written by: |November 20, 2020
We had the amazing opportunity to speak to Dr. Nicole Hyatt, who is a doctor of psychology. Nicole is the founder of the Centre of Perinatal Excellence and also is a mother of two. Nicole specialises in pre and postnatal mental health and psychology, with particular focus on effective treatments for postnatal depression.
One of the things that really struck her was the need for a dedicated organisation that focuses on emotional and mental health at this time, and talks more broadly about the other challenges that come with becoming a parent, not just focusing on illness. We need to focus on the range of challenges that occur, right along the journey to becoming a parent. For example for some couples that starts with just trying to get pregnant in the first place. Or problems around conception, dealing and coping with infertility, and pregnancy loss. We know that mental health conditions are common in pregnancy, but there's other issues to deal with, like changes to your work and your identity, dealing with change to finances, dealing with relationships, dealing with body image, all those things that come with pregnancy. And then, at birth we often plan to go into birth with great ideas of calm births and meditations but often birth doesn't go to plan, and for some that results in birth trauma and post traumatic stress disorder and likelihood of anxiety and depression.
Then of course adjusting to a new baby in your first year impacts on absolutely every aspect of your life. Emotionally, socially, financially, and relationships with your partner and family and friends. COPE make sure the information is tailored to the context of either pregnancy or the postnatal period or trying to become pregnant. And as part of that deal with the emotional and mental health problems, to provide the right support.
How common is it for parents to experience symptoms of anxiety or depression?
It's very common. In pregnancy, for example, up to one in five women will experience anxiety. This can be a generalised ongoing feelings of anxiety or it might be anxiety in relation to a particular thing. We also know that up to one in ten women will develop depression in pregnancy. That increases to one in seven in the postnatal period. That's a significant proportion of people.
It’s common for anxiety and depression to exist at the same time, in around 50% of cases in fact. We also know that the most likely time in a woman's life that she will develop one of these conditions, is around the time of having a baby. We also know that they're the greatest risk of death is in the perinatal period. The number one reason why mothers die is not from childbirth complications or health issues. It's actually suicide. And that's because quite often people are not getting the help or treatment that they need early, because they keep on putting it down to other factors. They keep hoping it will go away and are coming to terms with the fact that this wasn't the wonderful experience that I thought it was going to be.
How do we know whether it is anxiety or everyday life and at what point do we actually need to get help?
In order for someone to have a diagnosis of anxiety or depression they're likely to experience a number of symptoms, over a period of time. So for example with depression we would describe that if someone is sad or down for two weeks or more, and or had a loss of interest or pleasure in life.
In addition to that they're likely to experience a range of other physical symptoms such as changes in appetite, lack of motivation, no motivation to exercise, not having any energy, being lethargic, having problems sleeping, or wanting to sleep all the time. If you notice a change in these things over time and they're lasting two weeks or more, that's likely to be depression.
And similarly with anxiety, if you're feeling overwhelmed, or stopping doing things, or finding getting out of the house really difficult, it's likely once that's really impacting on your ability to carry out everyday life, then that's a sign it's a condition that needs treatment.
When you're experiencing stress it's usually because there's an external factor or something's happening to make you react like that. So, for example, if you're walking up the aisle to get married it's natural you're going to have butterflies or you might be going into an exam you might or you might hate public speaking and be asked to talk at an event. That's totally normal that you feel anxiety in those situations, but once the situation is passed you come back to feeling normal. With these conditions, there is no external event, it's just there. And the reason that's just there is because there's an underlying condition which affects the way you think, the way you feel, and the way you behave.
When there's no external event or particular stressor that's often a good indicator that maybe this is a sign of anxiety or depressive disorder. And with a lot of new parents, their focus becomes so much about the child and you do neglect your own needs.
How do we get rid of that guilt that parent guilt that we have?
We suddenly get into this place of our life like it’s not our life anymore, it's about the baby's life. But it's so important to look after yourself so you can be the best parent for your child and for your family. It's such a domino effect, once you start having that negative headspace it can affect the rest of your life.
It can be helpful to use analogies for physical health. Just say you were experiencing aches and pains on an ongoing basis. And you think you can't deal with that because you have to put the needs of the baby first. We would never do that with our physical health. It's not good for the baby If you are experiencing those symptoms, and putting yourself at risk of getting worse or something much more catastrophic happening. The same applies for emotional and mental health problems, it’s really no different.
You know you're going to be able to be a better parent when you're enjoying parenting, and your baby is going to enjoy you and the experience more if you're in a better place. We talk about physically preparing for birth, the same applies for emotional and mental health as well. Having conversations, and normalising it so everyone knows that it is okay to get help and not put on that facade. It's also really important to acknowledge that the parenting journey is different for everyone and different people will develop and experience different challenges along the way, just because you've had one child doesn't mean you're going to have the same experience the second time we know that those who've had more than one child.
It’s important not to make assumptions
We can't make any assumptions, we just have to we have to ride with it, to some degree, but being aware and informed and empowered within for strategies to really manage the different challenges that might come our way. That is the best that we can do to protect ourselves against developing a mental health problems and reducing our overall levels of stress.
And to manage expectations
It's really important to be monitoring and be aware of your expectations, because we know that we often go into this with high and unrealistic expectations. So, just like anything else in life. Always thinking everything's going to be perfect - if you go in thinking everything's going to be perfect and that is not reality, you're really setting yourself up for failure. This is where COPE have developed resources that parents can sign up to at any stage from six weeks into their pregnancy, and receive really quality timely information about that stage.
How to manage and prevent mental health issues
Like many physical health problems the faster you get help, the faster you recover. Getting help early is really important. It is the best thing you can do, is get help early.
But also there's so many strategies to prevent these conditions occurring in the first place. COPE really encourage every expectant or new mum and dad or dad to sign up at cope.org.au, and you'll be getting really quality information. It makes you realise that you're not alone. Everyone goes through different challenges, and it's not going to be a perfect experience. These resources play a very important role in identifying the need for help, either in themselves, or someone else. Not only do we have high expectations, but society does as well.
What should we do for a friend who is experiencing struggles?
It’s really helpful to think, well what would we do if that person seemed to be experiencing a physical health problem? Number one we wouldn't ignore it. Number two, we wouldn't alienate ourselves from them or make them feel like something was wrong with them. So it's really important to proactively reach out and make them feel supported and included. Also to be really mindful of our conversations that we're not all sitting around the group saying everything's perfect.
Is there any support specifically for new dads?
COPE has just launched a national directory of both support services for mums and dads but also health professionals and perinatal specific information. Visit cope.org au for more info.