Perinatal Depression: What is it Exactly?

As Britney Spears went public this week with the news that she's expecting her third child, her euphoric pregnancy announcement came with the open admission about her mental health.

The pop princess revealed her anxiety surrounding body issues associated with being pregnant, as well as her "absolutely horrible" experience of perinatal depression. 

So what exactly is perinatal depression and how does it differ from antenatal and postnatal depression?

Antenatal depression is experienced during pregnancy, and postnatal depression develops between one month and up to one year after birth.

However, given that depression can start during pregnancy and continue after childbirth, the term perinatal depression is now used to cover the period from conception through to the end of a baby's first year.

Julie Borninkhof, a clinical psychologist and the chief executive of Perinatal Anxiety & Depression Australia (PANDA), says that antenatal depression affects up to 1 in 5 expectant mothers and up to 1 in 10 expecting fathers.

Ms Borninkhof adds that Britney disclosing her own struggle with perinatal depression highlights that it can impact anyone.

"Regardless of the support systems you have around you, the experience of perinatal mental health, including anxiety and depression, can affect anyone, from any walk of life," she says.

For Canberra mother Antoinette Gaffney, antenatal depression took her by surprise. She had expected pregnancy to be the simple part of parenthood.

"I didn't identify the signs because I didn't even know you could get anxiety and depression during pregnancy," she says.

"I thought, 'Isn't this the easy part?' Fortunately, those closest to me did.

"Things that used to excite or interest me no longer held the same appeal.

"It took the people closest to me to help me see for myself that I was struggling and needed external support."

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The hidden pregnancy symptoms

Nicole Highet is the founder and executive director of the Centre of Perinatal Excellence (COPE) and says there are thousands of stories of hidden distress, anxiety and depression experienced by women throughout their journeys to parenthood.

"Unfortunately, depression and anxiety commonly arise in pregnancy, highlighting the critical importance of awareness and education — for expectant parents and health professionals — surrounding the signs, symptoms and effective treatments," Dr Highet says.

"It also highlights the imperative need for universal routine screening of all expectant mothers, as recommended in the national perinatal mental health guidelines."

Dr Highet also says that pregnancy is far from the "glowing" experience that many women hope for, leaving expectant mothers both physically and emotionally vulnerable.

"The truth is, the blissful experiences promoted by social media are often far from reality and many women feel alone and isolated," she says.

"This lack of awareness, shame and stigma prevent them from seeking appropriate support and assistance."

Signs and symptoms to look out for:

  • Feeling sad, angry or isolated;

  • Difficulty with focus, concentration or memory;

  • Feeling disconnected from your pregnancy and unborn baby;

  • Difficulty thinking clearly, concentrating or making decisions;

  • Loss of interest in things that were once enjoyed;

  • Thinking that your baby won't love you;

  • Constant tiredness or exhaustion;

  • Changes in appetite and libido;

  • Using alcohol, drugs or overspending to "escape" or cope;

  • Thoughts of self-harm, suicide or hurting your baby;

  • Emotional withdrawal from your partner, family or friends;

  • Thoughts like "I can't do this" or "I can't cope".

Source: PANDA and Raising Children Network

Seek help early

The signs and symptoms of depression during pregnancy are different for everyone, but, according to Ms Borninkhof, the most important message is to seek help early.

"Reaching out at the early stages can reduce the pressure of not knowing where to turn to if things get really hard," she says.

"Sometimes, it's enough just knowing support is out there."

Seeking help was vital in the recovery process for Kelly Hansberry of South Australia, who has two children.

"What helped me heal was being kind to myself, reaching out, seeking support and giving my body the time and self-care to rest and recover," she says.

"As the expression goes: 'You cannot pour from an empty cup'. We should never feel guilty looking after ourselves as mothers," says Kelly.

"We go through and give so much, therefore it's just as important to give as much back to ourselves. We are just as important as our babies." 

If you or someone you know is experiencing perinatal depression you can call your state's Mental Health Line for 24/7 professional help, advice and referrals to local mental health services. 

Prudence Clark