Entering motherhood can be one of the most rewarding life experiences. Unfortunately, for many women upon welcoming a new baby into their life and family, they may experience a mood disorder that extends beyond the natural hormonal shift after the delivery. To experience a mood disorder days or months following the delivery and when trying to care for a new born may be a terribly painful experience and goes against the many expectations of motherhood.
While most women find entering motherhood fulfilling, many find the transition to be more challenging than first expected; particularly during an adjustment period and if they are feeling low or if a feeling of anxiety continues for a long period of time. The experience of perinatal symptoms such as anxiety and depression are quite common and are often transient, but when untreated there may be direct and indirect consequences for the family.
Throughout a pregnancy many women experience depressive symptoms which are commonly referred to as the “baby blues” and then for approximately 10 per cent of those mothers will develop clinical depression. For this reason, it is important for us to look at when perinatal difficulties have become disorders, and how to successfully manage during this time.
What are the Baby Blues?
Following the birth of a baby, the mother will experience a sudden drop in hormones as their oestrogen and progesterone levels decrease. The hormonal shift may result in the baby blues. Most episodes occur three to six days following the birth and will end naturally within a few hours to two weeks after the birth.
While the baby blues are quite upsetting as it is associated with depressive symptoms, this is not considered to be a psychiatric condition. The most common baby blues symptoms include:
- Fluctuating emotions
- Tired or fatigued
- Difficulty concentrating
- Being forgetful and muddles
- Anxious and tense
- Sad and low mood
- Insomnia despite being very tired
So, then how do these symptoms differ to postnatal depression? When would a mother know the difference?
Postnatal depression (PND)
“Postnatal” refers to the period of time one year following the birth; and postnatal depression is often used as more of a generic term that is applied to a large range of postnatal conditions, excluding the baby blues. Diagnostically, PND comprises the more severe or prolonged states of clinical depression which interferes with the ability to cope. The term PND is often applied to women who are experiencing anxiety symptoms without depression.
More than 1 in 7 new mums and 1 in 10 new dads experience postnatal depression in Australia each year. The rates of postnatal anxiety is thought to be as common as depression and anxiety, and are often experienced at the same time. The signs and symptoms of postnatal anxiety and depression can vary, but commonly experienced symptoms include:
- Panic attacks
- Generalised worries
- Obsessive and compulsive behaviours
- Increased sensitivity to touch and sounds
- Changes in appetite (over or under eating)
- Disrupted sleep which is unrelated to the baby
- Feeling physically and emotionally overwhelmed and unable to cope with the demands of caring for your baby
- Diminished concentration
- Lowered self-confidence and self esteem
- Constantly sad or crying for no apparent reason
- Intrusive thoughts of harm to self or your baby
- Irritability or anger
- Loss of interest in sex or intimacy
- Thoughts or death or suicide
Melancholic depression constitutes around 10 per cent of PND cases; the period of time of greatest risk is during the first four weeks following the birth. Episodes of non-melancholic depression come on slowly, often in the first three months, whereas a depressive disorder can develop at any point within the first year.
A period of adjustment
Issues of adjustment are not solely the concern of the mother, fathers can also experience stress in the transition to fatherhood. Research has indicated that high rates of distress occur in around 1 in 5 expectant fathers. Entering a new life role, lifestyle changes are key contributors. Additional research has found that when fathers whom have limited knowledge about pregnancy and childbirth are at greater risk of distress.
While welcoming a new member into the family is generally a very exciting time, it is also a time of adjustment and may bring new an unexpected challenges. If you have noticed any of the symptoms listed above and have experienced these for two weeks or more, then seeking assistance from a medical or mental health professional is advised.
American Psychiatric Association. (2013a). Diagnostic and statistical manual of mental disorders (5th ed.). Washington DC: American Psychiatric Association.
Parker, G., 1942, Eyers, K., Boyce, P., & OverDrive, I. (2014). Overcoming baby blues: A complete guide to perinatal depression. Sydney: Allen & Unwin.
Boyce, P. Condon, J. Barton, J and Corkindale, C. (2007). First-time fathers study: psychological distress in expectant fathers during pregnancy. Australian and New Zealand Journal of Psychiatry, vol 41. Pp. 718-725.