The journey into parenthood can be both exciting and challenging. Seeing your little baby grow and develop during scans, bringing your new bundle of joy home, and getting to know each other, all bring an array of thoughts and feelings for parents. It can be an extremely vulnerable time for new parents, as thoughts and feelings are not always positive.
This week was PANDA (Perinatal Anxiety and Depression Australia) Awareness Week, I wanted to provide a bit of information about depression and anxiety during pregnancy and early parenthood. PANDA has a fantastic website, with a lot of resources and tip sheets which is where most of this info has been sourced. If you’re looking for more info head over to PANDA’s website.
It is important to know that both men and women can experience anxiety and/or depression during pregnancy and/or early parenthood. I would like to strongly point out that this does not in any way suggest you are a ‘bad or disengaged parent’. But seeking assistance early is important to ensure you can return to feeling yourself again and be the parent you want to be.
It is not uncommon for new Mums to experience ‘Baby blues’ in the first few days of their new baby’s life. Symptoms include teariness, anxiety, or irritability. So, what’s the difference between common baby blues and depression/anxiety? The symptoms of baby blues will resolve in a few days, whereas symptoms for anxiety or depression during pregnancy and early parenthood persist for weeks or months (depending on severity and treatment). For this reason, baby blues are not considered a mental health concern.
Antenatal Depression & Anxiety
This refers to anxiety and depression that occurs during pregnancy. Up to 1 in 10 women and 1 in 20 men experience antenatal depression. Antenatal anxiety is just as common, many parents experience depression AND anxiety at the same time.
Signs and Symptoms can include:
- Panic attacks: racing heart, palpitations, shortness of breath or shaking
- Persistent worry: this is often focussed on fears around the health or wellbeing of the baby and/or family unit
- Development of obsessive or compulsive behaviours
- Abrupt mood swings
- Feeling constantly low, sad, or crying for no obvious reason
- Feeling nervous, ‘on edge’, or panicky
- Feeling constantly tired and lacking energy
- Having little or no interest in things that normally bring you joy (like spending time with friends, exercise, or time with your partner)
- Sleeping too much or not sleeping very well at all (sleep is tricky with a little one, but this is relating to your own ability to fall asleep, stay asleep, quality of sleep, etc)
- Losing interest in sex or intimacy
- Withdrawing from friends and family
- Being easily annoyed or irritated
- Finding it difficult to focus, concentrate or remember
- Engaging in more risk-taking behaviour (alcohol or drug use)
- Having thoughts of death or suicide
*If symptoms persist for longer than 2 weeks, seek support
Postnatal Depression & Anxiety
This refers to depression and anxiety that begins in the year after birth. Each year in Australia, more than 1 in 7 new Mums and up to 1 in 10 new Dads experience postnatal depression. Postnatal anxiety is just as common, many parents experience both depression and anxiety at the same time.
Signs and symptoms include:
- Panic attacks: racing heart, palpitations, shortness of breath, shaking, feeling ‘detached’ from your surroundings
- Persistent, generalised worry: this worry often focusses on fears for the health and/or wellbeing of baby or the family unit
- Development of obsessive or compulsive behaviours
- Increased sensitivity to noise or touch
- Changes in appetite: under or overeating
- Sleep problems unrelated to the baby’s needs
- Extreme lethargy
- Feeling of being physically or emotionally overwhelmed and unable to cope with the demands of chores and looking after the baby
- Memory problems or loss of concentration
- Loss of confidence
- Lowered self esteem
- Constant sadness or crying
- Withdrawal from friends and family
- Fear of being alone with baby
- Intrusive thoughts of harm to yourself or baby
- Irritability and/or anger
- Increased alcohol or drug use
- Loss of interest in previously enjoyed activities
- Thoughts of death or suicide
*If symptoms last longer than 2 weeks, seek support
Also known as Puerperal or postpartum psychosis, is a form of acute mental illness usually seen in the first 4 weeks after giving birth but may occur up to 12 weeks post birth.
Postnatal Psychosis is relatively rare affecting 1-2 in every 1,000 women. It is a serious and potentially life-threatening condition that puts both mother and baby at risk.
Prompt diagnosis is vital as women with postnatal psychosis usually require admission to hospital for specialised psychiatric assessment and treatment. The good news is women generally make a full recovery given the appropriate treatment and support.
Signs and symptoms:
- Extreme sudden mood swings, from very high to very low
- Aggressive or even violent behaviour
- A high level of agitation
- Irrational or delusional thoughts or beliefs, which may include irrational beliefs or thoughts about the baby
- Hallucinations and changes in senses: such as smelling, hearing, or seeing things that are not actually there
- Paranoid or strange beliefs about the baby that cannot be countered by rational discussion
- Unrealistic beliefs about your own abilities as a mother
- Unusual or inappropriate responses to the baby
- Thoughts and conversations may be disordered or nonsensical
Factors that Contribute to Perinatal Depression & Anxiety
There are a number of factors that can contribute to developing perinatal depression and anxiety. It is important to note that if you have experienced one or more of these factors, it does not mean that you will develop perinatal depression and anxiety:
- History of depression and anxiety
- Family history of mental illness
- Previous reproductive loss (infertility, IVF, miscarriage, termination, stillbirth, death of a baby)
- Difficult or complex pregnancy
- Birth trauma
- Premature or sick baby
- Challenges with feeding or settling
- Sleep deprivation
- Pre-existing physical illnesses
- Financial stress
- Relationship stress
- Family violence
- Lack of social support
- History of childhood trauma or neglect
- Isolation and lack of social connections
- Loss and grief issues
- Absence of your own mother or mothering figure
Wellbeing and Self Care
Once you have a lovely little baby in your life, it is difficult to balance caring for your little bundle of joy, your family, and yourself. As a parent, you look after your child/ren, providing nutrition, exercise, opportunity to develop, warmth, comfort, etc. Your own health and wellbeing are just as important! Sometimes, we need to remember to prioritise our own health and wellbeing to ensure we can be the parent we want and need to be for our child/ren.
Here are a few basics of self-care that directly relate to wellbeing to encourage you to think about what you can do to improve your own self-care and overall wellbeing.
Granted I’m a certified sleep consultant, I want to put that aside for the time being and talk about YOUR sleep.
Sleep hygiene refers to the habits you maintain to promote sleep. I understand that as new parents, you will likely be experiencing fragmented or poor sleep due to the demands of your baby. But I want to discuss some factors you can incorporate in your day to give you the best chance at restful sleep when the opportunity arises; such as between feeds, when your partner is able to take over, when your little one is sleeping etc.
- Avoid cigarettes and alcohol
- Limit caffeine intake after 4:00
- Make your bedroom a restful, relaxing environment without screens
- Avoid screen time or other stimulating activity just before bed
- Try a warm bath or shower a couple of hours prior to going to bed
- If you can’t sleep, get up and do something quiet (such as read) in another room and try again when you feel tired
- Try some relaxation exercises – music, guided meditation, etc via YouTube
Our diet directly influences our mood, energy levels, and our overall health and wellbeing. The old saying ‘you are what you eat’ still rings true. Our diets also directly affect our mental health with research suggesting people who follow a healthy diet (complete with lots of fresh fruits and vegetables), are less likely to experience depression.
Due to the time restraints, hormonal and mood changes, and alterations to sleep patterns, the diet and appetite of new parents are often directly affected. Your appetite can increase or completely diminish. Try to put some effort into planning your meals ahead of time so you have healthy options available to you when you are time poor.
If your appetite is low, try having more frequent, small but substantial meals across the day including high-protein ingredients such as yogurt, nuts, eggs, lean meats, fish – such as salmon, to keep your energy levels up.
Making sure you stay hydrated (particularly if breastfeeding) is also vital. Carry a water bottle with you and have it handy when you are at home and out and about.
Research shows that exercise has many benefits to our health and wellbeing. These benefits are not only physical, exercise also improves your mental health. Exercise makes us feel good because it stimulates the release of endorphins and serotonin (hormones that contribute to improved mood and wellbeing) in the brain.
As well as this physiological benefit, exercise can also get you out of the house and has an added bonus of socialising if you choose to exercise with other people. This reduces loneliness and isolation which can become a big issue for new parents.
The good news with exercise is that it doesn’t need to consist of strenuous forms of activity, gentle exercise, such as walking, swimming or yoga, are just as beneficial and a great way to introduce exercise back into your lifestyle post baby. You are able to involve your little one if you choose an activity like walking or a structured ‘Mum’s/Dad’s and Bub’s class.
Some Mum’s experience issues with their pelvic floor function post childbirth but don’t let this stop you from participating in exercise. If you have concerns, contact a local physiotherapist who specialises in women’s health. Your GP or MCHN can help you to source a local physiotherapist if you’re not sure where to go.
Sometimes when I recommend having ‘me time’ or ‘time out’ people tend to raise their eyebrows or start to question what kind of parent they would be if they dared take time out from their baby or family. I want to stress that ‘me time’ is very different for everyone.
I do encourage parents to take time out away from their baby (even a few minutes) for themselves to recharge their own batteries as I feel this is extremely important. Me time allows you to relax, restore, and recharge, which better prepares you mentally for the everyday stresses of parenthood.
Have a chat with your partner about what this would look for you, think about the type of activities you participated in to wind down or relax prior to having children. How can you recreate or reconnect with this activity that will fit in with the lifestyle of your family?
Could Dad come home from work and take baby out for a walk while Mum has a cup of a tea and reads a chapter of a book/listens to music/catches up on an episode of her favourite show? Could the whole family participate in an evening walk together to ensure everyone gets out of the house? Some more ideas include:
- Returning to a group or class
- Returning to a previous hobby or sport
- Catching up with family or friends
- Going for a massage
- Getting coffee from your favourite cafe
It is so easy to get caught up in the routine of nappy changes, establishing feeding, keeping up with the washing, remembering to eat yourself, and feel you are isolated in your routine and ‘trapped’ at home. The amount of preferred social contact with family and friends differs from person to person but it’s important to remain connected during early parenthood. This may be via phone calls, social media, email, or face-to-face contact with family and friends.
There are a number of ways you can develop new connections with other parents, such as in your local mother’s group organised through the MCHN centres. There are local Storytime or playgroup sessions run through your local council, or you can look up a local group on social media and see if parents organise catch ups in your local area.
It’s very normal to experience a range of thoughts and feelings during pregnancy and early parenthood. It’s important that you help yourself by making sure you look after your mental health by maintaining good self-care habits.
If you are concerned about yourself or a loved one, it’s important you seek support from your partner, trusted friend or family member, or a health professional. There are several support groups you can link in to via your GP, MCHN, or the PANDA Helpline.
It is often comforting to know that having perinatal depression and anxiety is not a reflection on your ability to be a parent, and you are not alone. You don’t have to suffer in silence or go through this alone, support is available to you and getting help early leads to a faster recovery.