Perinatal Anxiety and Depression
Pregnancy, childbirth and parenthood are exciting and special human experiences. However, it can be difficult to adjust to the pressures associated with these life-changing events. For those that have good supports, helpful family and friends and the good fortune of placid newborn this adjustment is made much easier. However, for some a difficult adjustment can turn to despair, anxiety and depression.
80 % of women will experience anxious and depressive symptoms shortly after giving birth. Commonly referred to as “the baby blues”, you may be teary, despondent and feel inadequate to care for your baby. These feelings are short-lived by most, but for a sizeable proportion of women they persist.
Up to 20% of women and 10% of men will experience perinatal anxiety or depression.
Depression is typified by one or more of the following symptoms and behaviours that persist for more than 2 weeks, can occur at any time during pregnancy and up to a year after delivery, and interferes with your normal function and relationships:
- Depressed mood and persistently negative thoughts
- Loss of interests or a sense of indifference or feeling numb
- Difficulty concentrating, remembering things or getting things done Irritability, agitation or a “short fuse”
- Feeling out-of-control
- Feelings of guilt, shame, anger, inadequacy or hopelessness
- Thoughts of harming oneself or the baby
- Extreme lethargy and tiredness a lot of the time
- Teary and upset a lot of the time
- Social withdrawal
- Sleeping problems; difficulty going to sleep or waking early
- Change in appetite, weight gain or loss
- Palpitations, headaches, sweaty hands
Anxious thoughts to some degree are a normal part of everyone’s life, however an anxiety disorder involves a persistent impairment of one’s normal function, relationships and work and may present in the following ways;
- Generalized anxiety
- Panic attacks
Anxiety and anxious behaviours in this case may be considered excessive or irrational to someone impartial.
These feelings should be taken extremely seriously, especially where they persist beyond two weeks an occur on a daily basis. It is a desperately sad fact that perinatal anxiety and depression are the leading causes of maternal mortality in the developed world. A parent in this state may lose hope and perspective, and this is a dangerous combination.
Several factors put people at higher risk of developing perinatal anxiety and depression including:
- Past mental health illness including past perinatal depression/anxiety
- Perfectionist and vulnerable personality type
- Recent big life changes; financial pressure, loss of work, bereavement
- Emotional stresses; estranged family or strained relationships
- Social isolation: rural women, migrants and refugees
- Domestic violence
- History of physical or sexual abuse
- Difficult birth
During and after pregnancy it is recommended to screen women for anxiety and depression. The Edinborough Post-Natal Depression Questionnaire produces a score (EDPS) that estimates your risk of being depressed. It is not diagnostic, but a screening tool. About 70% of women that screen positive to this questionnaire will be diagnosed with perinatal depression, so it is a reasonable screening tool. Equally however it is not 100% accurate and some people may screen negatively but still have depression. This is why a medical professional must be sensitive to these conditions and revisit screening on multiple occasions during and after pregnancy.
There are effective ways to treat perinatal anxiety and depression and they include a range of counseling modalities through to psychiatric and medical treatments. Your doctor is trained to help facilitate this where they can play a central role in directing you towards effective treatments that are appropriate given your conditions and circumstances.
There is no shame in seeking and receiving help for anxiety or depression as it shows you care about your pregnancy, baby, family, friends and yourself. That makes you a decent and caring person.
People do find their way through perinatal anxiety and depression. It is important to hold onto this fact during recovery.
The following helpful links are provided for your assistance in understanding more about perinatal anxiety and depression and the supports available to parents experiencing these conditions.
Life should be enjoyed.