Treatments and tests

Treatment options for parents experiencing emotional problems during pregnancy and after the birth

There are a number of treatment options for emotional problems, and each has a place in a treatment plan.

Often, 2 or more treatments are used at the same time. The combination of treatments will depend on your needs, your symptoms and the services available in your community.

Health professionals can help you find the best treatment approach. You may be referred to a specialist if necessary.

Some of the treatment options for women and families include:

  • individual counselling
  • individual psychotherapy
  • couple counselling or couple therapy
  • group treatments or support groups
  • medication
  • admission to a hospital or mother and baby unit
  • lifestyle changes and alternative therapies
    • exercise
    • diet
    • relaxation, yoga or meditation
    • alternative medications
  • computer or internet-based interventions.

Individual counselling

Individual counselling involves talking about any problems or issues with a counsellor. The counsellor generally uses a non-judgemental approach to support and listen to you. This can help you develop effective ways to deal with challenges in your life.

Individual psychotherapy

Psychotherapy aims to help address those aspects of your life which make you vulnerable to developing mental health problems, such as depression and anxiety.

“In therapy I gained an enormous amount of self awareness. I feel like I know myself properly now and I have learned new ways of coping with the issues in my life.” Sophie

There are many types of psychotherapy to suit different people and situations. Trained mental health professionals, such as clinical psychologists or psychiatrists, usually provide psychotherapy.

Couple counselling or couple therapy

Counselling or therapy for couples can help you and your partner to understand each other and develop a good relationship. The demands of pregnancy and after childbirth can create tension and conflict in your relationship.

A couples’ counsellor or relationship therapist can help you find positive ways to adjust to changes, relate to each other and improve your relationship.

Group treatments or support groups

“The group was fantastic. I still use its principles to this day. The greatest gift of the group was support from other women who knew exactly how I felt. There was no judgement, no ridicule or hurt. Just nurturing and support.” Tanja

Many options are available such as self-help, support and treatment groups.

  • Organisations like Community Midwifery WA (external site) and From the Heart WA (external site) offer self-help groups which are run by women who have recovered from depression and anxiety. They have received special training and provide information and support.
  • Health professionals such as community nurses and social workers also run support groups. They provide the opportunity to share experiences, get useful information and develop practical skills.
  • Treatment or therapy groups are usually run by a trained mental health professional. These groups usually run for a set time, for example 10 weeks. An assessment is usually conducted before the first session. Partners may be invited to attend at least 1 session in the program.

Practical support in the home

Practical, at-home support usually involves help for parents with tasks like cooking, cleaning and taking care of the baby and any older children. This kind of help can take some pressure off you while you adjust to life with your new baby.

Practical support can be provided by a variety of sources including family, friends, and even your neighbours. Community service agencies in Western Australia may offer in-home support through volunteers or support workers.

Ask your GP or child health nurse for more information.

Medication

Medication can play an important role in treating depression and anxiety, and tends to work best when paired with counselling, therapy or other support services.

Many women worry about taking medication and the effect it will have on their baby.

The Obstetric Drug Information Service can provide further information on the use of drugs by mothers who are breastfeeding.

If you are prescribed medication, be aware that it can take 1 to 2 weeks to have an effect. Also, you should not suddenly stop taking it once you start feeling better. Usually antidepressant treatment should continue for 6 to 24 months after full recovery is achieved.

Antidepressants are not addictive. However you should be checked by your GP or psychiatrist for side effects and symptoms of relapse when coming off medication.

Needing medication doesn’t mean you’ve failed or haven’t tried hard enough.

You may feel sleepy, have little motivation and your thoughts may be foggy if you are depressed or anxious. This can make it hard to use self-help or psychological treatments. Medication can assist in improving your symptoms and helping you to cope. Once your symptoms improve you can try other strategies that will help you recover and prevent relapses.

“I went on medication which was the best thing I ever did. It took the edge off my feelings, enabling me to step back and look at the real things in my life. I now enjoy my life and family so much more, and have learned to prioritise.”  Mother of 2 girls

Medication is often needed when:

  • your symptoms are hard to shift ( for example a low mood that doesn't change for several weeks)
  • you have dramatic mood swings
  • you are not able to get back to sleep after feeding the baby
  • you have appetite changes and weight loss (or gain)
  • you have difficulty getting most tasks done
  • you are feeling constantly tired
  • you have thoughts of being better off dead.

Admission to hospital or Mother and Baby Unit

You may experience severe emotional difficulties and need to go to hospital as a result. This is even more important if you, your partner or family feel you may be at risk of harming yourself or your baby.

If you have postpartum psychosis you will usually be treated in a hospital. This will help your symptoms to become stable and allow you to start appropriate treatment.

The Mother and Baby Unit at King Edward Memorial Hospital (external site) can be very helpful to assist you in beginning your treatment while in a safe place. You can stay with your baby while getting additional support.

Mothercraft centres, for example Ngala (external site), are able to offer both day and longer stays for parents. This can help resolve infant-related problems such as settling and sleeping difficulties.

Raphael Services run by St John of God Health Care (external site) also offer services for the whole family. These include mental health assessments and a range of group and individual treatments. Raphael Services continue to be available to all members of the community with a GP referral and are provided free-of-charge or at low cost. 

Lifestyle changes and alternative treatments

Research shows that many therapeutic lifestyle changes can help you to improve and maintain your mental health and wellbeing. Not only has research shown them to be effective, they are also cheap, good for physical health and can complement any formal treatment you might be receiving.

If you are thinking of making changes to your lifestyle, especially to your diet or exercise routine, make sure you talk to your GP or another health professional first. This is especially important during pregnancy and in the first 6 weeks after the birth.

Exercise

There appears to be a dose-response relationship between exercise and wellbeing. That is, the more you do, the better you feel.

Exercise can boost your mood by increasing levels of serotonin and dopamine, which occur naturally in your body. Exercise can also release endorphins which create a sense of wellbeing and relieve pain.

Exercise can also help you just by getting you out of the house. It can be even better if you exercise with someone else, like your partner or a friend.

Ask your GP or obstetrician if it is safe for you to exercise during pregnancy. Also check when it is safe for you to start exercising after the birth. If your health professional agrees, and you have no other physical complications, exercise is likely to be great for you.

Diet

A healthy diet is essential to your physical and emotional wellbeing. It is especially important when you are pregnant or have just had a baby. There are major nutritional stresses on your body at this time.

A diet full of multi-coloured fruits and vegetables is a great way to take care of yourself and it can also boost your mood and sense of wellbeing. Fish is also excellent for its omega-3 oils.

Wherever you can, avoid excess calories and remember to drink plenty of water, especially if you are breastfeeding.

If you need advice, talk with your health professional about the type of diet you should be eating. Don’t take extra supplements or make major changes without talking to a professional first.

Relaxation, yoga and meditation

Learning ways to relax can assist with stress reduction by easing muscle tension and reducing anxious thoughts. You can teach yourself relaxation, but it can help to follow instructions from a professional or from an audio recording.

One of the most common relaxation techniques is progressive muscle relaxation, which involves tensing and then relaxing muscle groups one by one.

Yoga can also be used as a way to relax and reduce feelings of anxiety and depression. A typical yoga class usually involves a combination of physical postures, breathing techniques and meditation. Some yoga instructors specialise in pregnancy, post natal or ‘mums and bubs’ classes. As yoga is also a form of exercise you should talk to a health professional before taking a class during pregnancy or after the birth.

While meditation can be part of a yoga class, it can also be practised by itself. Although meditation was once more a spiritual practice, today it is also recommend by many health professionals as a form of therapy. There are many different types of meditation including visualisation, mindfulness and walking meditations. Different people are often drawn to different styles.

Alternative medications

Herb-based products are sometimes used to treat mild depression. However, these treatments may not be safe if you are pregnant, breastfeeding or have postnatal depression. Also, these treatments can interact with other medications prescribed by your doctor.

Fish oil is helpful in pregnancy and after birth. It is important to check that mercury levels in the fish oil are certified as low and in the safe range.

Talk to your doctor before using any kind of alternative medications. Alternative medications may not be appropriate for you.

Computer or internet interventions

There are online programs that provide information and structured activities to help you overcome depression and anxiety. Many programs have been designed to be worked through on your own, but the programs where you are linked to and monitored by health professionals are thought to work best.

Some internet based interventions you might link to try include:

More information

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 555 788 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.
  • Obstetric Drug Information Service
    • Opening hours 8.30am to 5.00pm Monday to Friday.
    • Phone: 9340 2723.

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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