The words postnatal, peripartum and postpartum are used interchangeably to describe the period of time around a pregnancy. Peripartum refers to the time during a pregnancy and the first six months following the birth. Throughout this timeframe, the early detection of depressive, manic, anxiety or even psychotic episodes is desirable to ensure that adequate treatment is provided in order to reduce and manage symptoms as soon as possible.
Depression in mothers and/or fathers has been shown through research to be associated with poorer emotional and behavioural outcomes in children years later.
According to Perinatal Anxiety & Depression Australia (PANDA), more than one in seven women and one in ten men will develop postnatal depression or anxiety.
These conditions can be both frightening and debilitating and can impact on your relationship with your baby. That's why it's important to know the signs and seek help immediately if you have any concerns.
Before discussing the signs and symptoms of the more serious perinatal mental health conditions, it's important to normalise the emotional changes that occur through the significant impact bringing a new baby into your family and home.
Having the 'Baby Blues' is a very common and normal experience for women to have in the days after giving birth. This is not a mental health disorder and is a very natural process. Here are some of the signs of the 'Baby Blues':
- The blues last for a few days only
- Onset within the first 5 days after delivery
- Mood swings
- The Bably Blues are completely normal
- They disappear quickly
The following are serious mental health conditions which require support and often treatment to reduce their impact on your family. At the end of the article you will find links to resources to read more about each of the conditions and find out where to seek help should you require it. Remember, your general practitioner is always the best first port of call to co-ordinate your care.
Please note, the following information comes from Beyond Blue and PANDA.
The symptoms of depression are the same regardless of whether someone is pregnant or not, it's just that they might be harder to identify following the birth of a child, because many of the symptoms of depression might also be caused by the changes that come with early parenthood. For example, changes in sleep patterns, exhaustion, changes in appetite, worries and adjustments to a new lifestyle can all provide a reasonable context to the symptoms of depression, making it harder to detect.
The key is to monitor the following signs and symptoms and if they are lasting longer than two weeks, it's probably time to ask for some help:
- Low mood
- Feeling as though you aren't doing a good enough job
- Crying a lot
- Feeling easily irritated and snappy
- Being worried about your baby's wellbeing or your capacity to care for it
- Fear of being alone
- Lacking interest in things you'd normally enjoy
- Sleep problems
- Changes to your appetite and diet
- Not coping
- Not caring for yourself
- Feeling tired all the time
- Feeling as though you can't concentrate or remember things
- Thinking about hurting yourself or your baby
If you think your partner or baby would be better off without you, or you are having thoughts of suicide or harming your baby, seek professional help immediately.
These symptoms can often be ignored because they develop over time. It's sometimes hard to know how much anxiety is too much, so if in doubt, talk to your doctor.
It's important to identify postnatal anxiety early, as it too can have an impact on your baby.
Here are some signs to look out for, particularly if any of them interfere with your day-to-day tasks:
- Overwhelming fears or worries that invade your thoughts
- Panic attacks
- Having a tight chest or racing heart
- Feeling on edge but not knowing why
- Difficulty relaxing or sleeping
- Constant worries about your pregnancy or baby
Beyond Blue has a checklist you can use to see if you are experiencing anxiety. Go to www.Beyondblue.org.au/checklist or call 1300 22 4636.
Perinatal Mania (Bipolar Disorder)
Bipolar Disorder involves periods of depressed mood and periods of mania or manic episodes. Women with a personal and/or family history of bipolar disorder should be observant of any changes to their mood throughout the pregnancy or after the baby is born. Manic symptoms may include:
- An increase in energy
- Elevated/high mood
- Racing thoughts
- A reduced need for sleep
- Talking rapidly
- Having difficulty focusing on one thing
- Feeling frustrated or irritable
- Unusual thoughts
- Unusual perceptions, for example, hearing things that might not really be there.
Postpartum/Postnatal Psychosis (Puerperal Psychosis)
This is a very rare, but very serious mental health condition that can affect around 1 in every 1,000 mothers. This condition comes with a very high risk that the mother may harm themselves or their baby and it requires urgent treatment which often comes in the form of close monitoring in a hospital environment.
This condition causes changes in a woman's usual behaviour within the first two weeks of giving birth, but can happen up to the first three months afterward. The symptoms are typically very distressing for both the woman and her family and friends.
The earlier symptoms are detected, the better.
Beyond Blue list the following common symptoms:
- Erratic, unusual or extreme behaviours that are out of character
- High energy, talking quickly, being unable to focus
- Appearing confused, forgetful or disorganised
- Not feeling the need for sleep
- Feeling strong, powerful, or invincible
- Beliefs or perceptions not based on reality
- Depressed episodes
Puerperal Psychosis is a medical emergency and a doctor should be contacted immediately.
Factors that Contribute to Perinatal Mental Health Issues:
- Having a history or family history of mental illness
- Previous fertility issues are a history of miscarriage
- Having a difficult pregnancy or labour
- Birth trauma
- Having a premature or sick baby
- Challenges with feeding or settling your baby
- Sleep deprivation
- Pre-existing physical illnesses
- Financial Stress
- Relationship Stress
Effective treatments are available for all of the conditions mentioned above and usually do not differ for the treatments available for women who are not pregnant, nor have recently had a child.
To read a personal account of post-partum depression you can follow this link to Diana Kirk's essay "Please Take the Baby."
Beyond Blue offer amazing free resources. You can find them at www.beyondblue.org.au/resources or by calling Beyond Blue on 1300 22 4636 in Australia.
PANDA also offer excellent free resources. You can find them at www.panda.org.au or call the PANDA National Helpline on 1300 726 306 in Australia.
Remember, early parenthood is a period full of adjustments. The signs and symptoms listed above are guidelines only but if you are concerned about anything be sure to discuss those concerns with your family doctor. There is no such thing as a silly question when it comes to your family. x