Psychological risk factors for perinatal depression and anxiety

PSYCHOLOGICAL RISK FACTORS FOR PERINATAL DEPRESSION + ANXIETY

By Joyce Chong (updated 26 April 2018)

Pregnancy and parenthood are times of great change and, with that, adjustment beckons. From changes to your body, your health, finances, potentially house/city/country, shifts to family dynamics, and also changing identity, it's no wonder that difficulties adjusting to this period of change may emerge. It's also during this time that we may see anxiety and depression emerge, or intensify should these be pre-existing conditions.

In our work as clinical psychologists with pregnant women and new mothers, we thought we'd highlight some of the psychological risk factors we often see that can negative affect mental health.

1. A history of depression or anxiety

Having a pre-existing history of depression or anxiety can make you more susceptible to developing perinatal depression or anxiety. It's therefore especially important to working on boosting your wellbeing and mental health as early on as possible so that you're prepared for the changes that lie ahead.

2. Negative thinking styles

We're all prone to negative thinking styles at any stage of our lives. During pregnancy and following birth, some common ones we see include:

• Emotional reasoning (e.g. “If I feel anxious it must mean that I’m not that confident.”),

• Black and white thinking (e.g. believing it’s either perfect or completely ruined),

• Catastrophising (e.g. believing that forgetting one thing will lead to a disastrous impact on your unborn child), and

• Mind reading (e.g. “They will think I’m so incompetent!”).

3. Perfectionism

Perfectionism can rear its ugly head at any time in the pregnancy, birthing, and parenting process, and it can make it difficult to adjust to change. From having the perfect pregnancy, to the perfect birth plan, to being the perfect parent with the perfect baby...are you putting too much pressure on things that are likely beyond your control?

4. A tendency to engage in social comparison

A tendency to engage in social comparison. We’ve previously blogged here about how social comparisons can hurt your self esteem and pregnancy and parenthood provides a new arena for social comparison.

From comparing your pregnancy body to what you see on Instagram, to assessing your parenting skills against those of other new mums, to gauging your child's milestones against others in playgroup - the potential for feeling anxious and depressed is heightened.

5. Unrealistic expectations

Unrealistic expectations present challenges for pregnancy and parenthood, and they underpin problematic (clinical) perfectionism. Examples of where unrealistic expectations trip us up include:

• Expecting to glow throughout pregnancy with only a tiny bump, when the reality is that you're ridden with nausea and swollen ankles for much of the pregnancy.

• Expecting to instinctively know what to do after you've given birth, when it's only your first time holding an infant.

• Expecting things to go according to your birth plan, only to end up with a completely opposite experience due to complications.

• Expecting to breastfeed when, in reality it isn’t possible due to problems latching, or illness.

With such unrealistic and potentially unattainable expectations, is it any wonder that your mind sets yourself up to feel like a failure?

6. Difficulties adjusting to change

Pregnancy and becoming a parent is a time of great change, and with that comes adjustment. It helps to adjust expectations regarding how much disruption there will be to life and to routines, how significant an impact it will have on productivity levels, and how it will impact on stress and mood levels.

For example, if you're used to ticking of item after item on your To Do list and streamlining your workflow, it may come as a rude shock to discover your main achievement for the day becomes leaving the house before lunchtime.

Do the above signs look familiar?

Not sure if you or someone might need help? A useful screening tool used by many health professionals is the Edinburgh Postnatal Depression Scale which you can take it here. 

Much can be done to support expectant or new mums with Perinatal Depression and Anxiety, but things can't change unless the first step is taken. A good starting point is to talk to your GP, obstetrician, or psychologist. If you'd like to work with us to build skills to help navigate this period of significant change, then contact us to make an individual appointment.

Excellent resources can also be found at Beyond Blue and also Perinatal Depression and Anxiety Australia.

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What about fathers and partners?

Perhaps it is telling that we don’t see as many expectant or new fathers in comparison to expectant mothers because it is the mothers who experience the more visible changes.

However, first-time fathers are also going through a period of great change, moving from what was once a nice twosome shifts to the focus being solely on a third new little being. Whilst this can be an absolutely joyous event, there's no denying that there may be financial stress, a diminished social life, impacted relationships, changes to quality of life, and even importance for fathers in ranking within the household.

Men can also experience Perinatal Depression and Anxiety, with similar risk factors as those for women. Perinatal Depression and Anxiety Australia has put together an excellent resource which you can find here, as has Beyond Blue here.

It may also be helpful for expectant fathers to talk to others who have been through the same process to understand what emotional changes may occur. For first-hand accounts of other fathers’ experiences, have a look at the Black Dog Institute here.

Alternatively, consider speaking to a mental health professional (like us!) about preparing psychologically for the upcoming changes, particularly if the psychological risk factors are present. 

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