Baby blues, postnatal depression, postpartum anxiety – wherever you fall on the spectrum of mood disorders that can accompany pregnancy and childbirth, they are all common ways in which our bodies respond to the enormous physical and emotional toll that comes with the journey to new motherhood.
While the ‘baby blues’ is the least severe form and will affect 70-80% of new mothers, as many as 1 in 5 women will experience some type of perinatal mood and anxiety disorder (PMAD) across the globe, according to the World Maternal Mental Health Campaign.
PMADs can affect women of every culture, age and income level and can appear at any time during pregnancy and in the first 12 months post-birth. They include postpartum depression, postpartum anxiety, postpartum obsessive compulsive disorder, postpartum bipolar, and postpartum psychosis.
During self-isolation in the pandemic, it’s never been more important to raise awareness of maternal mental health issues, so that partners can be aware if the mother may be in need of some help, and in order to highlight the tools and services that are available to support women. “Having a newborn can as it is be anxiety-provoking, as understanding and constantly providing for a baby's needs is often overwhelming,” says Pashmi Khare, M.Sc., PCOS and infertility support specialist at Thrive, which has a dedicated maternal mental health facility at its wellbeing centre in Dubai.
“One of the most important pillars of support for new mothers is the social support (or help from external agencies, especially for expats without extended families in Dubai),” adds Khare. “With the Covid-19 crisis, the precautionary social isolation and self-quarantine, new mothers are losing that support at the moment. This can trigger or strengthen self-doubt, guilt of not being able to do everything as planned or expected, or even resentment towards the partner. The uncertainty of how long it can go can make things much worse.”
Symptoms of PMADs can include, “constantly worrying about the pregnancy or baby's wellbeing, feeling on-edge, having a sense of dread, difficulty concentrating or racing thoughts, or engaging in behaviours or rituals to try and reduce negative thoughts, such as constantly checking the baby’s breathing throughout the night,” says Siobhan Miller, founder of The Positive Birth Company.
It’s estimated that 7 in 10 women hide or downplay their symptoms, and as a result these illnesses frequently go unnoticed and untreated, sometimes with tragic and long-term consequences to both mother and child.
But there are effective and well-researched treatment options available to help women recover. Tanya Dharamshi, Clinical Director and Counselling Psychologist at Priory Wellbeing Centre, Dubai says, “Physically, women go through huge hormonal changes post-birth, but there can also be mental challenges too. We can see already the impact Covid-19 is having on our way of life, the economy and our relationships, which may exacerbate existing mental health conditions, such as postnatal depression. Its impact therefore on parenthood cannot be underestimated.”
9 Strategies to help with Pre- and Postnatal Anxiety or Depression
Seek out an online community
“Investigate dedicated post-natal groups and communities with people going through similar experiences,” says Dharamshi. Out of the Blues is an active UAE-based Facebook group dedicated to those suffering from pre and postnatal depression (or any kind of depression and anxiety) and is full of advice, links to free resources and many UAE-based women in the same boat who are able to offer advice and support or just a listening ear at all hours of the day and night. It is an excellent place to start: as Dharamshi says, “sharing and talking about emotions and feelings is the first step to helping manage PND.”
It sounds obvious, but it is always best to seek advice, comfort and support from friends and family, says Tanya Dharamshi of The Priory Wellbeing Centre in Dubai. “While physical contact is not currently an option for most, it’s vital that new parents find alternative ways and means to communicate,” – and WhatsApp texts alone don’t cut it. Research shows that video chatting fosters greater bonding and emotional benefits than either audio phone chats or instant messages like WhatsApp, in that order. Schedule regular Zoom, Skype or Botim catch-ups with friends and loved ones.
It’s easier said than done, but when your mental health is on line it’s really important to prioritise scheduling some regular time - no matter how limited - to focus on yourself and no-one else. “Whether it’s having a relaxing bath, reading a book, or doing some exercise in another room,” says Tanya Dhramshi of The Priory. “Just 15 mins of time away from everything and everyone can do wonders for your mental health.”
Make a Self-care NEST
A regular routine (as much as is permitted by infants) with a focus on self-care based on NEST-S principles (Nutrition, Exercise, Sleep, Time for Self, Supports) is key, says Ryan Van Lieshout, Canada Research Chair in the Perinatal Programming of Mental Disorders, McMaster University. He says this can begin with taking a shower daily, changing out of Pjs into daytime clothes and opening all the blinds since these can really jump start the day, but also prioritise regular hydration (especially if breastfeeding), wholesome nutrition and sleep as much as possible (try sharing the nightfeeds with your partner if you can – there’s no medal to be had for doing it all yourself, rather it’s responsible and brave to ask for help rather than suffer in silence).
Set goals for small wins
“Pick one thing, doesn’t have to be a big task, but something that you can complete,” says The Priory’s Dharamshi. “This will provide a sense of accomplishment and purpose for the day.” Pashmi Khare from Thrive adds: “One of my clients mentioned to me how frustrated she feels for not having done anything in the last few weeks. So we started noting down what she did during this time and it turned out to be quite a list of accomplishments that made her feel happy or motivated in the moment, but remained hidden when she looked at her weeks in an overview. The reason was that she had many other things on her to do list that she was not able to finish. She expected too much from herself and the long (undone) to do list made the accomplishments look very small.” Whether it’s putting the washing on, eating a good breakfast or messaging a friend back, identify achievable goals that you can tick off.
Relaxation techniques like box breathing, a breathing technique that helps manage stress, and progressive muscle relaxation can benefit mothers who are struggling with anxiety or are feeling overwhelmed.
Talk to your partner
“You’re meant to be a team, so share your worries and concerns as a couple and discuss how you can help and support each other to get through this challenging time,” says Tanya Dharamshi of The Priory Wellbeing Centre in Dubai.
Seek professional support
Many health professionals are now providing virtual support and counselling, making help more available and reducing the barriers. Check out Thrive, The Priory, The LightHouse Arabia, Dubai Community Health Centre and The Psychiatry and Therapy Centre Dubai to find psychologists, counsellors and psychatrists based in the UAE who come recommended and are offering online services.
Do not suffer in silence
“If left unchecked, the problem is likely to worsen and potentially cause longer-term mental health problems for parents and even long-term repercussions for the child,” says The Priory’s Dharamshi. Please note:
**If you feel you are or your loved one is in a state of emergency it is vital that you/they are not left alone. Seek immediate help from a care provider;**
- If you are alone, call a friend or family member as soon as possible and ask them to stay with you on the phone until you are able to find help
- Call your family doctor if you have one
- Calling the emergency department Rashid Hospital in Dubai would be the best starting point for out of hours care 04 324 1111
- If you already have a mental health provider (counsellor or psychiatrist) get in touch with them and discuss how you are feeling
- Call 901 to get advice from the Dubai police over the phone
- The newly launched Taaluf initiative by the Ministry of Community Development (MoCD) is offering free counselling to help members of the community deal with stress and anxiety. A helpline 800623 is available 9am to 9pm Sunday to Thursday.