Perinatal Anxiety – the silent epidemic.
When my son was about four weeks old, I thought I would make an effort to get out of my slobby maternity clothes that were stained with baby vomit and breast milk and get showered, dressed – and hell, maybe even throw on some make-up and perfume! – and go for a walk into the nearby city centre to surprise my husband at work. We were living in Jerusalem at the time, and I never tired of the stunning scenery around me – 2,000 year old Roman ruins standing side-by-side with modern architecture. What an incredible city to live in!
The 20 minute or so walk to the city was uneventful. My son slept pretty much the whole way there. I basked in the Mediterranean summer sun and deeply inhaled the beautiful fresh air around me.
When I arrived in the CBD, I remembered that I needed to buy a few baby supplies. I decided to pop in to a local pharmacy and get them before I called my husband to meet us.
About two minutes into my brief shopping detour, my son decided to wake up. It was probably because every second person in the store decided to take a peek into my stroller and declare in loud shrieks (in Hebrew, of course) everything from; “Oh what a beautiful baby! Tfu tfu tfu” (superstitious pretend spitting) is it a boy or a girl? to “What! Are you insane? Why are you taking a newborn out of the house? Go home straight away! You’re a terrible mother!”
Needless to say, my son did not slumber through the near-constant invasion behind his muslin shade wrap. He took a deep breath in and let those little lungs of his rip. And he did not stop. He was howling. Not crying. Screaming. The kind of blood-curdling scream that sends a new mother into instant meltdown. I dumped the few things I was going to buy and just bolted out of the store as quickly as I could; trying to maintain what little composure I had left.
My husband’s office was directly opposite the pharmacy, so once I was outside in the street, I took out my phone and called him. I don’t think I stopped to take a breath. I just wailed down the phone, a sobbing, hysterical wreck. Looking back, I am sure he must have thought something absolutely dreadful had happened. It took him a while to understand that I was directly below him, crying my heart out, oblivious to all those passers-by around me, staring at the crazy, hysterical woman.
He ran down the stairs and when he reached me, he had a look of terror in his eyes. What was wrong? Was I okay? Was our baby okay?
I could barely talk. I was hyperventilating and then some part of my brain registered that I was having a full-blown anxiety attack.
My husband bought me a bottle of water and sat me down on a nearby bench.
“Breathe. Just breathe” he said.
I don’t know how long we were there. It could have been 10 minutes; it could have been an hour. Six years on, I still don’t remember.
The next thing I do remember was my husband walking us home again and then waiting at home until he was reassured that I was okay, and not going to do anything crazy (he was genuinely worried about me). I also remember that feeling of utter abandonment when he left us at home alone again because he had to go back to work for the rest of the afternoon. I think I cried for most of the day.
Like I said, this happened to me almost six and a half years ago. And yet, the emotions are still raw and I can conjure them up like it was yesterday.
According to Terri Smith, the CEO of PANDA (Perinatal Anxiety and Depression Australia), over 1800 Australian parents each week are now diagnosed with antenatal or postnatal depression, with the illnesses costing Australia close to half a billion dollars — a figure that doesn’t include those touched by perinatal anxiety.
Perinatal covers the period from conception to a year after the baby’s birth. While most people are aware of postnatal depression, the same cannot be said for perinatal anxiety, which many health care professionals believe is on the rise at a staggering rate. In fact, anxiety is just as common as depression in parents during the perinatal period, however many people (including care providers) fail to recognise the symptoms.
While anxiety, left untreated, can lead to depression, I think it is important for us to look at anxiety separately. As a Lamaze Childbirth Educator (I wasn’t back then – I was just a brand new mum, freaking out about everything!) I see a lot of anxiety in parents-to-be. I see it on their faces from the moment they walk in the room at the beginning of the course.
By the time most people do an antenatal class, they are well and truly into their third trimester. They’ve had seven, eight months to immerse themselves in pregnancy information overload. From family and friends, the internet, care providers, books and magazines… Endless information. Some good. Most crap.
Anxiety in pregnancy is reaching near epidemic proportions and we are not even touching the surface when it comes to preparing men and women for parenthood. Many public hospitals are turfing women and their babies out less than 24 hours after birth.
Less than 24 hours after giving birth! That’s before the enormous hormonal surge crashes, that’s before a woman’s breast milk has come in. Hell! She’s probably still changing her maternity pads almost hourly. And we are expecting that these women can function and care for themselves and a newborn baby at home on her own. What are we thinking?!
“We’re finding that anxiety is now just as common as depression and many parents experience both anxiety and depression at the same time so it needs to be front of mind as a health concern during pregnancy and after birth,” Smith said.
“Anxiety is not as well recognised and risks being overlooked because people may wrongly assume that the symptoms are not as debilitating or distressing as those associated with depression.”
Looking back, I actually think that I got off lightly. That was probably my lowest point in those early postpartum days, when I felt like I was walking around in a permanent sleep-deprived fog (I’ll have to write another blog about the time I fell asleep while I was sterilising my son’s pacifiers in a pot of boiling water and almost burnt the house down!).
But on a serious note – I was suffering from severe anxiety. It was thankfully short-lived and it resolved itself without the need for professional help or intervention, but while it lasted it was horrendous. Utterly debilitating. And it was real.
New figures from Perinatal Anxiety & Depression Australia (PANDA) indicate 70 percent of callers to their national helpline do not turn to general practitioners for issues regarding perinatal mental health and of those callers; more than 50 percent are experiencing symptoms of anxiety.
We can, and must do better to support new parents. There needs to be a lot more research conducted to understand not just the causes of perinatal anxiety, but more importantly, how we can better support the thousands upon thousands of new parents who are suffering in silence.
PANDA’s free National Perinatal Anxiety and Depression Helpline offers counselling, information and referral services with ongoing telephone support for families throughout Australia.
PANDA’s Helpline: 1300 726 306 (operates Monday to Friday from 10am to 5pm EST).
If you need help in a crisis, call Lifeline on 13 11 14. For further information about depression contact BeyondBlue on 1300 224 636 or talk to your GP, local health professional or someone you trust.
Tanya Strusberg is a Lamaze Certified Childbirth Educator (LCCE) and founder of birthwell birthright, an independent childbirth education practice based in Melbourne. In 2015, Tanya was inducted as an FACCE (Fellow of the Academy of Certified Childbirth Educators) in recognition of her significant contribution to childbirth education. Through her internationally accredited Lamaze Educator Training program, she is very excited to be training a new generation of Australian Lamaze educators.
Last, but absolutely not least, she is also the mum of two beautiful children, her son Liev and daughter Amalia.