Treatments for PNDA

Getting help and support

Early intervention

Early intervention for PNDA and related disorders is helpful for recovery. While acknowledging possible barriers, parents are encouraged to start help-seeking as soon as they identify concerns about their mental health or wellbeing. Early help-seeking or advice from a professional is also useful for partners, carers and significant others if they notice a new parent is struggling and has not been able to access help themselves.

Asking a health professional, such as a GP is a good way to start a conversation. Child and Family Health Nurses, Obstetricians and Midwives will also be aware of relevant support services.

Emotional support

Emotional support most commonly involves a partner, family or friends. The most useful support comes from those who take time to listen to a parent's distress or worries and validate their feelings and experiences. Responding to a parent’s concerns without judgement, unwanted advice or trying to ‘fix’ things for them can be really helpful.

A parent who is feeling negative may also find it helpful to hear from others that there is hope for the future and that recovery is possible.

Sometimes parents find there are only a small number of people in their network who can provide helpful emotional support. It is sometimes a shock if people don’t meet expectations for emotional support, and it can take time to find people who are good listeners. Parents who do not have a supportive personal network are encouraged to reach out to local community support, new parents’ groups, and online groups such as the Gidget Virtual Village.

How to alleviate symptoms

Exercise some self-compassion
Practise relaxation techniques or mindfulness activities
Try daily exercise, music, yoga or light therapy
Connect with nature, friends, baby, partner, support groups
Get some practical help from friends or family
Prioritise Self-care, including regular eating, taking time-out and setting good boundaries

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Professional care and treatment options

The mental health system can seem complicated and overwhelming to someone who is already struggling. Medical professionals who can provide initial help with new parents’ concerns about their mental health include:

Child and Family Health Nurse
GP
Midwife
Obstetrician

These professionals can provide some initial assessment, information and support around perinatal related mental health conditions. After initial assessment, a referral may be made for specialised treatment.

Referral types

The type of referral may depend on whether the parent’s distress appears mild, moderate or severe. Referral options include:

Perinatal psychologist or counsellor
Psychiatrist
Mental Health social worker
Specialist support groups or a specialist telephone support service
Online support tools
A mother-baby unit (MBU) within a hospital
Residential and day-stay parenting services

Psychological and counselling support

There are different practitioners offering counselling, including psychotherapists, psychologists, psychiatrists and mental health social workers.

If a parent is referred to one of these, they may need to navigate the Medicare system. GPs are available to help with this and can complete a Mental Health Treatment Plan with the parent. This plan allows a parent to claim part of the cost for eligible services back from Medicare (called a rebate). Not all counselling services are eligible for the Medicare rebate, so parents need to check with the service before starting.

There are some community services that provide free or low-cost counselling. Free psychological support is also available under Medicare bulk-billing through some services (including Gidget Foundation Australia). If a new parent is struggling to identify suitable and accessible support, it is important that a professional help them to explore options.

For people in rural and remote areas or people with accessibility barriers, there are an increasing number of counselling services that can provide video or phone support, including the Gidget Foundation Start Talking Telehealth program.

Psychological and counselling support varies according to different practitioners and therapeutic styles. Check that the practitioner has expertise in working with issues related to perinatal mental health. Doctors can provide referrals to counsellors or psychologists, and it can also be useful to ask for word-of-mouth recommendations. It is common for people to meet with more than one specialist, until they find someone who they feel comfortable working with.

What to expect in counselling

Factsheet: What to expect at your first appointment

Building rapport, trust and to experience a safe place to discuss difficult thoughts and feelings
Exploring emotional triggers and responses to different situations
Discussing patterns in relationships – how and when these are helpful and unhelpful, and how to improve them
Exploring the impact of past experiences with one’s own parents or other caregivers and how it influences their own parenting style
Exploring attachment with the pregnancy or baby
Monitoring of mental health, including asking about thoughts of suicide and harm to self or others
Identifying negative thought patterns and working on strategies to manage these
Helping with scary or intrusive repetitive thoughts
Identifying coping skills and building resilience
Helping to increase confidence in parenting
Identifying other resources and supports that might be helpful
Discussing relationship with self, baby and others
Identifying practical strategies and tools to manage anxiety
Incorporating sessions that include the partner
Developing an individualised and culturally appropriate treatment plan

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Medication

Medication is an option that GPs and perinatal psychiatrists may prescribe for their patients. For some parents in the perinatal period, medication can form an important part of their treatment plan and can be used in conjunction with counselling. However, it is common and understandable for parents to have reservations about taking medications.

One common concern is about possible physical effects on a baby if taking medication while pregnant or breastfeeding. There are a number of medications that are deemed low risk during these times. Always remind the health provider if pregnant or breastfeeding.

Other psychological barriers to taking medication include general stigma around mental health and fear about being viewed as a less capable parent. Doctors can address these concerns and allow the parent a central role in decisions about treatment. A doctor’s role is to provide balanced and up-to-date information and advice.

There are different types of medications used in the perinatal period, depending on the mental health issue. Specialist doctors such as perinatal psychiatrists work with the latest research and can advise on the risks and benefits of taking medication for each individual. They can help a new parent decide what is best for them and their baby.

Anyone taking medication in the perinatal period should not change or stop their medication abruptly without consulting a doctor as this can make a person unwell.

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Specialist advice resources

The following services can provide specialist advice on medicines for parents who are pregnant or breastfeeding:

NSW – Mothersafe at Royal Hospital for Women: 1800 647 848‍

VICTORIA – Monash Medical Centre, Mr Rodney Whyte: (03) 9594 2361‍

PERTH – Obstetric Medicines Information Service: (08) 6458 2723
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For general advice nationally (not specific to perinatal patients):

NPS MedicineWise - 1300 633 424 OR local pharmacies

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Barriers to seeking help

When pregnancy or parenthood is not as easy or enjoyable as expected, it can be difficult for new or expectant parents to admit they may be struggling or ask for help. This might be due to societal stigmas, cultural expectations, or social media norms that place pressure on new parents to associate the perinatal period with only positive feelings.

Perinatal depression and anxiety affects around 20% of mothers and 10% of fathers. This amounts to almost 100,000 parents in Australia each year. Perinatal Depression and Anxiety (PNDA) is a diagnosable, temporary, treatable medical condition. But to receive treatment, the person must reach out for help.

Some people worry they may be perceived as a bad parent or viewed as unable to care for their baby. They may fear departmental authorities becoming involved and worry that their children could be taken away from them. In Australia, this is an especially significant barrier within First Nations communities, as they have experienced the removal of children by welfare authorities over several generations.

In reality, if a parent seeks professional support, they can expect to be recognised as a responsible and caring parent who wants the best for themselves, their baby and their family. They will be given the support and treatment they need to recover.