Depression and anxiety are common during pregnancy and after the baby’s birth. In fact, about one in five people feel depressed or anxious within the first year of giving birth. And perinatal depression/anxiety doesn’t just affect the person who gave birth—sometimes the partners of people with perinatal depression also feel depressed, which can affect the whole family.
There are many reasons why people develop depression and/or anxiety during pregnancy or after birth. Changes in hormone levels can contribute to depression/anxiety, a past history of depression/anxiety, stressful life events or difficult relationships can all have impact. The enormous changes that a new baby brings to home life can also be a contributing factor.
The symptoms of perinatal depression/anxiety are varied and each person experiences it differently. Symptoms can include feeling sad, empty and helpless; feelings of guilt, worthlessness and hopelessness; loss of interest and pleasure in activities enjoyed in the past; decreased energy, feelings of fatigue; changes in sleep or appetite; restlessness and irritability; difficulty concentrating; having frightening thoughts about harming the baby; and possibly thoughts of death or suicide.
Just as there are many symptoms of depression/anxiety during pregnancy or after the birth, there are also many things people can do to manage symptoms. Many people experiencing these symptoms know something is wrong but don’t ask for help, as they may feel ashamed or embarrassed. Sharing feelings and experiences with trusted loved ones, whether family or friends, does help.
Self care is an important goal when someone has depression/anxiety. The “NESTS” model is often recommended as a way of promoting areas of self care.
‘N’ stands for Nutrition. Some find that snacking on healthy food throughout the day is easier than sitting down to a large meal. Try to stock your cupboards and fridge with healthy ready-to-eat or easily prepared foods. Don’t forget to take the multivitamin recommended by your health professional. Canada’s Food Guide makes excellent recommendations and is available at most health units throughout Vancouver Island.
‘E’ stands for Exercise. Regular physical activity is related to improved mental and physical well-being. Focus on exercise that you enjoy and keep in mind that regular short periods of exercise are better than irregular long periods. Even simple activities such as going for a walk can help you feel better.
‘S’ stands for Sleep/Rest. Try to get as much rest as possible. This can be very challenging with the never-ending demands of a baby or the discomfort of pregnancy. However, it’s important as rest is vital for brain health. Ask if any family or friends can babysit while you have a nap.
‘T’ stands for Time for Self. People suffering from perinatal depression or anxiety should try to be good to themselves. Postpone the laundry and have a quiet time instead. Sometimes just ten minutes is enough to have a cup of tea and take a breather. Keeping expectations realistic is also important.
‘S’ stands for Support. Support can come from friends, family or professionals and can be in whatever form is most helpful to the person who needs it.
It is also recommended that people consult with their family physician or midwife if they are feeling emotionally unwell. Health professionals can provide the Edinburgh Postnatal Depression Scale (EPDS) to anyone between 28 and 32 weeks in pregnancy as well as after the birth of the baby. This questionnaire helps to identify a risk for depression and provides the opportunity to put support and treatment in place if needed.
Child, Youth and Family Public Health also has a role to play in supporting perinatal families. Public Health Nurses call families six weeks after the birth of the baby to check in and offer the EPDS. If contact was not made at six weeks the EPDS is offered during the two-month immunization appointment. If it appears there is a risk of depression or anxiety, referrals can be made to counselors and/or support groups throughout Vancouver Island. Online resources can also be provided.
If there is a risk of harm to self or others, immediate action is necessary. Call the family physician, midwife or Vancouver Island Crisis Line at 1-888-494-3888 for urgent support and treatment.
Many families experience perinatal depression and anxiety. There is no need for anyone to suffer alone or in silence as there are many sources of support and information available.
Hilary Planden is a Clinical Coordinator at the Saanich Health Unit for Child, Youth and Family Community Health, Island Health.