Shining a light on Perinatal Mental Health: Recognising when to seek help.

 
 
 

Its not meant to be a walk in the park you think to yourself, your hormones are riding a rollercoaster so a few tears are understandable, surely? Your baby deserves everything to be just right and so you try to make everything perfect for them - every mother sacrifices this much - dont they?

Adjusting to life with a newborn, the changes in sleep and your focus shifting fully onto the dependant little bubba you have just birthed is undoubtedly exhausting, overwhelming and at times stressful and some level of mental struggle is common in the huge adjustment.


Fluctuations in mood and energy that come with parenthood are common but if these thoughts are persistent or you aren’t able to find some semblance of a new normal than maybe you might be experiencing perinatal anxiety or depression. 

Social media and the glimpses you get of mothers walking next the beach in their activewear pushing their sleepy infants in their prams can set you up with a trunk full of false expectations of how parenthood will look for you. It is easy to believe that raising a baby is all snuggly naps and catching up with new mum friends for a coffee - expectations that can set you up to feel like you have failed and make your mental health tumble down a deep hole. 

What we don’t get to witness in society is the massive shift in identity, the lack of time for exercise or personal pursuits. We don’t see how society has us set up to raise children single handedly. We don’t see the lack of support or the mums at home alone when their husbands have returned to work after an inadequate paternity leave. On the same train we don’t see the mothers forced back to work early by a system that doesn’t support the fledgling family.

We don’t see the mothers behind closed doors struggling with depression or anxiety. In the not seeing the truth of parenthood we can be blindsided by our own low mood or persistent worry when we become parents. 

Because we don’t see this reality it can be hard to know if what you are feeling is expected or when it might be time to get help or seek some more mental health support.  This post is all about helping you know understand when you might be struggling and when it might be time to reach out for help.

Its more common than you think:

“UP TO 1 IN 5 WOMEN EXPERIENCE ANXIETY AND/OR DEPRESSION DURING PREGNANCY, AND/OR FOLLOWING BIRTH.”

-PANDA


In Australia research shows that perinatal mental health challenges are common with around 15-22% of women experiencing post natal depression follow the birth of their baby and 1 in 5 women experience anxiety symptoms after the birth of their child. 


The perinatal period is a time where there is an increased risk of mental health relapse or new diagnosis - the reasons for this are multi-factoral but what is seen is higher rates in minority communities, Aboriginal communities and those who are culturally and linguistically diverse. 


When we use the term perinatal we are talking about pregnant women in this too. Diagnosis of a perinatal mental health condition usually encompasses the time from pregnancy through to the first 12 months of the childs life. But don’t feel just because your child is older this doesn’t count you too, the first 12 months is just when it is more common to see mood disorders.

Depression Vs Baby Blues

While its expected that there be some fluctuation of mood accompanying birth and the transition to parenthood due to varying levels of hormones dropping off and coming on board. This is often referred to as Baby Blues where it is normal to feel some level mood swings, tearfullness and vulnerability after birth.  However these feelings normally resolve in a few weeks when hormones level out and we get into the swing of this new identity.

However a persistence of these feelings beyond the first few weeks that intensify rather than alleviate can be a flag for Postpartum Depression. When the initial vulnerability segues into persistent saddness, irritability, feelings of worthlessness, changes in appetite and difficulties bonding with baby is when a mother, new or seasoned needs some more support.

There is no one way to experience perinatal mental health difficulties and how one person describes their experience will be different for you or others. This can make understanding if you need some more support difficult to know. Below are some of the common symptoms of Post Natal Depression. You might not notice all of these, not may they be present all the time but this should give you some help with assessing whether its time to reach out for more support. 

  • Persistent Sadness: A deep and prolonged feeling of sadness, hopelessness, or emptiness that persists for most of the day, for several weeks or more.

  • Loss of interest or pleasure: A significant decrease in interest or enjoyment in activities that were once enjoyable, including activities related to the baby or personal hobbies. 

  • Fatigue or Lack of Energy: Constant exhaustion and difficultly in finding the energy to perform daily tasks, even those that are typically manageable.

  • Changes in Appetite: Significant changes in appetite, such as a loss of appetite or increased emotional eating, leading to weight loss or weight gain.

  • Sleep Disturbances: Beyond those that come with tending to a baby at night and attending their needs, difficulties falling asleep, staying asleep or experiencing disturbed sleep patterns. 

  • Intense irritability or anger: Feeling irritable or on edge and easily provoked. This can be directed towards baby, partner or other family members.

  • Difficulty Bonding With Baby: Struggling to form a strong emotional bond or attachment with the newborn, feeling disconnected or indifferent towards the baby. 

  • Persistent Negative Thoughts: Frequent and intrusive negative thoughts, self-critical or guilty feelings, or a sense of inadequacy as a mother, feeling as though you child would be better off with someone else. 

  • Social Withdrawal: WIthdrawing from social activities, avoiding contact with friends and family, isolting oneself from social support networks.

  • Physical Symptoms: Headaches, stomaches, muscles pains without underlying cause.

  • Thoughts of self harm or suicidal ideation: Persistent thoughts of self harm, sucicidal ideation or thoughts of harming baby.

Postnatal Anxiety - when does worry become anxiety.

There is undoubtedly a degree of worry that comes along with learning to care for a new baby. Are they feeding enough, are they comfortable, are they sleeping enough. A little bit of anxiety is a natural response to threat and trouble. However persistent worrying or fretting excessively about baby or otherwise to the point of it impacting your day to day life can be a sign of perinatal anxiety (PNA). PNA usually presents as an inability to relax or excess panic or panic attacks. 

Again there is no one size fits all when it comes to experiencing anxiety but some of the common signs and symptoms are:

  • Excessive Worry: Constant and overwhelming worry and fear about various aspects of the baby's health, well-being, or safety. This worry may extend beyond the baby to include other areas of life.

  • Racing Thoughts: Having a mind that feels constantly busy and filled with racing thoughts. Thoughts may jump from one concern to another, making it difficult to concentrate or relax.

  • Restlessness and Irritability: Feeling restless, on edge, or easily agitated. Small things that wouldn't usually bother you may trigger intense irritability or frustration.

  • Physical Symptoms: Experiencing physical symptoms such as heart palpitations, shortness of breath, dizziness, sweating, trembling, or hot flashes, even when there is no apparent medical cause.

  • Sleep Disturbances: Difficulties falling asleep, staying asleep, or experiencing disturbed sleep patterns, unrelated to the baby's needs. Constant worry may make it challenging to relax and rest.

  • Intrusive Thoughts: Having intrusive, distressing, or unwanted thoughts or images related to harm befalling the baby or oneself. These thoughts are distressing but do not reflect a person's true intentions or desires.

  • Avoidance Behaviors: Engaging in avoidance behaviors to manage anxiety, such as avoiding certain situations, places, or people that trigger anxious thoughts or fears.

  • Physical Discomfort: Experiencing symptoms such as headaches, stomachaches, muscle tension, or other physical discomfort, often as a result of chronic anxiety and tension.

  • Difficulty Bonding with the Baby: Struggling to form a strong emotional bond or attachment with the baby due to excessive worry, fear, or anxiety.

  • Hyper-vigilance: Constantly being on high alert and excessively vigilant about the baby's safety, constantly checking on them or feeling the need to be in constant control of their environment.

  • Negative Self-Talk: Engaging in negative self-talk, self-criticism, or feelings of inadequacy as a mother, despite external evidence to the contrary.

The mask of perfectionism. 

Perfectionism is something that while well intentioned can can be as mask for post natal anxiety.  The striving for perfection I often see is way for mums to maintain some control when they feel their worlds are spinning out of control. While perfectionism itself isn’t a mental health disorder when it becomes extreme and is used as a way to manage or conceal underlying anxiety, it can negatively impact  a parents mental health.

It is not uncommon for women with perinatal anxiety to have an intense desire to be the perfect parent. They may obsess over every detail of their parenting, from following strict schedules to strongly adhering to specific parenting philosophies. This preoccupation can provide a temporary sense of control and order amidst the anxiety they are experiencing.

These perfectionistic tendencies can lead to a fear of making mistakes or falling short of their own impossibly high standards and so the parent strives to do it all and do it all right. They may constantly worry about doing something wrong or making decisions that could harm the baby's well-being. This fear can drive them to engage in excessive research and seeking reassurance to alleviate their anxiety.

The need for control drives the perfectionism. In the context of perinatal anxiety, women may try to control every aspect of their lives, including their baby's routine, feeding schedule, cleanliness, and more. By exerting control over these areas, they hope to minimize the perceived risks or uncertainties associated with their baby's well-being.

Those who strive to be the perfect parent at all costs can have real difficulty delegating tasks: The feeling that no one else can perform tasks or care for their baby as perfectly as they can or meet their impossibly high standards is common leading to increased stress and overwhelm, exacerbating their anxiety.

Self-criticism is often unrelenting in those with perfectionism induced anxiety. From constantly berating themselves for perceived failures or shortcomings. In the context of perinatal anxiety, this self-criticism can intensify, making women feel inadequate as mothers and fueling their anxiety.

So be aware if your trying to achieve some unrealistic standards that you’ve set for yourself take a moment to check in whether this is actually coming from a place of fear and whether this is making things unnecessarily hard for you.

When to Seek Help

It can be hard to know when things are at the point you need to seek help. But in general is any of the above signs or symptoms are persistent, impacting your day to day functioning or quality of life it can be the green light to seek some more support..

Seeking help is nothing to be ashamed of and should be seen as the biggest act of self-care for both yourself and your baby. At the heart of it, if you feel like you need support that is all you need to know or feel to reach out. You know yourself more than anyone else you deserve support whenever you feel its needed. If you still aren’t sure if your just dabbling with the baby blues or if it might be worth seeking help here are some pointers: 

  • Symptoms Lasting More Than Two Weeks: 

It is common for new mothers to experience a range of emotions and adjustments in the early weeks after childbirth. However, if symptoms such as excessive worry, persistent sadness, or other signs of anxiety or depression persist beyond two weeks and intensify, it is time to seek help.

  • Impact on Daily Functioning: 

When symptoms interfere with daily functioning, including the ability to care for yourself, bonding with the baby, managing household tasks, or maintaining relationships, it is important to reach out for support.

  • Inability to Cope: 

If you find yourself feeling overwhelmed, unable to cope with the demands of motherhood, or experiencing thoughts of self-harm or harming the baby, immediate help should be sought. Do not hesitate to reach out to a healthcare professional or a helpline for assistance. You can find all the necessary services discussed in this BLOG.

  • Feelings of Isolation and Hopelessness: 

If you feel isolated, detached, or hopeless, experiencing a persistent sense of sadness or despair, it might be time to seek support.

  • Impact on Physical Health: 

If your mental health concerns are affecting your physical health, such as appetite, sleep patterns, or experiencing physical symptoms, it is essential to seek professional help. Mental health and physical health are interconnected, and addressing the underlying mental health concerns can help boost your overall well-being.

  • Concerns Raised by Loved Ones: 

Sometimes, friends, family members, or healthcare providers may express concerns about your well-being or notice changes in your behavior that may indicate PPA or PPD. This can be the gentle nudge to seek out support for yourself. 


Remember that reaching out for help is not a sign of weakness but a courageous step towards prioritizing your well-being and the well-being of your baby. To find out more about finding the right help and support hop on over the this BLOG to find out how to find the right support for you.

 
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Where and How to Seek Help When Motherhood is Feeling Tough.

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