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The facts on antenatal depression

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Australia is in the midst of a baby boom. Not since 1961 – the original baby boom – have we seen such a surge in births, with the figures showing more than 300,000 new Aussies made their way into the world in 2011. That’s equivalent to one baby being born every minute and 47 seconds.

But among the excitement of a rising birth rate comes a confronting reality: more babies being conceived equates to an increase in the number of Australian women experiencing antenatal depression.

According to Belinda Horton, CEO of PANDA (the Post and Antenatal Depression Association), approximately 10 per cent of pregnant women are likely to experience and be diagnosed with depression, while anxiety rates are believed to be even higher. “These statistics have remained steady for the last decade, but as the birth rate has gone up, more mothers-to-be are suffering,” Belinda explains.

Signs something is not right
Pregnancy can be an emotional ride, to say the least. So how can you tell if you’re riding out a normal low, or if it’s something more serious? “If you’re experiencing a number of symptoms of depression, or if they persist over a period of time, it’s best to see a health professional, such as your GP, midwife or obstetrician,” says Dr Nicole Highett, psychologist and national perinatal advisor at Beyond Blue. The key signs to look out for, she says, include withdrawal or loss of interest or pleasure in life, constantly feeling sad or overwhelmed, and a negative outlook.

“Many pregnant women misinterpret the signs and symptoms and put them down to just being pregnant – they think they’ll end when the pregnancy does,” Dr Highett says. But don’t bury your head in the sand. Pay attention to the signs and don’t be afraid to seek help if you spot them.

It’s also important to know that while antenatal depression can affect anyone, there are some women who are most at risk. These include women with a family or personal history of mental illness, says Dr Vijay Roach, chairman of the Gidget Foundation, which promotes awareness of perinatal anxiety and depression. Other factors that increase the risk of antenatal depression include previous drug abuse, poor relationships with your own mother or partner, health problems or previous negative experiences in pregnancy, and external pressures, such as financial stress.

Getting diagnosed
“Unlike some physical illnesses, where you’re sent off for a blood test or ultrasound, diagnosing depression isn’t black and white,” says Dr Highett. It usually begins with a screening process, where your caregiver will talk to you at length about your symptoms and observe your behaviour, such as the way you present yourself, your demeanour, energy levels and your ability to get to the appointment, she explains. Sometimes a third party may be involved in the process for added insights and information. “For example, the pregnant woman’s partner might be asked about how she is managing at home and areas of concern,” Dr Highett says.

The Edinburgh Postnatal Depression Scale is a set of questions designed to indicate possible perinatal depression (‘perinatal’ being the period immediately before and after birth). It’s usually used in the diagnosis and can be taken at home, too. If you’re unsure about whether or not to seek professional help, visit www.beyondblue.org.au and click on ‘Postnatal depression checklist’ under the ‘Symptoms’ tab. If your score is 10 points or above, Dr Highett recommends you speak to your health professional about the symptoms. You can take the completed checklist with you to begin the conversation.

Speak up and seek help
“Pregnancy is ‘supposed to be’ a time of great joy and happiness, so many women suffering symptoms of depression are reluctant to come forward because of the fear of being labelled a bad mother or a failure,” says Dr Roach. “But knowing that your feelings are real and valid and that help is available is a huge relief for women who would otherwise suffer silently.”

If you suspect something may be awry, don’t bottle it up. “Acknowledging your feelings is the first step,” advises Dr Highett. And remember, there’s nothing to be ashamed or afraid of.

Post-diagnosis, the type of treatment for antenatal depression depends on the severity of the condition. Mild to moderate depression can be treated with psychological therapies, which aim to encourage rational thinking, while moderate to severe conditions can require intervention with medication. “There are some antidepressant medications that are proven to be safe and effective to use in pregnancy for depression – in fact, in some cases, not taking medication could be having a detrimental effect,” says Dr Highett.

Remember, health and wellness begins with you. “Staying fit and healthy during pregnancy is so important – antenatal yoga is empowering for the mind and body, while swimming, meditation and regular walks are kind on pregnant bodies,” says Belinda. And spoil yourself while it’s still so easy, she adds. “Find time for yourself and relax; ditch the vacuuming for a bubble bath instead.”

After bub’s birth
Research has found that women diagnosed with antenatal depression are at an increased risk of postnatal depression, which one in seven new mums develop. So what’s behind it? “Additional stressors, such as sleep deprivation, feeding and settling difficulties, relationship disharmony and the adjustment to new parenthood can contribute,” says Dr Roach.

As with antenatal depression, postnatal depression can be difficult to identify. “In the postnatal period, some women think what they’re experiencing is just the baby blues, though these only last eight to 10 days after having a baby,” says Dr Highett. “Even months down the track, it’s still common for people to misinterpret their symptoms. The reality is, being aware of your mental health during the perinatal period is just as important as keeping an eye on other pregnancy-related health concerns such as gestational diabetes or high blood pressure. The key is recognising and getting on top of it quickly – preferably before bub arrives.”


Where to find help

As well as talking to your GP, midwife or obstetrician, who will be able to put you in touch with a psychologist or counsellor, great information and support can be found through the following organisations...

Lifeline www.lifeline.org.au; 13 11 14
SANE www.sane.org; 1800 187 263
PANDA www.panda.org.au; 1300 726 306
The Gidget Foundation www.gidgetfoundation.com.au; 1300 726 306
Beyond Blue www.beyondblue.org.au; 1300 224 636
The Black Dog Institute www.blackdoginstitute.org.au


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