The conversation all pregnant women need to have with their doctor

Stressed pregnant woman under covers

Pregnancy can be a challenging time for any woman but it’s even harder for those with a mental illness. One in five Australian women will suffer from anxiety or depression during pregnancy and after birth, and yet many don’t seek help in the early stages which is when they need it most. We spoke about the issue with Terri Smith, CEO of Perinatal Anxiety & Depression Australia (PANDA).

More common than diabetes

According to Terri, having a baby is the peak time in a woman’s life where she’s most likely to experience mental health issues because there’s a lot going on with changes in physicality, relationships, work, sometimes home environment and self identity. Anxiety and depression are extremely common during pregnancy, although unfortunately it’s not top of mind for health professionals or the community.

“Gestational diabetes testing takes place with every pregnancy, but we know that anxiety and depression are way more common during this time, and yet we don’t talk about it,” says Terri. “I think it’s because as a society we don’t feel very comfortable talking about mental illness.”

There’s quite a lot of awareness out there now for postnatal depression, but why exactly aren’t women being checked for mental health issues BEFORE they have the baby?

Existing mental illness

Apparently half of all callers to the PANDA national helpline are women with a preexisting mental illness. Conditions range from anxiety suffered years prior, during end of school exams and teen eating disorders, to other issues like bipolar and personality disorder. According to Terri, this group is actually quite good at seeking help because they already know that something is going on.

“If you’ve had a previous mental health illness you can have babies but it’s extra important that you plan and work out how you’re going to manage it with your health providers,” says Terri.

“Sometimes you might need to find a better health professional who can handle your situation better, because the psychiatrist you’ve seen for ten years knows nothing about babies and might say you can’t have a baby, and likewise your GP might tell you to come off your medication which can create far more risks.”

Contrary to popular beliefs, there are actually mental health medications now that are perfectly safe to take when pregnant.

Silently suffering

Unfortunately the other group of women that PANDA talks to aren’t so clued up when it comes to mental health and often end up struggling alone, not realising they can get help.

“These women are totally blindsided by their issues and don’t know what’s happening to them. Because of the transition they’re going through often they don’t stop and think, ‘oh perhaps something’s wrong,'” explains Terri.

“They’ll think it’s crap and won’t like what’s going on, but it will take them a really long time to get help because they didn’t understand that something was wrong with them that they could get fixed.”

The dangers

Mental illness can be a difficult and painful struggle for the individual and their loved ones. When pregnant however, there are additional risk factors to think about.

“It’s normal to have worries and concerns when there’s a baby on the way, especially for women who have lost babies or struggled with fertility and gone through IVF. Anxiety however leads to an increase in the hormone cortisol, which is not good for growing babies and can lead to developmental issues with their motor skills and intellect,” says Terri.

“Depression can also be a very serious illness and in the worst sense can sadly lead a woman to taking her own life and that of her unborn baby.”

Men with partners who have anxiety or depression during pregnancy are apparently also more at risk of getting it themselves too.

Stressed pregnant woman

The warning signs

According to Terri, anxiety is very different to depression and it’s important to look for the signs and symptoms of both when you’re pregnant.

“With anxiety you’ll have enhanced feelings, heart palpitations and panic attacks. Normal worries are okay but with anxiety you’ll worry about every possible thing that could happen to the baby growing inside you, it will border on obsessive and you might not be able to go out,” says Terri.

Depression on the flip side will see women withdrawing from people, constantly crying or just not able to see any joy.

“Essentially what we’re looking for is a change in character. You want to recognise a change and symptoms for two weeks or more,” Terri explains.

“Often women will suffer a lot in pregnancy and their mental health not picked up until the baby is born which is so sad. It can be hard to know what’s going on so that’s why the two week figure is important.”

Getting help

If you’re pregnant (or have recently had a baby) and think you’re suffering from a mental illness, there is support out there. PANDA has a helpline you can call to discuss your problems and partners, friends or family members can also reach out if they suspect a pregnant woman might be mentally ill.

The PANDA website is full of helpful stories from real women who might have gone through similar feelings and issues that you might be experiencing too, which can help pregnant women realise that there is help available for what’s happening to them.

In many cases, just talking through issues with someone or reading about the same problems can be enough help for women. For others though, more support is required which is why PANDA also has an ongoing service where fully trained peer support volunteers (women who have experienced mental health issues themselves when having a baby) do follow up calls. When necessary they will also get partners or health professionals involved, and help get you doctor’s appointments too if need be.

The bright side

Although mental illness should be taken very seriously and can be a tough road, especially during pregnancy, there is a silver lining for all those sufferers.

“The joy in this illness is that it’s very recoverable. It’s hard to see that future though in the depths of anxiety and depression, which is why we need to be talking about it more so it’s easier for women to get help,” says Terri.

“One in five women will get it so just be aware that looking after your mental health, as well as physical health, is very important during pregnancy and remember to get help if you need it.”

Perinatal Depression & Anxiety Awareness Week runs from 12-18th November. For more information please visit PANDA’s website here or if you’re pregnant and  feel you’re suffering from mental illness, call their helpline on 1300 726 306.

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