Perinatal Depression and Anxiety

Perinatal Depression and Anxiety Awareness Week

12th – 18th November 2017

By Jennifer Smallridge, Accredited Exercise Physiologist

 

At Specialised Health, our Exercise Physiologists are frequently working with customers with a diagnosed mental illness such as depression, anxiety, PTSD or bipolar disorder. One less frequently encountered condition in the Life Insurance space is Perinatal Depression. In light of it being Perinatal Depression and Anxiety Awareness Week, we wanted to shine a light on this illness and provide some information about the profound effect it can have.

Over 100,000 Australian families are affected by perinatal anxiety and depression each year. PANDA – or Perinatal Anxiety and Depression Australia – exists to promote vital information and support mental health in the antenatal (during pregnancy) and postnatal (after pregnancy) periods.

Due to rapid changes in hormone levels, it is not uncommon for mothers to feel teary and overwhelmed in the three to five days after the birth of her child – up to 80% of women experience the phenomenon known as the ‘baby blues’ immediately after childbirth. The good news is, aided by reassurance and support, these symptoms generally do fade after a few days without treatment.

Signs and symptoms

Postnatal depression (PND) is characterised by a significant period of depression that comes on within the first 12 months of having a baby, and usually strikes within the first few weeks or months. It is most common after a woman’s first pregnancy, and although the severity can vary, symptoms include:

  • Feelings of low self esteem
  • Lack of confidence
  • Feelings of inadequacy and guilt
  • Feeling unable to cope
  • Difficulty sleeping, or sleeping too much

It is important to mention that around 3% of fathers also experience PND, and organisations such as PANDA can assist with both maternal and paternal changes in mental health.

Risk factors

 A large scale review1 of the literature has revealed some recurring risk factors for PND, listed below in order of their impact:

  • Depression and anxiety during pregnancy, which is then exacerbated after pregnancy
  • A personal history of depression
  • Perceived life stress
  • Lack of social support
  • Marital dissatisfaction
  • Low socio-economic status
  • A difficult or traumatic birth experience

 From the mother’s perspective

One study2 which looked into women’s beliefs and attitudes around treatment for PND revealed that the preferred treatment choice for most women was individual psychotherapy sessions. Interestingly, although the value of social support for this population is well established, the women surveyed did not perceive group psychotherapy to be a desired option – this may be as a result of concurrent anxiety or simply having too many scheduled appointments during this important time.

Much of the difficulty in managing PND is related to the stigma associated with asking for help, as it is socially accepted that having a baby is considered to be a joyous and positive life event. This attitude can further isolate a mother who is feeling depressed. A frequent barrier cited by PND sufferers to seeking help was around fear of being labelled a “bad mother”.

What can be done?

Research supports stigma reduction around this serious condition by shining a light on the subject – brochures and posters in waiting rooms, open conversations with obstetricians and GPs with clear referral pathways, routine screening, as well as the sharing of stories through groups, forums and ambassadors in the media.

Remember that the human brain is hard-wired for connection, and so a new mother feeling isolated and overwhelmed by her sadness requires strong social supports to counter this. The quote “it takes a village to raise a child” still rings true, and mothers who are striving to “do it all” may actually end up more susceptible to mental health issues.

If you are currently working with a customer who is suffering from PND, be sure to read our next instalment in the Specialised Health newsletter regarding the most up-to-date research and evidence based recommendations for engaging help for someone with PND.

References:

  1. Norhayati, M. N., Hazlina, N. N., Asrenee, A. R., & Emilin, W. W. (2015). Magnitude and risk factors for postpartum symptoms: a literature review. Journal of affective Disorders175, 34-52.
  2. Goodman, J. H. (2009). Women’s attitudes, preferences, and perceived barriers to treatment for perinatal depression. Birth36(1), 60-69.
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