Perinatal Depression and Anxiety

Published 9th November 2021 | Dr Ujwala Parashar

It is estimated that across Australia, one in seven new mums experience perinatal depression and anxiety.

Pregnancy and birth can be one of the most joyful and rewarding times in a women’s life. They also bring many changes in our body, our daily living, our family, and our households.
While most of us understand that pregnancy and a new baby bring change, and that pregnancy and motherhood have their “ups and downs” moments, when the “down” times become dominant, it could mean you are experiencing peri-natal depression and anxiety.
Although there has been less research about perinatal anxiety, it is believed to be at least as common as perinatal depression, with a number of women experiencing both during their pregnancy and following their baby’s birth. These are common health conditions that are temporary and treatable, and can affect not only the mum, but their partner. However, due to a lack of awareness or an unrealistic perceived stigma, not everyone gets the help they need when they need it.

What is the perinatal period?

The perinatal period extends from when you first become pregnant to the first 12 months of your baby’s life. For those who experience perinatal depression and anxiety, there is no set time period for these conditions to begin. They can set in during the early part of the pregnancy or begin months after the baby has arrived.

Isn’t it just the “baby blues”?

During pregnancy, estrogen and progesterone levels rise dramatically. These hormones are associated with moods and are needed to help the uterus expand and to sustain the placenta. After giving birth, these hormone levels drop drastically, and many researchers believe this postpartum hormonal crash causes the “baby blues.”
The “baby blues” usually occurs around 3-10 days after giving birth. It can cause women to feel tearful, irritable, or very sensitive, and is a normal experience after giving birth – affecting up to 80% of all mums.
Women who experience the baby blues usually find these feelings pass in a few days, but if these feelings remain after a couple of weeks, it could suggest perinatal depression and anxiety.

What are the symptoms of perinatal depression and anxiety?

Normal pregnancy and delivery of a baby shares some symptoms and signs of depression including a feeling of tiredness, insomnia, emotional changes, and weight gain. This means that real depression symptoms can sometimes be masked.
Everyone is different and therefore their experience of perinatal anxiety and depression will differ. Symptoms to be on the watch for include:
How you feel emotionally:
Be aware of any emotional changes, in particular recognise if you have changes to your usual emotional state such as:
  • Feeling overwhelmed
  • Guilt
  • Irritability
  • Frustration
  • A lack of confidence
  • Unhappiness
  • Indecisiveness
  • Sadness
  • Tension
  • On edge
  • Wound up
How you feel physically:
Physical changes relating to perinatal depression and anxiety can include:  
  • Panic attacks
  • Hot and cold flushes
  • Racing heart
  • Tight chest
  • Quick breathing
  • Restlessness
  • Tensions
  • Feeling sick or run down
  • Headaches or muscle pain
  • Difficulty sleeping
  • Upset or churning stomach
  • Change or loss of appetite
Behavioural changes:
Changes in your usual behaviour patterns that can indicate perinatal depression and anxiety include:
  • Lack of interest in socialising
  • Withdrawing from family and friends
  • Unable to complete everyday tasks (within a reasonable expectation – sometimes things don’t always get done to schedule when there is a new baby!)
  • A reliance on alcohol and/or sedatives
  • A lack of enjoyment for activities that you used to like
  • Difficulty concentrating
  • Avoidance of situations that make you feel anxious or worried
Changes in your thinking
Experiencing changes in the way you think can indicate perinatal depression and anxiety, with thoughts like:
  • I’m a failure
  • This is my fault
  • I’m worthless
  • Nothing good ever happens to me

What causes perinatal depression and anxiety?

As with many things related to health, it is hard to identify the exact cause of perinatal depression and anxiety. For most people, there are a number of contributing factors that cause these conditions. The reality is that having a baby is one of the biggest changes that can happen in your life – and even if you already have other children, a new baby makes a difference to the family dynamics and the whole household.
There are also the physical changes that occur in a mothers body due to shifting hormone levels, lack of sleep, discomfort, changes in eating and resting patterns, and even pain during the baby’s birth. All these things can affect a mother’s mental wellbeing.
Are there risk factors for developing perinatal depression and anxiety?
Perinatal depression and anxiety have been more commonly reported among women who:
  • Were younger (under 25 years old)
  • Were smokers
  • Come from lower income households
  • Spoke English at home
  • Were overweight or obese
  • Had an emergency caesarian section

When should you seek help for perinatal depression and anxiety?

If you, or someone who is close to you, believes you might have perinatal depression and anxiety, it is important to take action now. The condition is very treatable and the earlier you are diagnosed; the earlier treatment can commence.
What is the next step in seeking help for perinatal depression and anxiety? 
The first step is to speak to someone. This can be your GP, your specialist obstetrician, or your midwife. You can also take a first step by calling a free help line like Perinatal Anxiety and Depression Australia’s National Helpline (1300 726 306) or Beyond Blue (1300 22 4636).

Holistic care during your perinatal journey

Dr Ujwala Parashar and her team provide a holistic care model to pregnant mothers that encompasses ongoing monitoring of your physical health and your mental health during your pregnancy, and after the birth of your baby. 
Please call us to arrange for a consultation with Dr Parashar on 1300 811 822.

Dr Ujwala Parashar, Obstetrician & Gynaecologist

Sam Samant

Dr Ujwala Parashar is a highly trained female obstetrician and gynaecologist with over 15 years of professional experience and training, practicing in Sydney's North Shore and Barangaroo. If you would like more information on conception, or if you are seeking obstetric options and advice, please contact us or call 1300 811 827 to arrange a consultation with her.