Health conditions

Common emotional problems in parents with new babies

A number of emotional problems can arise when you’re pregnant or have had a baby.

Sometimes these emotional problems are all just called postnatal depression. This is not correct and can be misleading, especially since problems can arise during pregnancy too.  You can read more about postnatal depression below.

Baby blues

During the first week after birth, up to 80 per cent of mothers will get the baby blues.

This is usually a time when you are quite sensitive, and might cry, be irritable, feel anxious and have mood swings.

These symptoms tend to peak 3 to 5 days after the birth. They are mainly caused by hormonal changes after childbirth and normally go away within a few days without any special treatment.

Things that can help include:

  • understanding
  • support
  • help with learning how to care for your baby.

If symptoms go on longer than 2 weeks, it could be the start of postnatal depression.

Adjustment problems

You will go through a period of adjustment as you try to handle the huge changes your baby brings.

For most people, this time of adjustment is temporary and does not really interfere with daily life.

“I found it difficult coping with the demands of a newborn. No sleep, constant crying and a lack of time for myself. This was supposed to be the most beautiful time of my life.” Tanja

For others, adjusting to life with a baby can take a long time and cause a lot of distress. If this is the case you should talk to a health professional.

Attachment problems

After the birth, you may expect an instant bond with your baby, but for some parents, this doesn’t happen.

It may take a few days or even weeks to feel a connection to your baby, and this can create feelings of guilt, stress and disappointment for parents.

When you feel little or no connection with your baby, you may be distant or withdrawn and behave negatively toward your baby.

Usually, with support and rest, you will feel more attached to your baby within a few days.

“As I looked at my baby… I felt numb, emptiness. It was as if I was looking at someone else’s baby.” Mother of newborn

If you do not make a connection with your baby after a couple of weeks, it is important to talk with a health professional.

For more information about infant attachment, visit the Raising Children Network (external site).

Anxiety

“Out of the blue an intense feeling of dread came over me. My heart was racing, I had difficulty breathing, I was shaking, dizzy. I thought I was having a heart attack or going crazy.” Expectant mother

A little worry or anxiety is normal, but too much may affect your ability to cope with your pregnancy and your baby. You can experience anxiety while you are pregnant (antenatal anxiety) or after the birth of your baby (postnatal anxiety).

If you have anxiety you may fear you are going to lose control or go crazy. Often the anxiety you feel can lead to low self-confidence and a belief that you are a bad parent.

About 14 to 16 per cent of women have a clinical level of anxiety during their pregnancy, while 8 to 10 per cent of women will have clinical levels of anxiety after they have given birth.

“I felt so on edge and worried… I was constantly checking to see if the baby was still moving. What if something was wrong again?” Expectant mother

It is also common for people with anxiety to experience depression too.

Symptoms of anxiety

If you experience any of the symptoms below, talk about treatment options with a health professional:

  • anxiety or fear which interrupts your thoughts and interferes with daily tasks
  • panic attacks
  • anxiety and worries which are difficult to control
  • feeling irritable, restless or on edge
  • having tense muscles, a tight chest, heart palpitations
  • taking a long time to fall asleep in the early evening
  • anxiety or fear which stops you going out with your baby
  • anxiety or fear that leads you to constantly check on your baby.

If you think your partner or baby would be better off without you, or are having thoughts of suicide, contact a health professional immediately.

Different types of anxiety

“I felt unable to do anything properly. I would hardly ever leave the house. I was so worried that he wouldn’t sleep properly if we were out. I felt unable to relax and switch off even though I was exhausted.” Mother of a 6 month old.

Anxiety may emerge in a number of forms, and one mother experiencing anxiety may not experience the same symptoms as another. Some of the more common types of anxiety experienced by mothers include:

Depression

“I expected ups and downs during the pregnancy and to cry more easily. But I thought I’d enjoy it more. I don’t seem to look forward to things anymore and don’t feel like seeing people. I seem to find it difficult to get back to sleep as everything keeps churning through my head.

You might have heard of postnatal depression (depression after the birth of your baby, also known as PND), but have you also heard of antenatal depression (depression during pregnancy)?

Research shows that 8 to 11 per cent of women experience depression during pregnancy while 13 per cent of women will go through PND. The symptoms are the same for both. However, not everyone will experience depression the same way.

Depression tends to develop gradually and may go on for many months. It may start before or during your pregnancy and then continue after childbirth. It may also occur for the first time after your baby has arrived.

If left unrecognised and untreated, it may develop into a chronic condition or come back in a following pregnancy.

“People would say, you must be so happy with such a beautiful boy. Unintentionally their words made me feel like a failure. If I kept my fake smile going I might convince myself (and everyone else) that I was really happy. I was wrong.” Tanja

Symptoms of depression

If you experience any of the symptoms below for more than a few days, talk about treatment options with a health professional:

  • low mood
  • feeling inadequate, like a failure, guilty, ashamed, worthless, hopeless, helpless, empty, or sad
  • often feeling close to tears
  • feeling angry, irritable or resentful (for example, feeling easily irritated by your other children or your partner)
  • fear for the baby and/or fear of the baby
  • fear of being alone or going out
  • not enjoying or being interested in usual activities (including sex)
  • insomnia or excessive (too much) sleep, having nightmares
  • appetite changes (not eating or over-eating)
  • feeling unmotivated and unable to cope with your daily routine
  • decreased energy and feeling exhausted
  • withdrawing from social contact and/or not looking after yourself properly
  • having trouble thinking clearly or making decisions, lack of concentration and poor memory
  • having thoughts about suicide or wanting to run away from everything.

Some of these symptoms can also result from a lack of sleep, such as decreased energy, feeling exhausted, having trouble thinking clearly, lack of concentration and poor memory.

These symptoms are common with a  new baby. A health professional will help work out if the symptoms are within the normal range for you or if they could indicate depression.

If you think your partner or baby would be better off without you, or are having thoughts of suicide, contact a health professional immediately.

Postpartum psychosis

The least common, but most serious, postnatal mood disorder is postpartum psychosis (puerperal psychosis). It should not be confused with postnatal depression.

It affects only 1 or 2 in every 1000 mothers. There may be risk of harm for you, your baby or both.

“I felt flat, useless, not able to cope, I was constantly in tears. I felt overwhelmed by the responsibility. There was nothing to look forward to. I felt that the baby and my husband would be better off without me. They deserved someone better. I just want to be back to normal.”

If you have a personal or family history of bipolar mood disorder (manic-depressive illness) or schizophrenia then you are most at risk. It is very important to mention this at your check-up appointments.

Symptoms of postpartum psychosis usually appear within one month of childbirth and may include:

  • hyper-arousal (increased physical and emotional tension)
  • excessive euphoria (intense feeling of wellbeing)
  • significant and ongoing reduced need for sleep
  • confusion or very argumentative
  • erratic behaviour (not consistent or predictable)
  • delusions (unusual beliefs or belief in something which is not based on reality)
  • hallucinations (unusual perceptions, such as seeing or hearing things).

The management of postpartum psychosis normally involves:

  • urgent assessment
  • medication
  • hospital admission
  • help looking after the baby.

Although the problem is rare, it often occurs again in future pregnancies. If you experience this condition, you and your partner could greatly benefit from counselling to assist with planning your future pregnancies.

If you know a mother experiencing any of the symptoms listed above, contact a health professional immediately.

Puerperal Psychosis: A carer’s survival guide (external PDF 404KB) is an excellent and highly recommended resource for partners and family.

Where to get help

  • See your doctor, obstetrician, child health nurse or midwife
  • Talk to a counsellor, psychologist or psychiatrist
  • Phone the Pregnancy, Birth and Baby Helpline on 1800 882 436
  • Phone the Mental Health Emergency Response Line – Perth metro 1300 55 788 or Peel 1800 676 822
  • Phone Rural Link, an after-hours mental health phone service for rural communities, on 1800 552 002
  • Phone the Post and Antenatal Depression Association helpline on 1300 726 306 (9.30am to 4.30pm Monday to Friday)
  • Phone the Parenting Line on 1800 654 432

Acknowledgements
Women and Newborn Health Service

This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions.

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