultants, womens health physiotherapists, maternal child health nurses, to name a few.
Birth trauma is about an individual’s experiences and there are no specific events that must happen during childbirth for the woman or man to be traumatised.
All women are different; however some common feelings experienced during birth are:
- a loss of a sense of control
- not feeling heard by health professionals or support people
- feeling isolated and alone
- feeling anxious and afraid
- fearing for your baby and your own life.
Research suggests that many women, up to a third, describe their birth as traumatic, but quickly overcome this with good social and supports.
However, research suggests that up to 6% of women go on develop acute stress disorder or postpartum post-traumatic stress disorder (PPTSD) after child birth and these women may benefit from some additional professional mental health support.
Its very important we remember any person can be traumatized. Each of us has a threshold where we can cope with life’s difficulties without long term trauma symptoms. The more emotional and/or physical suffering people endure the more likely they are to surpass that threshold and develop symptoms consistent with trauma.
If you have a history of trauma, then you may be more vulnerable. Also, a history of mental ill-health can also be a risk factor. This does not however mean, you will be defiantly be traumatised by birth, it just makes you more vulnerable and helpful to know.
The content on this page has been kindly provided by Held – a program of The Australian Birth Trauma and PTSD Treatment Centre.
More information about symptoms, diagnosis and treatment is available from the Held website.