Pregnancy and the first year of parenthood (the perinatal period) can be a uniquely special time. It is also a time of great adjustment and the impact is often underestimated in our society. All expectant and new parents will have their good days and bad days, their ups and downs. But when bad days start to seriously outnumber the good they may be at risk of perinatal anxiety and depression.
Perinatal anxiety and depression affects 1 in 6 mothers and 1 in 10 fathers. Men are not immune from perinatal anxiety and depression. Commonly, but certainly not always, this develops as reactive depression to a partner’s illness – it’s understandably difficult to be around a person who is ‘down’ all the time. In fact, if the mother is depressed the whole family is affected: partner, baby and other children. That’s why it’s essential to get help straight away.
This term perinatal covers both antenatal depression and anxiety (occurring during pregnancy) and postnatal depression and anxiety.
Perinatal anxiety and depression is a diagnosable condition and needs to be considered when:
Perinatal anxiety and depression affects almost 100,000 expecting and new parents in Australia each year. It is a recognised and diagnosable medical condition, the result of biological, psychological and social factors. Mothers and fathers do benefit from receiving professional help and parents do recover. Early intervention and emotional support enables parents to move on to enjoy this time with their children.
You should consider seeking professional help if you have had one of more of the following feelings for two weeks or more and they are impacting negatively on the way you usually function.
Other conditions which may present with similar symptoms to a lesser or greater extent include:
Adjustment Disorders: It is normal to feel a range of emotions while navigating through this period of transition. Roles are often redefined as parents learn to manage the emotional and physical stresses and the ups and downs of life with a new baby. Parents who are experiencing adjustment disorders may benefit from speaking with an understanding professional who can help by listening, putting these feelings in context and providing some practical ideas.
Generalised Anxiety: Anxiety may present as generalised anxiety or ‘worry’, phobias (fears) or panic attacks.
Post Traumatic Stress Disorder: repetitive and intrusive thoughts which may be related to aspects of the birth experience. Women may also have flashbacks to past trauma or mental health issues and may try to avoid or block out situations, thoughts and feelings that trigger these flashbacks. Professional counseling can help to alleviate these thoughts.
Postnatal Psychosis: occurs in a very small percentage of women affecting 1 in 1000 women but requires acute professional support as the mother develops an altered sense of reality.
Perinatal anxiety and depression can strike anyone: first-time mums, experienced mums, older mums, younger mums, and mothers from all socioeconomic backgrounds and cultures. For some women it appears to be completely biological/hormonal on origin, for others a personal or family history of anxiety and depression, or social circumstances.
Whatever the cause, perinatal anxiety and depression is treatable, so if you suspect you or someone close to you, may be experiencing symptoms, it’s important to seek help as soon as possible.
Higher risk markers
What are the baby blues?
These symptoms should not be confused with the baby blues, a brief period of mood swings, tearfulness and anxiety that is very common among new mothers in the first week after giving birth. With the baby blues symptoms tend to appear 3–5 days after giving birth and usually resolve in a week or two.
Perinatal anxiety and depression is different and potentially serious. If a woman experiences symptoms every day for more than two weeks, and these start affecting her ability to cope in daily life, she may be developing anxiety and depression and should seek help and advice.
It’s very common to feel overwhelmed and stressed at this time, so it’s a good idea to have a conversation with a trusted person. Sometimes mothers and fathers can find help in supportive friends, relatives or health professionals.
Often offloading fears and frustrations is all that is needed. And a good listener can be a great sounded board, someone who might be able to help you work through how you’re really feeling. Sometimes emotional and practical support is all that is needed. However, if you are worried, there is treatment available for Perinatal Anxiety. Make an appointment with your early childhood nurse or GP as they will have the professional skills to support you or refer you to further help if necessary.
Friends and family can support families in many ways.
Emotional support: Take time to listen and acknowledge how the mother is feeling. Don’t minimise her feelings or tell her ‘to snap out of it’ or ‘get over it’. Don’t try to ‘fix’ her by offering solutions. While the crippling feelings will eventually resolve , the sufferer may feel they will never end. Let her know that you will be there for the journey and that while recovery can be slow, there is hope and in time she will feel better. Find out as much as you can about this illness – you may also need support. Support the mother in her treatment. Reassure her that she is not a ‘bad’ mother. She has an illness for which there is treatment. Try to avoid making big decisions at this time.
Practical help: Provide some meals (either home cooked or take away), help with housework, eg ironing, offer to do some shopping. Looking after the baby for a while can make a big difference to struggling parents – enabling them the opportunity to rest / spend time with each other / go to a doctors appointment etc. Offer to go to any appointment with the mother or father.
Self care takes many forms and might include:
Professional Care and Treatment
Professionals who can help include:
These health professionals can assess parents and can refer mothers and fathers to the following specialists if they require further support.
and in Sydney
There are many effective treatments for perinatal anxiety and depression.
Treatment includes psychological therapies that may be combined with pharmacological treatment.
Counselling There are many different counselling options which may include
Psychotherapist, Psychologist, Psychiatrist, Social Worker, General Practitioner. Counselling alone can be successful in mild to moderate cases.
Medication in conjunction with counselling has been shown to be successful in treating perinatal mood disorders. There are now a number of medications that are safe to take during pregnancy and while breastfeeding. If you are on medication it is important for you to continue taking it as discontinuing medication abruptly without medical supervision may cause problems.
Partners It is important to include significant others in the care of the mother (or father) who is unwell. They may also be struggling and feeling vulnerable and will often need support as well. Partners play an important role in caring, supporting and understanding. Stronger relationships and more resilient families are built around an inclusive model of care.
Mother and Baby Units In some situations, for example if a parent has thoughts of harming themselves or their baby, hospitalisation may be necessary. There are Mother and Baby Units in some public and private hospitals, where mothers can room with their baby while receiving treatment in a supportive environment.
With the right treatment the vast majority of parents will recover fully and go on to live happy lives with their baby and family.
Click here for our Get Help section which has more information on programs and organisations that can help.
Download Gidget Foundation’s Welcome to Parenthood brochure below:
The following fact sheets provide a wealth of information on the many and varied aspects of perinatal anxiety and depression. We would like to thank PANDA for sharing these with us:
Behind the Mask: The hidden struggle of parenthood
This DVD includes the stories of mothers and fathers as well as educational input from health professionals. We have created an emotionally engaging and informative resource that is relevant to consumers, health care providers and educators. The DVD brings the reality of perinatal depression and anxiety to life, deepening our understanding of the illnesses while providing practical ideas to assist in recovery.
To order a copy of the DVD please email contact@
Beyond The Baby Blues; The complete handbook for emotional wellbeing during pregnancy and early parenthood. Catherine Knox, Seana Smith, Benison O’Reilly (2011).
This is the first Australian handbook written with a specific focus on emotional wellbeing during pregnancy and early parenthood. Written for parents and health professionals, this book discusses the physical and emotional aspects of perinatal anxiety and depression and features personal stories. It is a must have for all health professionals working in this area, and for parents and parents-to-be.
Other Suggested Reading:
Reading about the thoughts and experiences of other parents can provide many insights. Considering social attitudes and the realities of contemporary motherhood provided through current research can also be enlightening. Many fiction and non-fiction books have been written in Australia over the past decade. Some will make you laugh out loud, others will make you cry. They will all make you reflect on your own situation and will reinforce the fact that you are not alone in your parenting journey.
The Bad Day Plan: how to make a bad day a better one – Essential Baby 13 May 2016
Postnatal Depression: Why couldn’t my mother feel my pain? – ABC News 12 March 2016
“Maybe I’m not cut out to do this motherhood thing” – kidspot online 17 November 2015
Kerryn Baird talks about her battle with postnatal depression – The Sydney Morning Herald 16 November 2015
Awareness key for mums at risk of perinatal depression – Daily Telegraph online 16 November 2015
The best cure for perinatal depression is talking about it – kidspot online November 2015
Depression During Pregnancy can be a ‘killer’ – The Huffington Post Australia 7 October 2015
Pregnancy and Depression: ‘It Was Like an Alien Had Invaded Me’ – The Huffington Post Australia 8 October 2015
Community Spotlight – The Gidget Foundation – Chadwick Community News Vol 1, No 5, Aug/Sep 2015
Women Fill Support Gap – Scone Advocate 25 June 2015
Perinatal depression estimated to cost $535 million a year if left untreated: report – ABC News 3 April 2014
Mums’ Comforter recognised – North Shore Times 26 February 2013
If I’d known then what I know now… – Essential Baby 10 December 2012
A father’s story of watching post natal depression implode his family – Mamamia 22 November 2012
2 of us – Catherine Knox & Vijay Roach – Sydney Morning Herald 4 February 2012