You should consider seeking professional help if you have several of the following symptoms for two weeks or more and they are causing significant distress or impairment.
Clinical signs and symptoms of anxiety, depression, and stressor or trauma-related disorders
It is important to remember that some anxiety and worries, and some changes in routine around eating and sleeping, are normal aspects of adjusting to parenthood.
However, the following list includes symptoms that can have a significant impact on quality of life and functioning. If a parent experiences several of these symptoms over a two-week period or more and affecting daily life, they may be vulnerable to, or experiencing, a depressive or anxious episode.
– Reduced enjoyment in activities that previously brought enjoyment
– Memory, concentration or decision-making difficulties
– Increased irritability or reactivity to others
– Physical symptoms that were not previously present, such as heart palpitations, chest tightness, headaches, body tension, sweaty hands, tingling, shortness of breath, stomach aches
– Sleep and appetite disturbance
– Feeling numb, hopeless or despairing about the future
– Feeling separate, remote or withdrawn from family and friends
– Feeling out of control or ‘crazy’
– Unable to rest when the baby is sleeping, including difficulty getting to sleep and/or difficulty getting back to sleep after baby has resettled
– Nightmares and/or flashbacks of upsetting birth events
– Avoiding situations that remind you of the birth
– Scary, unwanted, recurrent thoughts or images of something bad happening to themselves, their baby, or those around them.
– Frequent feelings of worthlessness or excessive guilt
– Frequent grief, loss, tearfulness
– Fatigue and loss of energy
– Feeling more angry than usual, experiencing frequent angry outbursts that are out of character
– Repetitive negative thought patterns, often including harsh self-criticism
– Regular anxiety about the need to stick to rigid routines
– Recurrent thoughts of suicide, wanting to die, wanting to escape or thinking about going to bed and never waking up
Clinical definition and symptoms of trauma-related disorders
A parent (mother or partner) may experience or witness an event they find traumatic in the perinatal period, such as a difficult or complicated labour or birth, a medical emergency for parent or baby after birth, miscarriage, ectopic pregnancy, stillbirth or neonatal loss.
Sometimes, labour or birth may not involve medical trauma, but can still be psychologically traumatic for a parent if they feel disempowered, ignored, ill-informed or out of control.
For some people, this trauma will resolve over time without intervention. Some parents may find it helpful to talk about the event, feel supported and heard by others, and be able to process emotions associated with the trauma. Not all people who witness or experience a traumatic event will develop a trauma-related disorder but some do.
Some, however, may also develop a trauma-related disorder indirectly by hearing or learning about a traumatic event.
Acute stress disorder can occur immediately after a traumatic event and is a short-term condition often lasting only up to a month. A person who has ASD experiences psychological distress and its symptoms are similar to PTSD as explained below. ASD is a temporary condition and treatment focuses on decreasing symptoms, improving coping strategies, and preventing PTSD. In dealing with ASD, talking to family and friends and seeking community support is often enough to deal with the effects of trauma if it is not complicated or perceived as life-threatening. If symptoms are ongoing however it can develop into PTSD.
The most widely-recognised trauma disorder is post-traumatic stress disorder, commonly referred to as PTSD.
Some of the following symptoms may contribute to a perinatal PTSD diagnosis if they are distressing and do not start to recede several weeks after birth:
– Re-experiencing the trauma through vivid and distressing flashbacks or dreams
– Negative thoughts and feelings such as fear, anger, guilt, feeling flat or numb a lot of the time, thinking they are to blame for what happened
– Being in a constant state of ‘alertness’ – watching out for danger to themselves, their baby or other loved ones
– A stress response to noises, smells or sights that remind them of the traumatic event
– Avoiding particular places or situations that may evoke reminders of the traumatic event, for example not wanting to drive near the hospital
If a parent has one or more previous significant experiences of trauma, they are more vulnerable to PTSD in the perinatal period. These include sexual trauma, childhood abuse, bereavement of a significant person and family violence, previous adverse birth or pregnancy-related events.