A Guide on How to Proactively Prevent Postnatal Depression (PND)

Postnatal Depression (PND; also known as Postpartum depression) is a mental illness that can commonly affect women post-birth. There is good reason to increase your awareness around PND, given the high prevalence in new mothers. Statistics show that 80% of mothers of a newborn report severe mood swings, and 1 in 10 reportedly suffer from major PND, within the first year post-birth (Epstein, 2015).

Whether you are about to become a new mum, or know someone who is, boosting your knowledge on how to prevent this mental health illness is vital. Usually, PND develops 4-6 weeks after giving birth however it is also known to occur several months later (Nordqvist, 2015). Women who suffer from PND may experience symptoms such as extreme sadness, overwhelming fatigue, a reduced libido, episodes of crying, anxiety, irritability, mood swings, and sleep disturbance (American Psychiatric Association [APA], 2013).

According to the most recent research, women who suffer from PND display overt warning signs throughout their pregnancy. Such symptoms and signs to look out for include depressed mood, excessive fear/anxiety about becoming a mother, lethargy, a disinterest in or avoidance of previously enjoyed activities, social avoidance, and/or isolation (Nordqvist, 2015). Commonly, women who have a high predisposition to developing the illness many have risk factors, including a history of depression. For women who have previously experienced PND, there is a 50% chance of relapsing again in following pregnancies (Epstein, 2015).

It is necessary to note that PND is most effectively viewed through a wellness model, rather than one of illness. This means that any new mum displaying symptoms of PND should be encouraged to open up, talk about her mental health, and actively be supported to seek help; rather than being left on her own to fight an often hidden illness. Also, it is important to highlight that there is no link between a mother having PND and not loving her baby. PND is a mental health illness, not a sign of poor mothering or weakness in character (Nordqvist, 2015).

The good news is there are numerous steps you can take to safeguard your well-being (and the wellbeing of other new mums) against PND, both before and after your baby is born. PND can be prevented with early intervention and is very treatable. So let me guide you on how to best prevent and manage signs and symptoms of PND with the below 9 strategies.

9 Ensure Good Nutrition

Looking after your health via good nutrition and hydration is critical throughout your pregnancy, particularly to maintain energy and ensure positive mental health. Maintain regular nutrition-packed meals, as this is important for optimal health of you and your growing bub. 

Eat regular, balanced meals and do not skip meals or this will leave you feeling fatigued and low in mood. Ensure you enjoy a variety of healthy snacks (including dried fruit and nuts, whole grain bars, and fresh fruit). If needed, take additional vitamin and mineral supplements (however, consult your health professional before doing so).

What you eat does more than just feed your belly

Keep hydrated, and always have a bottle of water on hand. In accordance with the American Pregnancy Association’s guidelines, pregnant women should consume between 8 and 12 glasses of water daily. Amongst other health benefits, this ensures that the amniotic fluid is maintained and breast milk production is on track. Where possible, drink extra fluids and avoid caffeine and sugary drinks. 

8 Stay Active

There is a wealth of research to highlight the link between exercise and reducing depression. In fact, exercise is often used as a treatment for depression (when incorporated within a holistic treatment plan). Exercise produces endorphins which act as a “natural high” both immediately after the activity and also has longer lasting effects on overall mood.

Whether you are new to exercise or a dedicated gym junkie, the important thing is to get active and have fun! Get involved in exercise that you can manage and will be able to maintain. Get out and about, enjoy the outdoors, and make sure you have fun! Grab a friend as a “fitness buddy” or join a group class.

Exercising with friends ensures a better state of mind

Please be aware that there are general guidelines to follow when exercising throughout each stage of your pregnancy and post-partum. Pregnancy is not the time to begin a new type of exercise if you’ve never exercised before. Be sure to discuss exercise with your treating Health Professional who can guide you around safe exercise when pregnant and post-partum. 

If you're not sure which types of exercise is best for you, or how often you should be exercising, please consult a Personal Trainer.  

7 Keep Positive!

Positive thinking has a significant role in overcoming depression. “Never underestimate the power of a positive mind” (unknown), as it can be your most valued asset. Positive thoughts are extremely empowering and result in positive behaviours, mood, and actions. This, in turn, is linked to an increase in motivation and energy. Conversely, negative thoughts can lead to unhealthy behaviours and irrational or poor choices.

A negative mindset can set in motion negative mood, behaviours, and actions; which contributes to slipping further and further into a depressed state. When you are focused on negative self-thoughts, it becomes a drain on your energy. Such thoughts can leave you feeling helpless, unhappy, powerless, depressed or unmotivated.

However, gaining awareness and insight into how you feel and acknowledging those feelings allows you the ability to transform those thoughts into something more positive. By changing the negative into positive thoughts, you will feel more in control, happier, more energized, and motivated. There are various strategies to increase positive thinking, which can be powerful tools to combat negative thoughts.

Focus on positivity and leave the negativity behind

The best way to combat negative thinking is to firstly get in touch with your thoughts and feelings. You need to gain an awareness of your negative thoughts and how these link to negative actions. For example, you could keep a daily journal in which you write down your negative thoughts and feelings linked to unhealthy behaviours.

The second step is to then make a conscious effort to change your negative thoughts into positive ones. It may be difficult however if you are able to stand strong and take control of your thoughts, then you will have better success at preventing depression from kicking in. Using your attention and awareness towards positive thinking will help to create greater self-esteem and motivation.

6 Relax and Get Plenty of Rest

Having lots of rest will ensure you feel good and this means you will have energy to tackle each day with a positive mindset. Wherever possible, take regular breaks. Being pregnant and motherhood can leave you feeling tired, worn out, and physically strained. 

Don’t give yourself a hard time for resting as it will benefit both you and bub. It will replenish your energy instead of you feeling tired and exhausted.

Relaxing and getting the proper amount of sleep is NOT being lazy

Choose therapeutic environments for your rests which invoke a real feeling of relaxation. Put your feet up, immerse yourself in the atmosphere, and let the recharging begin! Enjoy your rest time and make it a priority. Ensure you maximize every opportunity to take a break, rest up, and recharge – you deserve it!

5 Bounce Back From a “Bad” Day

Sure, we all have challenging days. But when the difficult days become more frequent than the “good” days, we need to take a step back and find ways to get back on the positive train! You may find the following useful:

4 Love Yourself

Carrying a growing baby for 9 months, giving birth, and raising a new born are not an easy feat! Go easy on yourself, appreciate yourself, and LOVE you with the following tips on a daily basis:

  • Acknowledge the positive Start to recognise your good qualities, accept compliments, and celebrate your achievements.
  • Appreciate your qualities Acknowledge your special characteristics and what makes you unique.
  • Talk to yourself in a positive way Be kind and less critical. Engage in positive self-talk.
  • Challenge your negative thinking with positive self-talk – Become mindful of your negative thinking and look for objective evidence that the criticism is rational and founded.

Feeling loved starts wit loving yourself first

  • Stop comparing yourself to others Start to accept yourself, and realise that everyone is different. Comparing yourself to others just sets you up for failure from the beginning.
  • Focus on the present - Forget past disappointments and upsets; focus on the now.
  • Stop worrying about the future and focus on what you can control Keep your thoughts in the present and accept that you don’t have the power to change every element of the future
  • Get out and be actively engaged - Have fun! Spend time with friends, start a new hobby, enjoy the outdoors and the company of others!
  • Get active by exercising – There is nothing like a boost of endorphins to change a negative mood into a positive one!
  • Be assertive Communicate directly and honestly, state your needs and do not accept poor behaviour from others.

3 Stay Calm and Regularly De-Stress

Staying calm and de-stressing are so important when pregnant and even more so once we have a newborn demanding our attention 24/7! There are loads of ways to keep your cool and maintain your inner Zen. Give any (or all) of the following a try:

  • Know yourself and what type of life balance works for you. This means establishing how much rest, play, food and exercise you need to function at your optimum. You may need to trial different options and changes to see what works best for you.
  • Keep your mind alert and fine-tuned. Our brains benefit from remaining active – we need to be constantly seeking new ways to get the synapses firing. Knowledge is power! Try to learn new information on a daily basis, even if it is just from reading the newspaper or browsing the internet!

Don't keep stress bottled up, let it go

  • Keep physically active.Exercise is good for us, both physically and mentally. The endorphins released from exercise have been shown to reduce depression and anxiety, and we feel good when we look good!
  • Engage in time with family and friends.Day to day life is busy; however we should not allow ourselves to be too busy to connect with our loved ones. It may be easy to “put off” seeing friends or family, but remember that it is the people we love the most who quite often provide us with the deepest sense of happiness.
  • Be kind to yourself. Appreciate your good qualities and reward yourself for achievements. Even if it is simply taking a nice relaxing bath at the end of the day, to reward yourself for making it through a busy work day – every ounce of self-kindness is important!

Spend time with yourself being calm and relaxed

  • Make “me time”. This means making time for YOU! By the end of each day ensure that you've taken time to unwind. If you can, go for a morning walk or jog, watch the sunset, enjoy a nice bath, read a book, listen to music, practice mindfulness, etc. 
  • At least once a week switch off from everything and everyone (arrange for daddy or a family member to take bub) and enjoy a lengthier “me activity” (go to a café for a coffee, take a beach walk, go to a yoga class, meditate, take some reflection time, write in a dairy, etc.).
  • Do something spontaneous.It is healthy every now and again to take a step back from our structured everyday lives to do something different. Go for a bush walk, have a picnic, go for a long drive, get a massage, visit an old friend, go to the museum or theatre, enjoy a bite to eat at a new chic café, practice yoga or meditation at the beach, get away for the weekend…the list and opportunities are endless!

Do something nice for yourself to unwind and de-stress

  • Practice relaxation and mindfulness:Using relaxation strategies is a great way to help us shift towards a positive mindset. Mindfulness (one commonly used relaxation strategy) is defined as paying attention and focus to the here and now, both internally and externally. It takes practice to really focus for long without your thoughts wandering off, and it can be frustrating at first. 
  • However, the trick is tenacity. The more you practice, the more mindful you will become. There are numerous benefits of practicing mindfulness including: helps to create a clear state of mind, assists to increase self-awareness and an awareness of your environment, improves concentration, promotes a sense of calmness and relaxation, slows down thought processes, and aids in more regulated functioning of the central nervous system. 

2 Maintain a Healthy Balance

Gaining a healthy balance is critical to ward off the baby blues as “happiness is not a matter of intensity but of balance and order and rhythm and harmony” (Thomas Merton). We have a tendency to overlook the importance of balance in contributing to living happily and successfully. To function at our optimal, we need to balance looking after ourselves mentally, physically, and spiritually. In saying that, it is certainly not easy in such a fast-paced and hectic world!

Balancing all our new duties as a Mummy often leaves us with very little time to even consider ourselves and what keeps us balanced. Also, externally, our balance is further jeopardized by the daily grind - change, speed, new technologies, globalization and the demands of daily life. Focusing too much on any one area of our life catches up with us which ultimately leads to health and well-being issues in the other unbalanced area/s.

Make sure you have activities in your schedule that keep you active and de-stressed everyday

The outcome of imbalance is an increase in stress and its related effects. We become stressed, we become unhappy and unhealthy, and we feel off centered. Thus, we need balance in everything we do on a daily basis – this means a balance in our daily activities and responsibilities, our emotions, our focus, and or goals.

So then, what constitutes balance? Essentially, balance is about successfully and happily living our lives. This means finding an equilibrium between the extremities of daily life – between rushing and slowing, stopping and going, order and chaos, working and playing. It is about feeling in control over knowing when and how to transfer fluidly from one extreme to the other, and actually being able to take the right course of action to be able to do so. 

1 Seek Help: Talk to Family, Friends, and Professionals

Having support from others can make a huge difference when dealing with any change in life, and becoming a mummy is one of the biggest changes you will ever experience! Support from loved ones can pull you through the tough times, help you deal with challenges, and also celebrate and enjoy the fun parts of your journey! 

Having family members and/or close friends to turn to during rocky patches, having a listening ear and a sounding board, can make all the difference in how we cope. Support can help to renew our confidence to push through the hard days. Without social support, pregnancy and motherhood can be a significant struggle. So surround yourself with people who love and support you to keep the baby blues at bay!

Don't be scared to reach out for help if you need it

If needed, seek professional support. If you are finding that you need more serious help to manage symptoms of PND, see your doctor for a referral for professional help from a Psychologist or a trained Counselor. You may also wish to join a support group, as surrounding yourself with others who are experiencing similar symptoms may provide a source of comfort.

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