New mothers and fathers naturally expect the time around childbirth to be a very happy time. However, it is a time of great change in our lives, and there can be a range of emotions from happiness and excitement to sadness and worry.

You have probably heard of or experienced the “baby blues”, which women commonly experience a few days after the birth, often related to tiredness and hormonal change. The blues may trigger tearfulness and irritability, and they settle within a couple of weeks.

Up to 1 in 10 expecting mums and 1 in 20 expecting dads struggle with antenatal depression, whilst more than 1 in 7 new mums and up to 1 in 20 new dads are diagnosed with postnatal depression each year in Australia. And 40 per cent of new mums diagnosed with postnatal depression three months post birth, first experienced symptoms during pregnancy.

However, significant anxiety and depression can also develop after birth. Postnatal Depression (PND) and anxiety occurs in up to 10–20% of all women during the first year after childbirth and also 10% of men. PND describes the more severe or prolonged symptoms of depression that last more than a couple of weeks and interfere with the ability to do daily tasks, or to relate to the baby or others. It often goes hand in hand with anxiety.

Causes of postnatal depression and anxiety

Postnatal Depression develops because of biological, psychological and social factors. It is important to rule out medical causes of symptoms similar to PND, such as low thyroid hormone or anemia. Biological factors might also include a genetic vulnerability to depression (is there a family history?), previous episodes of depression, and hormone fluctuations during and after pregnancy.

Childbirth and becoming a parent involves change and stress, probably the most significant you may ever experience. Plus sometimes there can be other stresses such as financial stress, relationship stress or even grief around the same time. There may be lack of support. Fatigue is an important factor, and being sleep-deprived makes us more vulnerable to depression, as do difficulties with breastfeeding or having an unwell baby.

Symptoms and signs of Postnatal Depression

Watch out for symptoms occurring most of the time and nearly every day for at least two weeks:

  1. Sadness, depressed mood, tearfulness or irritability.
  2. Loss of interest in daily activities, or enjoyment in activities usually enjoyed.
  3. Loss of confidence; feelings of guilt or worthlessness.
  4. Fatigue, reduced energy (beyond what typically occurs when caring for a baby), low motivation.
  5. Broken sleep (irrespective of the baby).
  6. Change in appetite, weight loss or gain.
  7. Inability to concentrate or remember things.
  8. A sense of hopelessness, guilt or shame.
  9. Thoughts of self-harm, not wanting to be alive or suicide (seek help immediately).

If you have either of the first two symptoms, plus a few of the others, then you may be suffering with PND.   Also notice symptoms of anxiety, such as worrying excessively about the baby, your health or feeling panicky. The following table summarises some of the main symptoms of anxiety in terms of what you might feel, think or do.

Symptoms of Postnatal Depression and Anxiety

Where to go for help

If you are concerned about having PND or anxiety, or about someone you love, then speak with your General Practitioner (GP) or health professional. You can also call Beyond Blue on 1300 224 636, or your local community or emergency mental health service for advice.

Visit www.drcatehowell.com.au for more information about mental health, and feel free to contact her clinics if you would like to.. The websites below may also be helpful.

Author

Dr Cate Howell CSM, OAM is a GP and therapist, researcher, lecturer and author. She has over 30 years of training and experience in the health area, with a special interest in mental health and assisting individuals experiencing life stresses or crises. Cate holds a Bachelor in Applied Science (Occupational Therapy), a Bachelor of Medicine, a Bachelor of Surgery, a Masters in Health Service Management and a Doctor of Philosophy (Medicine). She also has a Diploma in Clinical Hypnosis and has trained in Couple Therapy, Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT) and Interpersonal Therapy. She has travelled internationally to present research findings on depression and has been published in a number of academic journals. The author of three books, in 2012 Cate was awarded the Order of Australia Medal for services to medicine, particularly mental health, and professional organisations.

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