Perinatal depression includes a wide range of mood disorders that affect a woman during pregnancy and postpartum. It includes prenatal depression, the ‘baby blues’, postpartum depression and postpartum psychosis.
The 2010 Australian National Infant Feeding Survey showed that one in five mothers meet clinical criteria for depression in the first two years of the child’s birth (postnatal) and more than half of these mothers reported that their diagnosed depression was during pregnancy until the child’s first birthday (perinatal). Few women seek help for depression during the perinatal period with just over one in five were diagnosed during the perinatal period. In Australia, universal screening for all perinatal women is recommended.
Experience of perinatal depression include feeling:
- Unable to cope with new role as a mother.
- Frequent irritation and frustration.
- High anxiety about baby.
- Recurring negative thoughts – e.g. ‘being a bad parent’
- Afraid of being alone with baby.
Signs of perinatal depression include:
- Appetite change.
- Inability to concentrate or cope with daily chores.
- Often close to tears.
- Having thoughts of self-harm or harming baby.
The survey also found that perinatal depression was more reported among mothers who were: under 25 years old, smokers, from lower income households, spoke English at home, overweight or obese, and had an emergency caesarean section.
The major risk factors of perinatal depression are:
- A history of depression and/or anxiety.
- Lack of support from partner or the presence of relationship problems.
- A family history of depression and/or other mental health problems.
- A lack of practical, financial, social and/or emotional support.
- Recent major life events and stresses.
- Poor attachment with a woman’s own mother.
Perinatal depression is very responsive to the following treatment options:
- Cognitive behaviour therapy (including mindfulness based cognitive therapy, acceptance and commitment therapy, dialectical behaviour therapy, and schema therapy)
- Interpersonal psychotherapy
- Engaging partners and dealing with relationship problems in therapy
- Mother-infant psychotherapy.
Medications can be considered especially in cases where symptoms of depression are severe but often not preferred treatment option due to potential side effects for the women and their breastfed infant.