MOVING THROUGH POST-NATAL DEPRESSION

Exercise will help to clear away the ‘baby blues’ & depression

Over 100,000 Australian families are affected by perinatal anxiety and depression each year. PANDA - Perinatal Anxiety and Depression Australia – is a fantastic organisation which exists to share vital information and support mental health in the antenatal (during pregnancy) and postnatal (after pregnancy) periods to assist women moving through post-natal depression. Due to rapid changes in hormone levels, it is not uncommon for mothers to feel teary and overwhelmed in the three to five days after the birth of her child – up to 80% of women experience the phenomenon known as ‘baby blues’ immediately after childbirth. The good news is, aided by reassurance and support, these symptoms generally do fade after a few days without treatment.

SIGNS AND SYMPTOMS.

Post-natal depression (PND) is characterised by a significant period of depression that comes on within the first 12 months of having a baby and usually strikes within the first few weeks or months. It is most common after a woman’s first pregnancy and although the severity can vary, symptoms include:

• feelings of low self esteem

• lack of confidence

• feelings of inadequacy and guilt

• feeling unable to cope

• difficulty sleeping or sleeping too much. It is important to mention that around 3% of fathers also experience PND, and organisations such as PANDA can assist with both maternal and paternal changes in mental health.

RISK FACTORS.

A large scale review of the literature has revealed some recurring risk factors for PND, listed below in order of their impact:

• depression and anxiety during pregnancy, which is then exacerbated after pregnancy

• a personal history of depression

• perceived life stress

• lack of social support

• marital dissatisfaction

• low socio-economic status

• a difficult or traumatic birth experience.

FROM THE MOTHER’S PERSPECTIVE.

One study which looked into women’s beliefs and attitudes around treatment for PND revealed, that the preferred treatment choice for most women moving through post-natal depression, was individual psychotherapy sessions. Interestingly, although the value of social support for this population is well established, the women surveyed did not perceive group psychotherapy to be a desired option – this may be because of concurrent anxiety or simply having too many scheduled appointments during this important time.

THE ROLE OF EXERCISE.

The antidepressant effect of exercise has been established across general

and clinical populations and PND is no exception to this. During post-natal depression, it is worth mentioning that antidepressant medications have some clinical benefit in one small trial, but there can be barriers regarding this treatment option during pregnancy and breastfeeding. Please seek advice from your General Medical Practitioner. On the other hand, exercise such as regular walking has minimal side effects and can be empowering for a new mother as they can self-administer the ‘treatment’. A review of exercise in managing PND acknowledges that physical activity improves physical and psychological health in the mother simultaneously and therefore has a positive flow on effect to her children’s health. The barriers to engaging in exercise after childbirth must be considered, including changes in body weight and fitness, lack of time, low energy and self-efficacy due to PND. Fortunately, an exercise physiologist can use motivational interviewing techniques to work with customers to overcome recognised barriers and bring awareness to other lifestyle factors which may be conducive to wellbeing.

The take home message: While most people know that exercise is good for them, we cannot underestimate the perceived barriers to being active, while moving through post-natal depression. Referring to an exercise physiologist during this time ensures that there is a comprehensive assessment and conversation around exercise. This allows lifestyle advice to be tailored to the individual, with frequent follow up and support, resulting in higher adherence and better outcomes for all.

Jennifer Smallridge is an Accredited Exercise Physiologist at Upwell Health

Collective in Camberwell, Victoria; as well as an Academic Lecturer in the fields of Exercise Science and Functional Human Anatomy.