For women, having a baby can be one of the biggest changes that we ever experience. While we may have come to terms with the idea of becoming a mother, we often still worry about what's to come, and our ability to cope with the first few months of our infant's life (this is especially true during a first pregnancy). On top of that, we're navigating our way through the multitude of messages from outside about what is acceptable to do during pregnancy.
If changes are observed and addressed early on, women are in a better position to avoid more severe difficulties in the postnatal period. This is true not only of physical changes — but emotional changes, too. Among the emotional changes many pregnant women experience can be increases in anxiety and depression.
The word perinatal refers to the pregnancy and birth as well as the postnatal period. This is a helpful term as it acknowledges that many changes occur early on in pregnancy — not just after the baby is born. Becoming aware of these changes helps us to cope better with them.
Here are some of the common signs of perinatal depression and anxiety.
Anyone can develop heightened levels of anxiety during the perinatal period — during pregnancy, birth and the postnatal period. The entire process is a time of huge physical, hormonal and mental adjustments. Not only are we dealing with our changing shape and weight, but also unpleasant symptoms like nausea, heartburn, back pain, urinary frequency and fatigue. It can be a struggle to continue working and maintain our pre-pregnancy lifestyle due to outside or internal pressures.
For those of us who have experienced anxiety in our lives generally, there is a greater chance of becoming more anxious during and following pregnancy. But if we become more aware of our anxiety, then we can be better equipped to put in place strategies to deal with it, and enlist support from family and friends.
Anxiety can present itself physically, with symptoms including increased heart rate, feeling short of breath, dizziness or headaches, stomach pains, constipation or diarrhea or increased frequency of urination. We can also experience racing thoughts, intrusive, obsessions, and worry about the future. We may focus on scary hypothetical ideas like doing accidental harm to our baby. Or we may experience acute nostalgia for pre-baby life.
Undergoing labor itself is an overwhelming experience due to its unpredictability and our heightened emotional state at this time. Physically, labor can involve high levels of pain and unexpected complications, which all influence our experience of the delivery and can have implications with our adjustment in the postnatal period.
Throughout the process, panic attacks may also occur, which are intense, sudden bursts of anxiety with a wide variety of possible physical symptoms and an overwhelming sense of "I can't cope" or "I'm going to die". They can range from lasting for a few minutes to hours and often it can take some time to "come down" from an episode. Afterward, we may feel extremely drained and lethargic.
Avoidance can feel like a useful coping mechanism in the short-term, as it seems like a way to escape unbearable feelings of distress. Though it's essential to cultivate courage around our fears, and not to limit our behaviors.
When we find ourselves in extended periods of low mood or sadness during pregnancy or following birth, it may indicate that we are suffering from depression. Depression affects everyone differently, but feelings of worthlessness, helplessness, hopelessness and guilt are common. Physically, we may lack energy, sleep more or, alternatively, suffer from insomnia and disrupted sleep. We may lose our appetite, or eat more to compensate for feelings of emptiness.
Depression can also have negative effects on our relationships at a time when we need them most. We may feel lonely, numb and bored, but feel unable to do anything to shift these unpleasant feelings.
During the pregnancy, we may feel unable to bond with our baby and feel disconnected from the idea of being pregnant. This can cause feelings of guilt for being a bad mother. And once the baby has arrived, our depression may make the task of taking care of the baby feel impossible. This, too, can often become exacerbated, as we can end up feeling terrible guilt as a result.
Understanding possible manifestations of anxiety and depression during the perinatal period can be a critical step in identifying signs of your struggle early and getting help. There is no reason to be struggling so much.
It's not always easy to identify when we are living these experiences. Keep an eye on family and friends. See your general practitioner to brainstorm what the most appropriate support system can be for you. Everyone is different; even with the helpful advice of friends, it can be productive to get a more objective, professional opinion.
Never forget that you are not alone, and there is always help available. The first important step is to acknowledge — and accept — what you're going through. From there, you have already begun the journey of self-care.
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