Postnatal Anxiety: Should I Be Worried?

According to Perinatal Anxiety and Depression Australia (PANDA), approximately 1 in 7 new mums experience PND and PNA is just as common.

Many parents experience both anxiety and depression at the same time. Australian research suggests that up to 10% of women experience antenatal anxiety and depression. They also point out that 16% of women experience postnatal anxiety and depression.

PNA is anxiety experienced during pregnancy or in the year after childbirth. You also may hear it called:

• Prenatal or antenatal anxiety, if you experience anxiety during pregnancy
• Postnatal anxiety, if you experience it after giving birth

When Should I Be Worried About Anxiety?

It is normal to feel some degree of worry during pregnancy – after all, your body is going through major growth and hormonal changes during pregnancy may affect the chemicals in your brain.

PNA is more than feeling concerned; it arises when the feelings of being stressed become so large that they start to impact on the way that you are functioning from day to day. PNA can impact the way that you feel and care for your baby. Excessive worry and the stress of anxiety can start to have a serious impact on your life and stop you doing things that once were easy and enjoyable to do.

Anxiety is one of the most common types of mental health problems in Australia and your chances of developing it are greater when you’re pregnant. However, the symptoms are often overlooked and put down to hormones, being over-organised or as just a normal part of being pregnant.

Many mothers describe PNA as:

• Feeling an uncontrollable sense of anxiousness
• Worrying excessively about things, especially their health or the health of their baby
• Experiencing an inability to concentrate
• Feeling irritable or agitated
• Having tense muscles
• Sleeping poorly

Read here for one mother’s touching story of living with PNA

Am I at Risk of Developing PNA?

PNA can develop during any pregnancy. However, if you have previously experienced an anxiety disorder, are someone who tends excessive worry or has a Type A personality you may be at a higher risk of developing PNA.

There are also risk factors that have been highlighted that suggest that some people may be at a higher risk of developing PNA. These include:

• Family history of anxiety or panic attacks
• Personal history of anxiety, panic attacks or depression
• Previous trauma
• Use of certain illegal drugs
• Excess stress in everyday life

What Are the Symptoms?

Every person is different in terms of how PNA affects them. Sometimes, symptoms can creep up over time and the illness has a slow build. Other times it can come on suddenly and in full force. Regardless of how PNA affects you, if you don’t seek help, the symptoms can intensify. It is important to understand that PNA is a treatable and temporary illness.

Some of the common symptoms can be:

• Panic attacks (a racing heart, palpitations, shortness of breath, shaking or feeling physically “detached” from your surroundings)
• Persistent, generalised worry, often focused on fears for the health or wellbeing of the baby
• The development of obsessive or compulsive behaviours
• Abrupt mood swings
• Feeling constantly sad, low or crying for no obvious reason
• Being nervous, “on edge,” or panicky
• Feeling constantly tired and lacking energy
• Having little or no interest in all the normal things that bring joy (like time with friends, exercise, eating or sharing partner time)
• Sleeping too much or not sleeping very well at all
• Losing interest in intimacy
• Withdrawing from friends and family
• Being easily annoyed or irritated
• Finding it difficult to focus, concentrate or remember (people with depression often describe this as a “brain fog”)
• Engaging in risk-taking behaviour (for example, alcohol or drug use)
• Having thoughts of death, suicide or self-harm

Suicide has become one of the leading causes of maternal deaths in Australia. If you or your partner are at immediate risk of harm call 000 or Lifeline on 13 11 14.

Did You Know That Men Can Get PNA Too?

It’s not only women who are at risk of developing PNA. 10% of fathers are also affected. 1 in 10 new dads experiences PNA or PND.

How Do I Get Help?

PNA is a serious illness, but, there are treatments, support and services available to help. It’s important to remember that PNA is temporary and treatable. It is also important to keep in mind that you are not alone and the sooner you seek help the sooner you will be on the road to recovery.

A good place to start is with your GP. Most health professionals are well trained in diagnosing PNA and will be able to assist you in getting the appropriate treatment.

Some Other Great Resources

Lifeline Australia - 13 11 14 - Crisis Support and Suicide Prevention. Lifeline is a national charity providing all Australians experiencing a personal crisis with access to 24-hour crisis support and suicide prevention services

Centre of Perinatal Excellence (COPE) provides information that can help you to work through all the emotional challenges of becoming and being a parent.

PANDA - Perinatal Anxiety & Depression Australia. PANDA supports women and their families who are suffering from antenatal and postnatal anxiety or depression

How is PNA Treated?

Treatment options vary according to each mother. Generally, a combination of medication (which includes an anti-anxiety compound) and counselling is recommended.

Can I Still Breastfeed with PNA?

In a nutshell yes! Breastfeeding is encouraged and still very possible with PNA. Many mothers feel that breastfeeding helps them to continue to feel connected to their baby and helps to reduce the symptoms of PNA.

However, for some, breastfeeding is the thing that is triggering their PNA. Giving up breastfeeding can be what some mothers need to get better. But, for other mothers, it can have the opposite effect and make the symptoms worse. This is why it is so important to get professional help.

A recent study showed that stopping breastfeeding was associated with an increase in levels of anxiety and depression. The study suggested that women who experienced high levels of anxiety during pregnancy are at additional risk for postpartum anxiety and depression if they stop breastfeeding early.

If you are considering discontinuing breastfeeding because you think that may help with the anxiety that you are experiencing, or you need support to continue breastfeeding, it is important to seek help from an IBCLC or your health practitioner. They can fully support and guide you to manage your decision.

Disclaimer: Nothing in this article is intended to be medical advice.

References

Perinatal Anxiety and Depression - RANZCOG

Perinatal Anxiety & Depression Australia

Pregnancy, Birth and Baby – Anxiety and Pregnancy

BMC Pregnancy and Childbirth

*Borra C, Iacovou M, Sevilla A. New Evidence on Breastfeeding and Postpartum Depression: The Importance of Understanding Women’s Intentions. Matern Child Health J. 2014 Aug 21