Shore Therapy

Postnatal Depression and Anxiety

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Most of us have an idea of what postnatal depression is, but its important to understand the scope to which it can affect indivduals and families.Postnal Depression

Postnatal depression can include both depression and anxiety and can occur anywhere within the first year after the birth of your child. It is thought that somewhere between 10-20% of new mothers (this includes mums with baby number 2, 3, etc) may experience diagnosable postnatal depression.

There are a few widely accepted risk factors which many professionals believe may increase the probability of postnatal mental health issues forming. This includes but isn’t limited to:

  • A history of mental health issues – depression, anxiety and most other mental health conditions.
  • A lack of support before, during and after the birth – this can include issues with the relationship of the child’s parents, as well as a lack of social support such as isolation from family (e.g. Living in a different town/country from the rest of family etc.)
  • Life stresses – money issues, trouble at work, relationship problems etc.
  • Difficulties within the pregnancy itself – this can range from severe morning sickness (Hyperemesis Gravidarum), to break through bleeding, regular ED admissions or requiring extra scans etc.
  • Difficult birth – Post natal mental health issues appear to be more common in those who had tricky births and deliveries – emergency caesarean surgery, loss of blood, use of vontouse or forceps, episiotomies etc.
  • Health of the infant – if the baby is born with health issues, a lot of stress is placed on the family – particularly the parents. Often parents who have an unwell child at birth struggle with feelings of guilt, sadness and stress, which are all risk factors for depression and anxiety.
  • Lower socio-economic families – in the 2015 New Mothers Mental Health Survey (2015) it was found that mothers coming from a ‘Low Household income’ (Under $40,000) were more likely to develop post-partum mental health issues.
  • Issues with the baby after birth i.e. feeding issues, colic, sleeplessness etc

Many feelings and thought patterns associated with postnatal depression and anxiety are normal to feel as we adjust to life with a new baby so it is important to be able to recognize when help is required. Here are a few signs and symptoms to be aware of:

  • Feelings of hopelessness, confusion and sadness which linger.
  • A belief that you can’t cope. Not just one-off thoughts, but reoccurring or constant thoughts
  • Irritable and angry for no known reason
  • No pleasure in usual activities
  • Changes to sleeping and eating – above and beyond what is expected with a new baby
  • A lack of concern over appearance and self-care
  • Negative thoughts about the baby, an unwillingness to hold or care for the baby or thoughts of harming the baby
  • Being overly anxious, overwhelming uncertainty and excessive worry and fear
  • Feelings of guilt or worthlessness
  • Difficulty thinking clearly and making every day decisions.

The ‘Baby Blues’ are common in the first few weeks after baby is born which include several of the thoughts and feelings listed above. Postnatal depression and anxiety is when these issues linger for an extended period of time or become so severe that they interfere with everyday life affecting the care and health of both mum and baby.

As new parents, we often turn all of our attention to our new baby and forget to look after ourselves. It is important to remember that we need to be well in order for us to provide the best care for our children. The ‘Fourth Trimester’ or first 12 weeks after our baby is born is still a hugely important area for both mum and baby with a lot of physical and hormonal changes occurring, not to mention an adjustment to family dynamics, routines and our mental health. This period is when support systems are invaluable. Make use of family, friends, support groups, health professionals, call lines and mental health professionals. It is important to remember that a happy, healthy mum is going to immensely help your baby.

Recently there has been some media coverage about postnatal mental health and lack of help, delay of treatment and gaps within the current health system. Here in Auckland, there are several places you can reach out, detailed below. However, Shore Therapy caters to many parents dealing with different types of post-natal issues. We are baby friendly and often will have mum and dad in our offices, seeking therapy together. Babies are more than welcome to come along as we understand that separation, child care etc… is not always an option. Northland has high rates of post-natal issues, why this is, we’re not quite sure, but help is still available. If you want to visit Shore Therapy in their offices in the Whangarei area or Auckland Click Here to make a booking online or send us an email for more information.

Where to get help:

Postnatal Depression

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Potsnatal DepressionBeing pregnant and having a child are known to be the most exciting time for women, but not everyone feels this way. Sometimes, we feel angry, sad, hateful or resentful of our pregnancy or our baby. These feelings can be terrifying to acknowledge, but it does happen, and happen regularly. In fact, up to 70% of new mothers experience what is commonly called the ‘Baby Blues’, this occurs around 3-10 days after giving birth and the mother feels very emotional and tearful. But this should only last a few days, and can be quite manageable.

However, around 15% of new mothers develop a much deeper and more long-standing depression after the birth of their child. This is known as Postnatal Depression or Postpartum Depression and arises around four to six weeks after birth. Postnatal Depression can develop quickly, or it can slowly progress over time. It is also common to experience severe anxiety and even panic attacks, when experiencing PND.

Everybody experiences this differently, so it is important to keep an eye on your mood after pregnancy.

Common Signs of Postnatal Depression:

  • Feeling sad
  • Feeling very low
  • Exhaustion
  • Feelings of hopelessness
  • Feeling worthless or useless
  • Feeling guilt
  • Feeling hostile or indifferent to you partner
  • Irritability
  • Feeling angry
  • Feeling hostile towards you baby
  • Feelings of hatred towards your baby
  • Difficulty concentrating
  • Difficulty sleeping
  • Reduction of appetite
  • Libido or sex drive diminishes
  • Thoughts about death or harming yourself or others.

If you or your partner are experiencing any or all of the above signs, please reach out and tell someone, whether it’s a friend, family member or a professional.

What Causes Postnatal Depression?

Unfortunately, there is no single cause for Postnatal Depression, however, both the physical and emotional changes that occur after childbirth may have a significant influence.

The obvious physical changes that occur are the dramatic decrease in the hormones oestrogen and progesterone. This can dramatically affect your mood, memory and increase the feeling of depression. Other hormones that are produced by your thyroid gland can also considerably alter your mood, increase tiredness, lethargy and hot flushes.

The emotional changes that can impact Postnatal Depression can be overwhelming. Having a new-born in the home is not an easy adjustment, sleep deprivation can make coping with minor problems feel unachievable. Many parents describe an overpowering feeling of anxiety around their ability to care for their new baby, and often feel less attractive to their partner. This can increase the feeling of sadness, hatred and resentment towards your baby, partner and birth. Frequently, feeling out of control of your life and as though you have lost your identity can be a factor in the development of PND.

Risk Factors:

While there are no specific causes of Postnatal Depression, there are risk factors that can influence the likelihood of developing Postnatal Depression.

The big thing to keep in mind is that Postnatal Depression can happen during any pregnancy or birth – Not just your first. However the risks can increase if the following occur:

  • You have a history of Depression.
  • You have already experience Postpartum Depression with a previous pregnancy.
  • You have Bipolar Disorder
  • You have close family members who have Depression or Bipolar Disorder.
  • The pregnancy was unplanned or unwanted.
  • You experience severe complications during the pregnancy or birth.
  • You experience a significantly stressful event within the year of your pregnancy, such as sudden unemployment, loss of a family member or illness.
  • Your baby has health issues, or other special needs.
  • You have difficulty breast feeding.
  • You and your partner are having relationship difficulties.

What To Do?

As with Depression, treatment options and recovery times vary depending on the severity and your individual wants and need. Everyone experiences depression differently, so each person’s treatment needs to be different. However, most people find contacting their GP is a great first option. Your Doctor is able to refer you to a mental health provider or other appropriate specialist.

Baby Blues:

For a lot of women, this is a normal part of pregnancy and post pregnancy care. The Baby Blues, usually fade away on their own and you should be experiencing an improvement in mood between 3-10days.

However, during that time it can be pretty difficult to maintain your wellbeing. Below are some self-care techniques that could really improve your mood and ability to cope with a new born.

  • Rest when you can, your body has been through a massive change, give your body time to recover.
  • When friends and family offer to help, accept their support. It does not mean you are a failure, or a terrible parent.
  • Try and socialise with other new Mums. ‘Mummy and Me’ groups are brilliant at offering support for new parents.
  • Avoid as much as possible, mood altering substances like alcohol and drugs. These can severely negatively influence your mood.
  • Try to do something relaxing for yourself at least once a day.

Postpartum Depression

A common treatment for Postnatal Depression is Psychotherapy, medication or a combination of the two.

Psychotherapy can also be referred to as ‘talk therapy’, this is due to the concept that by talking through your thoughts, feelings and concerns with a professional you may be able to find new understanding and better ways to cope with your feelings. Psychotherapy can also be helpful with setting realistic goals, managing your emotions, developing positive interpersonal relationships and self-discovery. Each therapist is different, so it is important to find the right professional that fits you and your needs.

Medication can also be an integral part of treatment for Postnatal Depression. Anti-depressants are commonly prescribed for this condition, and have a good success rate. However, it is important to work closely with your GP around your medication. If you are breast feeding it is essential that you mention this to your Doctor so you can be prescribed medication that does not transfer into your breast milk and affect your baby. It is also significant for your GP to monitor your wellbeing while taking anti-depressants, there are a number of side effects that can severely impact your ability to cope and function. These should dissipate after 4-6weeks of taking your medication, however, if they do not, it is wise to contact your GP and discuss your options. Anti-depressants should also be weaned on to and off of, you can become really unwell if you just stop taking your medication. Consult your Doctor before stopping your medication. As with seeking therapy, it is important that you find the right medication for you, it may take a few goes, but when you find the right medication it can radically change your outlook on life and increase your mood.

When taking medication and working with a Psychotherapist for Postnatal Depression, it can dramatically increase your mood and ability to cope with your new born. The medication can lift your mood enough to be able to cope and process the emotional work you do with your therapist. Everyone is different, so it is all about you finding your own treatment options that suit you and your needs.

With a treatment option that works for your, Postnatal Depression should begin to change and subside. It is important to continue your treatment even after you begin to notice the positive changes, stopping treatment too soon can lead to relapse. Speak with your Psychotherapist and/or GP about your desire to end treatment.