Perinatal Mental Health

Perinatal Mental Health

Anxiety

Anxiety is a common problem, with around 1 in 3 women experiencing this at some point in their life (29, 30). It is not just a feeling of stress, which is quite reasonable from time-to-time. Instead, anxiety is the continuation and escalation of these feelings. They continue to affect people when circumstances change and can occur for no apparent reason (30). Appropriate treatment is the key to recovery.

Anxiety can be debilitating and life-altering. For some, it is manageable, and healthy day-to-day life is achievable. However, most people experience anxiety at different times in their lives. However, if it becomes an anxiety disorder, the feelings are often overwhelming, uncontrollable, and you can’t just switch them off.

Symptoms of anxiety don’t generally develop overnight but over time. To be diagnosed with anxiety, the feelings must significantly impact a person’s life and affect how they go about their typical day. Symptoms vary depending on the condition the individual has.

Symptoms of anxiety include (30):

Behavioural Symptoms

• “Snowballing” thoughts
• Obsessing
• Withdrawal from activities
• Lack of confidence
• Poor decision making
• The need to perform specific tasks in a particular manner as to avoid anxious feelings
• Easily frightened or startled
• Feelings of being overwhelmed
• Hypochondria
• Feeling of dread
• Feeling nervous, on edge or tense
• Uncontrollable panic

Physical Symptoms

• Shortness of breath
• The feeling of a heart racing
• Cold and hot face or whole-body flushes
• Chest pain or tightness
• Pain in muscles
• Heavy sweating
• Affected sleep patterns
• Dizzy, faint, light-headed
• Difficulty concentrating
• Stomach pains, nausea or vomiting

Depression

For some people feeling sad or low becomes an intense feeling that affects their day to day life. These periods of depression can last for days, weeks, months or years, resulting in cycles which can come and go for life. Depression is not just a low mood – it is a serious condition which affects both mental and physical well-being.

Depression affects approximately one in five women. It can change the way people feel about all aspects of their life, including partners, friends, work, hobbies and children. They may also lose interest in things that used to be important to them. They may be unable to sleep at times and unable to stay awake at others, while some experience a feeling of irritability and lack of satisfaction with life.

People may be diagnosed with depression if they have felt miserable, down or sad for more than two weeks. Depression may also be the problem if they have lost interest, satisfaction or joy with everyday life activities, and experience several of the other depression symptoms (31, 32).

Symptoms of depression include:

Behavioural changes

• Withdrawal from friends, family and activities
• Unable to finish tasks
• Unable to concentrate
• Substance use
• Unable to enjoy things in day to day life
• Change in sex drive
• Lack of motivation
• Change in sleeping patterns
• Lack of energy

Physical and emotional changes

• Lacking self-confidence
• Feelings of failure or guilt
• Increased feelings of negativity
• Varying moods
• Miserable, unhappy, disappointed
• Always tired
• Headaches
• Upset stomach
• Weight loss or gain
• Muscle complaints
• Aches and pains
• Unable to control emotions

What causes depression?

Causes of depression are specific to the individual, meaning no one event or situation is responsible. However, stressful life events, abusive or neglectful relationships and loneliness are known triggers for depression. Family history, long term illness, medical conditions and drug/substance abuse are also contributing factors. Mental health during pregnancy vital as the physical health of a mother and her baby. Many women feel overwhelmed and completely clueless. However, when these emotions turn into everyday occurrences and are starting to affect their day to day living, it becomes a big problem.

Around 15% of women will suffer from depression during their pregnancy and postnatal period; an estimated 40% will have anxiety (33). If you take medication for your mental health, please don’t stop these without consulting with your doctor. Some alternatives are safe for pregnancy.

Managing your mental health will enable you to enjoy your pregnancy and reduce the risk of preterm labour (34), and help to improve birth outcomes (35).

If you develop mental health issues during your pregnancy and postnatal period, seek medical attention as soon as possible. Just like physical illness, mental health issues need to be treated early.

Your midwife should screen you during the antenatal and postnatal period with a tool called Edinburgh Perinatal Depression Scale (EPDS). This tool is a set of questions to help identify those at risk of depression. Midwives ask these questions of every woman during pregnancy to identify to help diagnose and treat mental health problems early.

Treatment for your mental health

Throughout the world, mental health conditions are becoming more widely recognised and accepted. As a result, treatment can be partially funded in many regions. Doctors can provide the information needed to find support in each person’s local area. Anxiety and depression don’t appear overnight; so its important to remember that recovery is a multi-layer processes. It takes time.

A healthy diet and exercise routine are essential components to recovery. But, the severity of mental illness is will determine what treatment is needed. Therefore, the more severe the condition, the more likely it is that therapy and medication will be required. Using a full mind and body approach to anxiety and depression has proven benefit in the recovery and rehabilitation process (31).

Depression and anxiety are common. Please remember that individuals are affected by this condition – it does not define who they are. The world is far more accepting of mental health conditions now than ten years ago, resulting in less stigma seeking help.

Doctors will make plans that are very important to ensure a person’s safety. Please share them with your close family and friends so they can provide support. There is no shame in having a mental health condition. Acceptance, planning and treatment will help you recover.

Kate Sycz (BN, BMid) Registered Nurse, Registered Midwife
Photo by Lyudvig Aristarhovich used under license from Shutterstock.com

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