Having a baby is exciting and challenging and can raise many positive and negative feelings and thoughts. Feeling anxious or depressed during this period can make it difficult to cope and leave you feeling like you are not a good enough parent. An expectant, or new mother or father can easily feel shame or guilt around having negative feelings at this time and that can get in the way of seeking help. The reality is many parents feel similar thoughts and feelings. Getting help as early as possible can lead to a faster recovery and lessen the impact on your baby, your partner and yourself.

No-one can quite prepare a new mother for the rollercoaster ride of pregnancy, childbirth and motherhood. From coping with the physical changes in your body and your view of your sexuality and identity, to hormone fluctuations, physical exhaustion and the emotional highs and lows of motherhood. A new mother faces all of this within herself whilst caring for her newborn and all that that entails alongside managing the changing dynamics of her close relationships.

For an expectant father the impending arrival of a baby is a major adjustment to their life and gives rise to many powerful and conflicting emotions. The dynamics of his relationship with his partner adjusts when the newborn when it arrives and a man can struggle with finding how he fits into things. Added to this is coping with physical and mental exhaustion whilst feeling the pressure and expectations of providing for his family.

Given all of this it is understandable that so many new mums and dads experience mental health problems during the perinatal period (defined as from conception to one year old baby).

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Antenatal Anxiety and Depression

Anxiety or depression during pregnancy is referred to as antenatal anxiety or antenatal depression. Current figures indicate up to 1 in 10 women and 1 in 20 men experience antenatal depression. Anxiety is recognised to be as common and most parents experience both at the same time.

It’s quite usual to feel anxious or low at this significant stage of your life. However feelings of anxiety or depression can begin to affect your capacity to function day-to-day and if symptoms last for more than two weeks its time to seek help and support.

Symptoms may include:

• Panic attacks (a racing heart, shortness of breath, shaking, dry mouth, sweaty palms feeling cut off from things)
• Persistent worries often focused on fears for the safety or wellbeing of your baby
• Recently developed compulsive thoughts or behaviours
• Sudden mood swings or becoming easily angry or irritable
• Feeling nervous, anxious or on edge
• Unable to stop or control your worrying
• Feeling sad, down, depressed or hopeless or crying for no reason
• Feeling tired and lacking energy
• Unable to take enjoy activities that you used to (such as socialising, exercise or time with your partner)
• Your sleep has recently been affected too much, or too little
• Lost interest in sex or intimacy
• Withdrawing from those around you
• Lack of ability to focus or concentrate (brain fog)
• Engaging in risky behaviours (such as alcohol or drug use)
• Having thoughts of harming yourself or others

Postnatal Anxiety or Depression

Most women experience the baby blues (teariness, anxiety or irritability) following the trauma of birth and whilst adjusting to the changes within their body and in caring for her baby this is normal and usually passes after a week.

Anxiety or depression in the first year after birth is referred to as postnatal anxiety or postnatal depression. In Australia more than 1 in 7 new mothers and 1 in 10 new fathers experience postnatal depression. Postnatal anxiety and depression can feel frightening and overwhelming and arrives at a point when parents are coping with the demands of their baby. If your symptoms last for more than two weeks it could be helpful to seek professional advice and support.

Symptoms may include:

• Panic attacks (a racing heart, shortness of breath, shaking, dry mouth, sweaty palms feeling cut off from things)
• Persistent worries often focused on fears for the safety or wellbeing of your baby
• Recently developed compulsive thoughts or behaviours
• Feeling sad, down, depressed or hopeless or crying for no reason
• Extreme lethargy feeling overwhelmed and unable to cope with the demands of
• Memory problems or lack of concentration (brain fog)
• Loss of confidence and low self-esteem
• Fears of being alone with the baby
• Intrusive thoughts of harm to yourself or your baby
• Sudden mood swings or becoming easily angry or irritable
• Feeling nervous, anxious or on edge
• Unable to stop or control your worrying
• Engaging in risky behaviours (such as alcohol or drug use)
• Your sleep has recently been affected, too much or too little, unrelated to your babies needs
• Lost interest in sex or intimacy
• Withdrawing from those around you
• Having thoughts of harming yourself or others

If we take the perinatal period as a whole, from conception to one-year old baby, the current figures are 1 in 5 women are affected by anxiety and depression at the perinatal stage. Figures following women from conception to a four year old child indicate as many as 1 in 3 women experience depression during this period in Australia.

Overall 100,000 new parents in Australia each year are affected by ante or postnatal depression. This indicates major depression is the may be one of the common major complications of pregnancy.

Factors that contribute to perinatal anxiety & depression

• Previous history of anxiety or depression
• Family history of mental health problems
• Previous reproductive loss (infertility, IVF, miscarriage, termination, stillbirth, death of baby)
• Complex or difficult pregnancy
• Traumatic birth
• Premature or sick baby
• Difficulties with feeding/settling
• Financial or relationship stress
• Domestic violence
• Lack of social support
• History of childhood trauma or neglect
• Social isolation
• Loss or unresolved grief

Given the prevalence of these mental health problems there still exists stigma for a parent in coming forward to access the emotional and psychological help that they may need. Social media, advertising, marketing portray an idealised image of parenthood yet each new parent’s experience is individual and unique. Parent’s can compare their journey to this idealised image and find themselves lacking and become self-critical feeling they are not good enough or a bad parent. Added to this is the impact of the nuclear family which can leave parents feeling quite isolated and unable to access support.

I am a father and an experienced therapist who has provided many perinatal women and men with individual psychodynamic therapy often within a brief framework.

Psychodynamic therapy is a ‘talking therapy’ treatment which may help promote your mental health and sense of wellbeing. In your sessions I will empathically encourage exploration of your emotional experience (past and present), your experience of being pregnant or of your baby and your patterns of relating and behaviour within your relationships. The aim is to develop your self-awareness and emotional insight which may enable behavioural change and help promote sustained growth.

Related links

Shot of mother and newborn goes viral sparking debate on perinatal mental health

≠Badassundies: Australian mother poses on facebook to silence body shamers

References

Deloitte Access Economics. (2012) The cost of perinatal depression in Australia. Report. Post and Antenatal Depression Association

Gavin, N.I., Gaynes, B.N., Lohr, K.N., Meltzer-Brody, S., Gartlehner, G., and Swinson, T. (2005) Perinatal depression: a systematic review of prevalence and incidence. Obstet. Gynecol. 106: 1071–1083

Oates, M (2000) Perinatal Maternal Mental Health Services Council Report CR88. Royal College of Psychiatrists

Paulson, J. F. & Bazemore, S. D. (2010). Prenatal and postpartum depression in fathers and its association with maternal depression: A meta-analysis. JAMA, 303(19), 1961-1969. (doi:10.1001/jama.2010.605)