What is perinatal anxiety and depression

One in 5 women experience depression or anxiety during pregnancy, or after having a baby. While many of us are aware that we can experience depression after having a baby, less is known about the experience of postnatal anxiety, and the experience of depression and anxiety during pregnancy. So, what is perinatal anxiety and how does it differ to perinatal depression?

There are numerous terms that are used to describe the period during pregnancy and after having baby:

• Prenatal or antenatal – the period during your pregnancy
• Postnatal or postpartum – after having baby until 1 year of age
• Perinatal – your experience from conception until around 1 year after having baby

What is the difference between perinatal anxiety and depression?

Perinatal Anxiety

We can all feel anxious at times. Feeling anxious is a normal response to stressful situations in our lives. For example, you might feel anxious about an important event like starting a new job, public speaking or your current financial situation. A low level of anxiety can be helpful for us. It can motivate us to carry out our daily tasks, increase our ability to focus and make us alert. However, anxiety can become a problem when it is severe, continues for a long period of time, or causes distress, preventing us from doing the things we want to do.

The symptoms of anxiety are the same during pregnancy and early parenthood as any other point in our lives. You are about to embark on something new and exciting and it is OK to feel some anxiety about this. However, many mums (and dads) experience significant anxiety during this time. They may feel panicky or restless, or having difficulty making decisions about everyday things, such as what to cook for dinner. If you are noticing that you often feel anxious and it is interfering with daily life, you may be experiencing perinatal anxiety.

Perinatal anxiety is common, and occurs in approximately 15% of expectant and new mums. Having perinatal anxiety does not make you weak, crazy or a bad parent, it is not a reflection of your parenting skills. With the right support, difficulties with anxiety during your pregnancy and after having baby can be overcome.

Common symptoms of perinatal anxiety can include:

• Worrying thoughts
  • Excessive worry about baby and baby’s health
  • Worry about being a good enough parent
  • Worry about other things, such as finances and relationships
  • Feeling scared, fearful or irritable
• Feeling keyed up or on edge
• Physical symptoms
  • Difficulty concentrating
  • Fatigue or tiredness
  • Restlessness
  • Trembling or shaking,
  • Heart palpitations
  • Light-headedness or dizziness
  • Disrupted sleep
  • Racing or pounding heart, or shortness of breath

You may be experiencing an anxiety disorder if you have experienced several of these symptoms for an extended period of time, have found them difficult to control, and experienced significant emotional distress.

For further understanding of your anxiety symptoms, see our self-assessment tools.

Perinatal Depression

The word ‘depression’ is often used to describe moments when we’re feeling sad or down. It’s normal to feel down from time to time and this may not necessarily mean you are depressed. Major depressive disorder is more than just sadness; it’s a period of two weeks or more that you feel depressed or down nearly every day, coupled with other symptoms, such as loss of interest in activities you usually enjoy. Different people will experience depression in different ways, but there are some common signs and symptoms.  The symptoms of depression can include:

• Feeling sad, irritable or unhappy most of the time
• Loss of pleasure or interest in activities you usually enjoy
• Significant weight loss or gain, or an increase or decrease in appetite, unrelated to pregnancy
• Difficulty sleeping or over-sleeping nearly every day
• Feeling restless or slowed down
• Fatigue or loss of energy
• Feelings of worthlessness or excessive guilt
• Difficulties thinking, concentrating or making decisions
• Recurrent thoughts of death, suicide or self-harm

Additional symptoms you may recognise include:

• Tearfulness
• Feelings of hopelessness
• Slowed or fast speech

During the perinatal period, symptoms of depression are the same as at any other time in our life. The difficulty is that it can be harder to recognise depressive symptoms during your pregnancy or after having a baby. Often, we are not sure what is ‘normal’ because of all the changes that occur during this time. The other difficulty is that some of the symptoms of depression overlap with the changes that naturally occur during your pregnancy or after having baby (e.g., disrupted sleep and changes in weight and appetite). It is also common to experience symptoms of perinatal depression at the same time as anxiety. There are some symptoms of depression and anxiety that overlap, and feeling anxious all the time can lead us to feeling depressed.

If you have been experiencing several of the symptoms listed above for two or more weeks, consider reaching out for support.

What causes perinatal anxiety and depression?

The perinatal period is a time of transition that involves significant physical, emotional, mental and social changes. It can be overwhelming adapting to these changes and many new and expectant mums (and dads) experience difficulties adjusting to this transition. There is no one cause of anxiety and depression during the perinatal period but often there is an imbalance between our positive and negative, or stressful experiences. For example, we may have less capacity to connect with our friends during this time and feel more emotional exhaustion. There are also some common risk factors that can compound these difficulties. These include:

• Limited social support
• Past history of depression
• Major life changes or events (e.g., moving house, separation from your partner or job loss)
• Family violence
• Low self-esteem
• Depression during pregnancy
• Anxiety during pregnancy

Other stressors and experiences that can increase our vulnerability to perinatal depression and anxiety include:

• Family history of mental health problems
• Relationship difficulties or family conflict
• Poor relationship with your own mother
• Previous pregnancy loss
• A traumatic birth
• Complications during your pregnancy

Each expectant and news mums’ journey is different, and the stressors and personal experiences of someone with perinatal depression or anxiety will also differ. If you are experiencing any of these concerns and it is affecting your emotional wellbeing, then please reach out for support.

How can I get help?

The experience of perinatal anxiety and depression can significantly affect our emotional wellbeing and prevent us from doing the things we want to do. It can affect any new or expecting parent. It can occur during our first, second or third pregnancy, or after our first, second or third baby. Reaching out for support at this time can feeling challenging. Here are a few tips on how you can find the support you need.

Notice how you are feeling.

You may be feeling anxious, flat, sad or are struggling to copy. Recognise this and talk to your family or partner about how you feel.

Explore that you may have anxiety or depression (or both).

Having anxiety or depression is not something to be ashamed about. A lot of people don’t seek help early (or at all) due to the stigma surrounding depression. How you are feeling is common and accepting that will allow you to seek further help from those close to you and a health professional.

Seek Support, from loved ones and professionals

Everyone experiences perinatal anxiety and depression differently. The best way for you to start feeling better will depend on your own experiences, the symptoms you are feeling and how strongly you feel them. The one thing that is common for all parents experiencing perinatal anxiety and depression is that the sooner you seek support, the sooner you can start to feel better.

It is important to remember that you are not alone. If you are worried about your emotional and mental wellbeing, we encourage you to reach out. Speak with a partner or trusted friend, and connect with a health professional, such as your GP, midwife or maternal and child health nurse. They are there to help, and have the knowledge and understanding to guide you in taking the steps toward the help you need.

For further information, self-assessment tools and links to FREE online treatment programs, visit our online resource, MumSpace; developed to support your emotional health during pregnancy and after having baby.

Need urgent help?

If you require urgent help, please call PANDA’s free National Perinatal Anxiety & Depression Helpline. PANDA provides a vital service across Australia by offering the only specialist perinatal mental health telephone counselling.. For immediate 24/7 support, please contact one of our trusted support organisations.