Emotional Health for Parents Common Emotional Problems A number of emotional problems can arise when you’re pregnant or have had a baby. Sometimes these emotional problems are all lumped together and just called “postnatal depression.” This is not correct and can be misleading – especially since problems can arise during pregnancy (antenatally) too! The most common emotional problems are: Baby Blues Adjustment problems Attachment problems Anxiety (antenatal anxiety and postnatal anxiety) Depression (antenatal depression and postnatal depression) Postpartum psychosis Baby Blues During the first week after birth, up to 80% of mothers will get the Baby Blues. This is usually a time when new mothers are quite sensitive, and they might cry, be irritable, feel anxious and have mood swings. These symptoms tend to peak 3-5 days after delivery. They are mainly caused by hormonal changes after childbirth and normally go away within a few days without any special treatment. Things that can help include understanding, support, and help with learning how to care for a baby. If symptoms go on longer than 2 weeks, it could be the start of postnatal depression. Adjustment problems Every parent goes through a period of adjustment as they try to handle the huge changes a baby brings. For most people, this time of adjustment will be temporary and not really interfere with their daily life. For others, adjusting to life with a baby can take a long time and cause a lot of distress. When this is the case, talking to a health professional can be helpful. “I found it difficult coping with the demands of a newborn. No sleep, constant crying and a lack of time for myself. This was supposed to be the most beautiful time of my life.” – Tanja Attachment problems After the birth, most people expect an instant bond with their baby, but for some parents, this doesn’t happen. It may take a few days or even weeks to feel a connection to your baby, and this can create feelings of guilt, stress and disappointment for parents. When a parent feels little or no connection to their baby, they may be “distant” or “withdrawn” and behave negatively toward the baby. Usually, with support and rest, most parents will feel more attached to their baby within a few days. If a connection is not established after a couple of weeks, it is important to talk about how you’re feeling with a health professional. “As I looked at my baby… I felt numb, emptiness. It was as if I was looking at someone else’s baby.” – Mother of newborn Anxiety (antenatal anxiety and postnatal anxiety) A little worry or anxiety is normal for parents. The trouble is, too much anxiety and distress may affect your ability to cope with your pregnancy and your baby. People with anxiety often fear they are going to lose control or go crazy. Often the anxiety they feel can lead to low self-confidence and a belief that they are a bad parent. About 14-16% of women have a clinical level of anxiety during their pregnancy, while 8-10% of women will have clinical levels of anxiety postnatally. It is also common for people with anxiety to experience depression too. “Out of the blue an intense feeling of dread came over me. My heart was racing, I had difficulty breathing, I was shaking, dizzy. I thought I was having a heart attack or going crazy.” – Expectant mother “I felt so on edge and worried… I was constantly checking to see if the baby was still moving.. What if something was wrong again?” – Expectant mother Symptoms of anxiety If you experience any of the symptoms below, talk about treatment options with a health professional. ■Anxiety or fear which interrupts your thoughts and interferes with daily tasks. ■Panic attacks. ■Anxiety and worries which are difficult to control. ■Feeling irritable, restless or “on edge”. ■Having tense muscles, a “tight” chest, heart palpitations. ■Taking a long time to fall asleep in the early evening. ■Anxiety or fear which stops you going out with your baby. ■Anxiety or fear that leads you to constantly check on your baby. “I felt unable to do anything properly. I would hardly ever leave the house. I was so worried that he wouldn’t sleep properly if we were out. I felt unable to relax and switch off even though I was exhausted.” – Mother of a 6 month old. If you think your partner or baby would be better off without you, or are having thoughts of suicide, contact a health professional immediately. Mental Health Emergency Response Line – 1300 555 788 Fact Sheets Generalised Anxiety Disorder Obsessive Compulsive Disorder Panic Disorder Phobias Post-Traumatic Stress Disorder Depression (antenatal depression and postnatal depression) Many people have heard of postnatal depression (often called “PND”), but antenatal depression is not as well known. Research shows that 8-11% of women go through antenatal depression (depression during pregnancy), while 13% of women will go through postnatal depression. The symptoms of depression are the same antenatally and postnatally, however not everyone will experience depression the same way. Depression tends to develop gradually and may go on for many months. It may start before or during pregnancy and then continue after childbirth, or it may arise for the first time after your baby has arrived. If left unrecognised and untreated, it may develop into a chronic condition or come back in a following pregnancy. “I expected ups and downs during the pregnancy and to cry more easily. But I thought I’d enjoy it more. I don’t seem to look forward to things anymore and don’t feel like seeing people. I seem to find it difficult to get back to sleep as everything keeps churning through my head.” “People would say, you must be so happy with such a beautiful boy. Unintentionally their words made me feel like a failure. If I kept my fake smile going I might convince myself (and everyone else) that I was really happy. I was wrong.” – Tanja, mother of 2 children Symptoms of depression If you experience any of the symptoms below for more than a few days, talk about treatment options with a health professional. ■Low mood ■Feeling inadequate, like a failure, guilty, ashamed, worthless, hopeless, helpless, empty, or sad ■Often feeling close to tears ■Feeling angry, irritable or resentful (for example, feeling easily irritated by your other children or your partner) ■Fear for the baby and/or fear of the baby ■Fear of being alone or going out ■Not enjoying or being interested in usual activities (including sex) ■Insomnia or excessive (too much) sleep, having nightmares ■Appetite changes (not eating or over-eating) ■Feeling unmotivated and unable to cope with the daily routine ■Decreased energy* and feeling exhausted* ■Withdrawing from social contact and/or not looking after yourself properly ■Having trouble thinking clearly or making decisions*, lack of concentration and poor memory* ■Having thoughts about suicide or wanting to run away from everything The symptoms with an asterisk * can also result from a lack of sleep – which often happens with a new baby! A health professional will help work out if the symptoms are within the normal range for you or if they could indicate depression. “I felt flat, useless, not able to cope, I was constantly in tears. I felt overwhelmed by the responsibility. There was nothing to look forward to. I felt that the baby and my husband would be better off without me. They deserved someone better. I just want to be back to normal.” If you think your partner or baby would be better off without you, or are having thoughts of suicide, contact a health professional immediately. Mental Health Emergency Response Line – 1300 555 788 Postpartum psychosis The least common, but most serious, postnatal mood disorder is postpartum psychosis (also known as puerperal psychosis). It should not be confused with postnatal depression. It affects only 1 or 2 in every 1000 mothers. There may be risk of harm for the mother or her infant (or both). Mothers with a personal or family history of bipolar mood disorder (also known as manic-depressive illness) or schizophrenia are most at risk. If you or members of your family have these conditions, it is very important to mention this at your antenatal check-up appointments. Symptoms of postpartum psychosis usually appear within one month of childbirth and may include: ■Hyper-arousal (increased physical and emotional tension) ■Excessive euphoria (intense feeling of wellbeing) ■Significant and ongoing reduced need for sleep ■They may appear confused or very argumentative ■Behaviour may be erratic (not consistent or predictable) ■Delusions (unusual beliefs or belief in something which is not based on reality) ■Hallucinations (unusual perceptions, such as seeing or hearing things) The management of postpartum psychosis normally involves urgent assessment, medication, hospital admission, and help looking after the baby. Although the problem is rare, it often re-occurs in future pregnancies. Women who experience this condition – along with their partners – could greatly benefit from counselling to assist with planning future pregnancies. If you know a mother experiencing any of the symptoms listed above, contact a health professional immediately. Mental Health Emergency Response Line – 1300 555 788 Choose a Topic ■Becoming a Parent ■What is Emotional Health ■Common Emotional Problems ■What Causes Emotional Problems ■Emotional Health Across Cultures ■Treatment Options ■Help and Support ■Personal Stories of Depression and Anxiety ■Information for Health Professionals