What does perinatal mean?
Perinatal is a term used for the time when a woman is preconception planning or from conception up to 24 months following the birth of their baby.
What is perinatal depression and anxiety and who does it affect?
Perinatal Depression and or Anxiety (PNDA) can happen before or following the birth of a baby and affects about one in five women and one in fifteen dads. Commonly, women and men experience a combination of Depression and Anxiety together. Parents can experience low level or moderate signs and symptoms, through to a diagnosable mental illness where professional support and intervention is essential, to treat the illness and recover. Women are more at risk of developing a mental illness in the perinatal period than at any other time in their life, due to a combination of factors including hormonal changes, birth trauma, other acquired illnesses and the adjustment to becoming a parent. Men are also more vulnerable to developing mental health problems or illness in the perinatal period and particularly if their partner becomes unwell.
For people who have experienced mental health problems or illness in the past prior to having a baby, it is important to be aware of the possible return of similar signs and symptoms and know where they can seek support. For those who have already experienced long-term mental illness like clinical depression and plan to have a baby, specialist medical support is required to plan treatment during the pregnancy, delivery and following the baby’s birth, to ensure mum and or dad can remain as well as possible. Specialist health professional input is also necessary when considering if a mum needs medication to support recovery during pregnancy and if she wants to breastfeed once her baby is born. Perinatal Depression and Anxiety are very treatable illnesses and most parents recover with no long-term issues. Most importantly, early identification and treatment of perinatal mental health signs and symptoms will prevent problems from developing into longer term illness. Evidence-based treatments with good success for recovery include anti-depressant medications, and talking therapies including Cognitive Behavioural, Interpersonal and Acceptance and Commitment therapy.
What are some signs people can look out for?
For most people, there is a noticeable change in their normal mood for a period of two weeks or more while pregnant or in the first month following the birth of a baby. They can feel quite unlike their normal selves, sad, and low, or very worried with most of their time taken up by the worry. These symptoms are worse than the “baby blues” and last longer. Most people have trouble with the same “ruminating” thoughts (thoughts going around and around in their head) and these thoughts have a negative/catastrophic or “worst case scenario” tone to them. Most people notice a significant change in their sleep and eating routines, either too much or too little or also significant changes to their normal energy levels. People may “withdraw” into themselves, reduce contact with others and become socially isolated. A lot of people describe feeling very “stuck” with their thoughts and feelings and are so pre-occupied with them they cannot do the normal day to day living tasks as they used to.
Where can help be sought for PNDA?
Your General Practitioner (G.P.) is a great point of contact and very helpful in referring people to local and specialist services that provide early intervention, treatment, and support. Hospital Social Workers and Maternity and Child Health Services can also provide referrals to mental health services. There are also some incredibly helpful national services that offer over the phone counselling and support, information and referral to local services including:
- Perinatal Anxiety and Depression Australia (PANDA) Mon-Fri 9am-7.30pm, 1300 726 306
- beyondblue support service 24hrs/7days, 1300 22 4636
- Queensland Parentline, 8am-10pm 7 days/week, 1300 30 1300
- Pregnancy and Counselling Link, 1800 777 690, Mon-Fri 9am-5pm
- MumSpace online program, https://www.mumspace.com.au
These services are very helpful for all expecting and new parents at any time, but particularly in the middle of the night, when things can sometimes go pear-shaped for new parents.
How can PNDA affect the mental health of children and the relationship between parent and their baby? Mental Health problems and mental illness make it extremely difficult for parents to carry out their normal routine daily tasks or function in their life roles due to severe lack of sleep, or not being able to get out of bed, low energy and motivation, and poor nutrition. Parents can also find their ability to organise their day, think through issues, problem solve in positive ways, focus and concentrate can also be significantly harder than normal. A very small number of parents may become so unwell that they need hospitalisation, to receive specialist medical and psychological treatment that will support their recovery. These signs and symptoms can make it hard to look after a baby and a parent’s mental health difficulties can result in them as experiencing their relationship with their baby as stressful. Parents can still develop good relationships with their babies while experiencing mental health problems or illness, but some may need professional help and other supports to do this.
Why is it essential to look after the mental health of children?
Babies brain connections start forming in the uterus and develop more quickly in the first 12 months of life than at any other time. Babies are very social and need their parents to respond in kind, loving, caring and predictable ways over countless moments in a day to promote their brain connections that enable them to develop skills like sucking, feeding, speech, movement, etc. Babies also need repetitive experiences of routine, comfort when they are upset to feel safe and secure, to be talked to, and to have their caregivers support appropriate exploration of their environment so they can develop a sense of trust in people close to them. A secure trusting relationship with parents and other close caregivers like grandparents is the essence of good emotional (mental) health and wellbeing which enables a child’s positive development. This positive start also significantly reduces babies’ risk of developing mental health problems and illness in their future. Good mental health and wellbeing also promotes resilience in children to cope with life’s future ups and downs.
Here are 4 or more tips for parents to ensure their baby’s mental health is looked after during a period of PNDA?
- Seek help and take care of yourself: when parents have the right supports to look after themselves and their emotional/psychological needs they are in a much better position to parent positively and care for their baby’s needs.
- Finding time to connect one on one with your baby during the day: Little moments can add up to a lot over time so it’s important for parents experiencing PNDA to try and find small amounts of time where they can try and connect with their baby whether it’s by looking at a baby book together, bathing their baby with their partner, taking the baby for a walk in the pram or singing them a nursery rhyme while changing their nappy.
- Enlist the support of other helpful people: If caring for your baby is a real struggle it’s important to ask for help from trusted family members or friends who will listen to you and support you to provide care for your baby that is nurturing and consistent or take this responsibility on for a while if you’re not able to because of your illness. Support from a mental health professional such as a Psychologist can also be very helpful and speed up the recovery process.
- Develop social connections: Social isolation is a big risk factor for mental health problems. Social supports are one of the biggest factors contributing to people’s recovery and important for babies’ mental wellbeing. Small regular amounts of time with other parents and babies is good for your babies’ wellbeing whether it’s through a PNDA support group, mum’s groups, or at community groups like baby rhyme-time groups at your local library.
What can instill hope about the journey to PNDA recovery for parent and child?
Perinatal mental illness is very treatable and there are health professionals and support groups out there ready to provide the help you need to recover and enjoy your family. You are not alone and speaking about out early signs and symptoms to a friend, your partner, or your doctor can go a long way to protecting your own and your family’s mental wellbeing. There are some great websites to help you understand and build your babies emotional wellbeing including: