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perinatal depression and anxiety - PNDA
Having a baby is usually a happy event but can be a stressful time during which many adjustments have to be made and mild to severe mood changes are common. In the year after childbirth a woman is more likely to need psychiatric help than any other time in her life.

Many women who are diagnosed with postnatal depression and/or anxiety report their symptoms started during pregnancy. Statistics show that 16% of women will be affected by postnatal depression and anxiety and 10% of women will experience depression and anxiety during pregnancy.
Postnatal depression and anxiety (PNDA) is one of three mood disorders that can follow childbirth. The other two are the baby blues and postnatal psychosis. Because these disorders are so different and need to be defined so that there is a much better understanding, I’ll give a brief explanation of all three.

The baby blues often occurs between day 3 and day 12 and affects up to 80% of new mums. You may feel tearful, anxious and lack the confidence in taking care of your new baby. The baby blues is caused by a sudden change in hormones but balances out on it’s own after a few weeks. Support, empathy and understanding will see you through this time and no treatment is needed.

Postnatal depression and anxiety is another story! It affects at least 1 in 7 women who give birth in Australia. Symptoms usually appear in the first few months after childbirth, either gradually, over several months or, it can hit you like a mack truck. In reality though, symptoms of PND can appear anytime in the first year and can range from mild to severe. Some women have only a few symptoms which have little affect on their lives while other women will experience most or all of the symptoms which has a severe and debilitating effect. PND doesn’t discriminate either, with it affecting women of all ages, races and cultures. It can affect you after natural childbirth or caesarean. It can affect you on your second, third or fourth baby and not the first, or can happen after each pregnancy. There are no set rules and no such thing as ‘normal’. Early diagnosis is vital and with the appropriate treatment most women can expect to make a full recovery with you feeling back to your old self again. If left untreated PND can turn into chronic depression.

Postnatal psychosis (PNP) is rare! However, still occurs with it affecting 1 in every 1,000 new mums. PNP is usually picked up in the first four weeks after childbirth because the symptoms are so severe and obvious. Symptoms of PNP include severe mood disturbances, confusion, morbid or scary thoughts, bizarre behaviour and insomnia. Women can also experience hallucinations (seeing, hearing and feelings things that aren’t there) and delusions (believing things that are not true). This illness needs URGENT medical attention! Again, with the appropriate treatment, most women make a full recovery.

So what causes postnatal depression? There are a number of factors that increase the likelihood of developing PND. There isn’t usually one single cause, but more likely a combination of factors including:

• a past history of depression
• a past history of anxiety
• a stressful pregnancy
• depression or anxiety during the pregnancy
• a family history of mental illness
• difficult labour and/or birth
• problems with the baby’s health
• difficulty breastfeeding
• lack of support (financial, emotional…)
• a history of abuse
• difficulties in close relationships
• sleep deprivation (the root of all evil)
• being a single parent
• having an unsettled baby
• unrealistic expectations about motherhood
• moving house
• work adjustments

So, as you can see from this long list, we are all susceptible to falling victim to clutches of PND.

Before we move on to the signs and symptoms of PND, I want to touch base on one factor in particular… Unrealistic expectations about motherhood. You know the thoughts and ideas we have about how things should be 'mothers bond with their babies straight away', 'mothers know instinctively what to do' (yeah right), 'motherhood is purely a time of joy'.
We see it on TV, in films, in other people’s life (so it appears anyway), in magazines and the rest of the mass media. They show new mothers coping wonderfully, having an instant and loving bond with their baby, having a baby that sleeps and settles well, and we’ve all seen the images of baby and mother taking to breastfeeding like ducks to water. As if all that doesn't make you feel like a failure! But I'm here to tell you that it's not reality and you're not a failure. You're doing a great job, despite the fact that early days with a baby are incredibly difficult. Don't be too hard on yourself, allow yourself to make mistakes (less the self-criticism).
No one sign or symptom is an indicator of PND, but the following list might give you an idea on whether or not to seek professional help. In saying that, even if you aren't experiencing any of the following symptoms but feel like you're not coping as well as you would like, still seek help. A new mum who exhibits or experiences some of the following signs or symptoms for two weeks or longer, may have PND and should see an experienced health professional immediately. The sooner you get a diagnosis the sooner you can feel back to normal.
Symptoms of PND might include;

• Feeling sad or irritable most of the time
• Loss of interest in things that used to be enjoyed
• Chronic exhaustion
• Unable to sleep despite being exhausted
• Feeling unable to cope with daily tasks
• Anxiety & panic
• Negative or morbid thoughts
• Feeling alone, guilty or inadequate
• Thoughts of suicide

There are many ways that a women with PND can help herself feel better such as;
• Seeking help... the first and most important thing you can do for yourself
• Seeking friendships
• Organise childcare
• Take time out
• Develop a support system
• Restrict visitors
• Meet with other mums that are experiencing the same feelings
• Take one step at a time and don't worry about the washing up
• Talk about your feelings
• Eat a balanced diet
• Practice relaxation techniques
• Do some research on PND and
• As difficult as it is, try to establish good sleeping patterns. "Sleep deprivation is the root of all evil when it comes to PND!"

I have worked as a counsellor for many years, and as a past sufferer and survivor or PNDA I always wanted to start a support group, this is something pretty close to my own heart. I know how dreadful it feels to have PNDA, especially when it's a time that is 'suppose' to be joyous and memorable. It's an incredibly difficult time to get through. However, the right support can help you get through this easier and faster.

The group is an open group so mums and mums-to-be are free to come along at any time. It's an opportunity to talk with other's in a safe and caring environment and to those that are experiencing the same feelings as them, but more importantly it's a positive group that will teach mums how to help themselves, feel better and 'cope' .

I have lots of helpful information and resources from beyondblue to give to every mum that comes along to the support group.

The group is held on the first Thursday of each month at 11:00am in school terms at Balgownie Village Community Centre and is a free service.


Thursday 4th March at 11:00am

Thursday 1st April at 11:00am

Thursday 6th May at 11:00am

Thursday 3rd June at 11:00am

Thursday 1st July at 11:00am

Thursday 12th August at 11:00am

Thursday 2nd September at 11:00am

Thursday 7th October at 11:00am

Thursday 4th November at 11:00am

Thursday 2nd December at 11:00am

Anyone interested in coming along can contact me on 0410 138 196.

If however, you feel that you aren't up to facing a group and would prefer private counselling, I also offer one-on-one counselling for women (and their families) with PNDA.  If you would like to make an appointment please call me on 0410 138 196.


Other helpful websites

Birthing Sense: www.birthingsense.com

Beyondblue: www.beyondblue.org.au

Lifeline: www.lifeline.org.au

PaNDa: www.panda.org.au

Multiple Births: www.expectingmultiples.com

Gidget Foundation: www.gidgetfoundation.com.au/


National Information and Help Lines 

Beyondblue info line: 1300 22 4636
Lifeline: 13 11 14
Suicide Call Back Service: 1300 659 467
Mensline: 1300 78 99 78
Kids Helpline: 1800 551 800


© 2008 Melinda McKeown Counselling Services