It is common for women to go through various pleasant and unpleasant states after childbirth, and partly during pregnancy.
Anxiety is a common reaction to an unknown or new situation and is almost inevitable in pregnancy and parenthood. It is not possible to predict how the birth will go, whether everything will be fine with the baby. It is not possible to be sure of all the information and always know whether the baby is developing well. It is difficult to stay calm when the baby cries a lot and be sure it is “just colic”, and it is even harder to accept that we cannot calm him or her. For generations, mothers have found way to check whether the baby breathing: by placing their hand on the belly, a mirror on the nose and probably there were many other creative ways.
Sadness, crying for no reason, low mood are also common, due to physiological changes after childbirth and due to psychological adjustments to motherhood. Most parents – both moms and dads – experience ambivalent feelings to a greater or lesser extent: sadness and anger, which can arise due to the perception that they have lost their “old life”, and happiness due to the arrival of the baby, love for the baby.
Sometimes these feelings develop into a more serious condition that is more intense, lasts longer, and can have consequences for the parent-baby bond, as well as the baby’s psychophysical development. That is why it is necessary to recognize them and seek support in a timely manner. With adequate professional help, a more beautiful and easier path to parenthood will soon be possible.
Perinatal depression or anxiety includes a variety of mental health difficulties that occur either during pregnancy or in the year after giving birth. Unfortunately, the area of perinatal mental health in women is still under-researched and we do not know exactly how many mothers are affected, but estimates for perinatal depression and/or anxiety are that 1 in 5 mothers are affected.
How to recognize perinatal depression and anxiety?
Perinatal depression usually includes at least several symptoms from this list, lasting at least 2 weeks:
- Feeling sad or depressed mood
- Loss of interest or pleasure in activities you once enjoyed
- Changes in appetite
- Problems sleeping or sleeping too much
- Loss of energy or increased fatigue
- Increased aimless physical activity (e.g., inability to sit still, walking, arm jerking) or slowed movements or speech (these actions must be severe enough for others to notice)
- Feelings of worthlessness or guilt
- Difficulty thinking, concentrating or making decisions
- Thoughts of death or suicide
- Crying “for no reason”
- Lack of interest in the baby, lack of feeling connected to the baby, or feeling very anxious about/around the baby
- Feeling like we are a bad mother
- Fear of harming the baby or oneself
Perinatal depression does not necessarily look like the “typical” picture of depression: with extremely low energy levels. Loss of energy is less common, while it is often accompanied by anxiety symptoms: excessive worry about the health and development of the child, the outcome of pregnancy and childbirth, and worries about how we will cope as mothers. Worry is accompanied by thoughts that are difficult to exclude and physical symptoms such as difficulty sleeping, concentrating, and restlessness.
There is also the possibility of exclusively developing perinatal anxiety, which can come in one of the following forms:
- A feeling of worry, lasting most days for an extended period of time (a few months), about things related to the pregnancy and/or baby: e.g., the well-being, safety, and possible threats to the infant; planning and dealing with things in one’s own life, constant worry about how to cope with the situation, worries about breastfeeding (e.g., whether the baby had enough milk, whether she would run out of milk), how to cope with work and parenting, how to give enough attention to other children while meeting the needs of the new infant
- Panic attacks: frequent attacks of intense anxiety accompanied by a feeling of loss of control
- A pronounced fear of criticism or embarrassment from others, e.g., worrying about what others will say about our parenting practices or the baby, whether it be friends and family or strangers who we judge to be judgmental of parenting (e.g., a crying baby in a store).
More important than both numbers and diagnosis– which is best left to an expert, is to remember the following:
Seeking support isa sign of awareness, not weakness
Pregnancy and early parenthood are very sensitive periods for women.
Some will develop serious conditions such as the described depression and/or anxiety. It is not possible to fully predict who will and who will not develop symptoms. It is possible for it to happen to each of us, and it does not indicate weakness, flaw, craziness, but only that we need support.
Some will experience a range of different, more or less pronounced, unpleasant feelings and states. They come with less intensity and more good periods than in perinatal depression and anxiety, and there is no official diagnosis for them. However, the absence of a diagnosis does not mean that support is not needed.
Support can come in many forms: household help, a good friend, an involved partner who cares about how we are and wants to help in any way we need.
Support can come from other moms. Often moms make friends informally, in the park, at a coffee shop, or online, and provide much-needed understanding and companionship. In some places, there are also support groups and places and programs for new parents.
Support can also come in the form of psychoeducation, counseling, psychotherapy – which serves to overcome this period in the best possible way.
Support is anything that provides mothers with a listening ear, a shoulder to cry on, time just for themselves, with confirmation that they are not alone or crazy, but are having a normal reaction to an abnormal situation.
We could expect a much easier transition into motherhood if mothers were more supported by society. If midwives and gynecologists had more understanding and time for pregnant women and mothers-to-be, if hospitals were a more pleasant place for check-ups and childbirth, if postpartum families had more time to be with their baby, without other worries, chores, or obligations, with less advice from others, and more support from others.
What about fathers?
Fathers have a very important role to play in recognizing symptoms and providing support to their partners. They shouldn’t be left alone in this, because in this real world of ours, it’s hard to be a lone superman savior.
Fathers need to be made aware that they too can experience difficulties adjusting to parenthood. It is important to understand that fathers are not immune to developing perinatal depression and anxiety and can develop very similar symptoms.
If you notice that you or a parent in your environment needs support and an expert opinion, contact an expert: You can look for a community nurse who will be able to direct you to the right address, or contact a psychologist or psychiatrist at the Health Center.
https://www.uc.pt/site/assets/files/1285626/riseupppd_clinicalpracticeguidelines.pdf
https://www.psychiatry.org/patients-families/peripartum-depression/what-is-peripartum-depression
Author: Barbara Perasović Cigrovski, mag.psych.