Perinatal Mental Health Explained

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What do I do if I feel sad and anxious about my baby?

Perinatal Anxiety and Depression Explained

Getting pregnant and having a baby can be an exciting and joyful experience. However, it can also be overwhelming. Having a baby is a big life change – it’s a lot of responsibility, you’re probably going to have less sleep, and pregnancy and birth can cause hormonal changes that can impact your mood.

Around 1 in 7 women experience anxiety and depression around the birth of their baby. Even though this is a common experience, many women feel ashamed or afraid of these emotions. This can make having a new baby a scary and isolating experience. 

If you’ve just had, or are about to have, a baby and you haven’t been feeling quite like yourself, then this information on perinatal anxiety and depression might be helpful to you. This information could also be helpful for people supporting a new mum.

What is Perinatal Anxiety and Depression?

Perinatal anxiety and depression are feelings of worry, fear, dread, sadness, and doubt that begin during pregnancy or just after having the baby.

Most people experience these emotions at some point around giving birth – having a baby can be exciting, overwhelming, happy, and terrifying all at once! For some people however, these emotions can become persistent and intense, preventing people from enjoying this special time.  

Depression is characterised by long-lasting low mood, low energy, and low motivation. Anxiety, on the other hand, is characterised by excessive and persistent worrying. These conditions can impact people’s physical, emotional, and social well-being, from their sleep, to their concentration, to their ability to stay calm and communicate clearly. As a result, they can also impact women’s confidence in their ability to be a good mum. 

In rare cases, some women can experience postpartum psychosis after giving birth. Postpartum psychosis is very different from perinatal anxiety and depression – it involves hallucinations, delusional and paranoid thinking, and confusion. Postpartum psychosis is a medical emergency. If you are worried that you or someone you know is experiencing postpartum psychosis, contact emergency services immediately.

What Are The Signs of Perinatal Anxiety and Depression?

Anxiety Symptoms

  • Worrying about bad things that are unlikely to happen.
  • Muscle tension.
  • Difficulty thinking clearly.
  • Feeling persistently irritable and 'on edge'.
  • Difficulty relaxing.
  • Repeatedly asking friends, family or doctors for reassurance.

Depression Symptoms

Any of these features may serve as warning signs of depression or anxiety. Remember, only a qualified mental health professional can diagnose depression or anxiety following a thorough assessment of your personal situation and circumstances. If you’re concerned about the way you’ve been feeling, please don’t delay speaking with your regular healthcare provider or check out our anonymous online test below and see if one of our online courses could help.

What Causes Perinatal Anxiety and Depression?

There isn’t one specific thing that causes anxiety and depression. In fact, anxiety and depression are most likely caused by a combination of factors.

There’s good evidence that genes play an important role here. These disorders run in families and having a parent or sibling with a mental health disorder can increase your risk of having anxiety or depression.

Stress can also play a part in the development of perinatal anxiety and depression. You might be juggling medical appointments, work commitments, and changes in your relationships all at once, which can understandably leave you feeling overwhelmed.

Previous mental health difficulties can also be a risk factor. For example, you’re more likely to experience post-natal depression if you have had it before, or if you’ve had a traumatic birth experience.

Your personality structure can also influence how you feel. For example, being self-critical or perfectionistic, setting high standards for yourself can increase your risk of developing anxiety and depression.

Anxiety can also cause depression to develop, and vice versa. Constantly worried can leave you feeling tired and unmotivated. Likewise, people with depression often think negatively, which can trigger worry and anxiety.

How To Deal With Perinatal Anxiety and Depression

Effective treatments for health anxiety are available, including Psychoeducation, Cognitive Behavioural Therapy (CBT), and medication.

Psychoeducation refers to learning about how anxiety and depression develop, and what keeps them going. This kind of information is extremely valuable – it can help women understand that what they’re going through is understandable and treatable (and not a sign of being a bad mother).

Partners, friends, and family can also benefit from learning about anxiety and depression. Having this knowledge base can help them understand what the person might be going through and provide them with appropriate support.

The most important pieces of information for mum-to-be or new mum are:

  • Perinatal anxiety and depression are very common.
  • Feelings of sadness, guilt, dread, worry, and anxiety are very normal, and not a sign that you’re ‘going crazy’ or ‘a bad mum’.
  • It’s okay to have frightening or upsetting thoughts about your baby sometimes. Having a thought is not the same as acting on that thought.
  • Effective treatments for anxiety and depression are available, and there is a suitable treatment for most people.
  • Recovery is the exception, not the rule.

CBT is the recommended treatment for perinatal anxiety and depression. CBT involves learning skills to:

  • Combat the negative and unhelpful thoughts that contribute to anxiety and depression.
  • Shift any unhelpful behaviours that might be maintaining anxiety and depression.
  • Manage the emotions of sadness, anxiety, and dread, so that you can enjoy this special time.

Some perinatal CBT courses also teach people assertive communication and self-care skills. CBT will often be recommended when:

  • The person has found CBT helpful in the past.
  • The person wants to take an active role in their recovery.
  • The person wants to learn skills to help them get well and stay well.
  • A competent, trained clinician who has expertise in CBT is available, or the person is prepared to use internet CBT (iCBT).
  • The person does not want to take medication or there is a medical reason that they cannot take antidepressant medications.
  • The person prefers CBT or iCBT.

Perinatal anxiety and depression can sometimes be treated with psychiatric medications called antidepressants. Antidepressants might be recommended for women with severe anxiety or depression, or who have experienced mental health problems in the past. Although birth defects from antidepressants are rare, some can have side-effects. Pregnant and breast-feeding women should work closely with their doctor, who can provide advice and support based on your personal circumstances.

Some things to remember when taking these medications are:

  • Don’t start taking these medications without talking to your doctor about pregnancy and breastfeeding.
  • Take the medication as prescribed.
  • Don’t stop the medication without contacting the health professional who prescribed it.
  • Side effects lessen as your body adjusts. If the side effects don’t diminish, or are unreasonable, contact your health professional.

What is CBT?

Cognitive Behavioural Therapy for Perinatal Anxiety and Depression

Cognitive Behavioural Therapy or CBT is considered to be one of the leading psychological treatments for depression. All of our online courses use CBT strategies to help ease symptoms of anxiety and depression. Click below to see if CBT can help you tackle your symptoms to improve the way you feel.

Coping with Symptoms of Perinatal Anxiety and Depression

Sometimes, just a few small changes can have a significant impact on how you feel. See if any of the below strategies work for you.

  • Get up at the same time every morning.
  • Avoid sleeping for too long during the day.
  • Don’t lie awake in bed for more than about thirty minutes—get up and find a relaxing activity.
  • Be kind to yourself, and acknowledge that you’ll probably be more tired and grumpy than usual if the baby isn’t sleeping well.
  • Make sure to do at least one enjoyable or restorative activity each day.
  • Recruit people to help you look after the baby, so that you can have some time off to re-fuel.
  • Schedule rest and relaxation into your week (e.g. 10 minutes each day, or every Friday night).
  • Try to eat well and drink plenty of fluids.
  • Treat yourself with small luxuries, like a warm bath, warm pyjamas fresh out of the dryer, or your favourite meal.
  • Monitor your well-being and ask for more support if your mood or energy dip too low. Don’t push yourself too hard, this is a marathon, not a sprint.
  • Ask the right person for the job (some people are better for advice; others are better for care and support).
  • Clearly state what you need, whether it’s practical support, someone just to listen to you, or a hug. Don’t expect the other person to ‘just know’ what you want or need.

Interested in learning more?

The Perinatal Anxiety and Depression Courses

Check out our practical, self-paced online course that teaches step-by-step strategies for tackling symptoms of depression.