In the early weeks of what was otherwise a smooth pregnancy, there were a couple of days when 34-year-old Nicole* felt really low.
"I don't know where it came from because I'd never had depression before. I felt so flattened out and I couldn't understand why I was feeling that way."
She mentioned it at her next prenatal check-up and was referred to a psychiatrist and told that there was an increased likelihood of developing post-natal depression. She was instructed to keep an eye on how she was feeling.
Nicole said she felt empowered by her birthing experience: it was a short labour and completely drug-free. The new mum was smitten with her baby girl and all seemed well for the first six weeks.
It was then that Nicole began venturing out with Lola, who by then had her first vaccinations.They were walking up the street when Nicole suffered a panic attack.
"My heart started racing and I was overwhelmed by an instinct to protect Lola from all the dangers in the world. I couldn't breathe and felt like I was outside my body."
The feeling passed after 10 seconds, though it felt like an eternity.
Nicole had just experienced postnatal anxiety: a condition that affects one in five mothers and one in 10 fathers. Although it is as common as postnatal depression, awareness about it is lower. According to clinical psychologist Chris Barnes at the Gidget Foundation Australia, this is because it used to be lumped in with postnatal depression and was simply called 'PND'.
"Now we know that the term perinatal depression and anxiety (PNDA) describes the condition more accurately. For some women depressive symptoms are felt more strongly but for others it is anxiety. However, they are often experienced together but just at different levels."
The next time Nicole suffered a panic attack, she was taking Lola to her partner's workplace on the other side of Sydney.
"I was stopped in traffic and I suddenly thought, 'Oh my God, I'm trapped in this car. I can't move. And the baby's in the back.'"
After the panic attack passed, Nicole turned the car around and drove home. She told Essential Baby that she decided she simply wouldn't leave the house so that it wouldn't happen again.
When there was no way around having to go to an appointment, Nicole would become fearful and anxious. She explained that the anxiety wasn't triggered by her baby being overly demanding. Something else was going on.
"Lola is such a good baby and I love being her mum. The anxiety wasn't surrounding looking after her. It was sort of just me."
But even though Nicole kept outings to an absolute minimum, things kept going downhill.
"Every day I'd wake up and think straight away, 'How am I going to feel today?' I felt like I was going crazy," she explains. "My fears were completely irrational. I can't put my finger on one specific thing that I was afraid of – the feeling was just always there."
Nicole said that her partner, mother and sisters were all really supportive of her battle with anxiety, yet she still felt alone.
"No one really understood the severity of what I was going through, because it was too hard to explain it. My mum, for example, was very supportive, but she'd say things like, 'You'll be okay.' But I was thinking to myself, 'I'm not going to be okay.' Nobody could console me and it was terrifying."
When Nicole went with Lola and her partner Nick on a business trip to Darwin, she started having a panic attack on the plane. She kept imagining their daughter falling off the hotel balcony.
And even though it turned out that their room had no balcony, Nicole was terrified of the hotel's internal balcony, and would strap Lola into her pram and rush past it.
The recovery begins
It was at that point that Nicole realised she needed to do something more to get her anxiety under control.
For four months, she had been trying to combat it by doing more yoga and meditation, cutting out white carbs and continuing to see the psychiatrist, as well as limiting activities that could trigger a panic attack.
She had put off taking the antidepressant medication she had been prescribed because she hoped that natural remedies would work, and the very thought of taking it made her feel anxious.
"I'm a pretty big yogi and am into meditation and I thought it could knock the anxiety on its head. But I would just cry in the car, wondering when I would feel normal again."
Nicole was also concerned about Zoloft's possible side effects, and that during the first two weeks she might start feeling worse. This sometimes happens, as the medication takes time to build up in a person's system.
"I felt that I wouldn't be able to bear things getting any worse," she said.
Nicole did experience a couple of dizzy spells but was otherwise okay, and she was happy to be able to continue breastfeeding while taking Zoloft.
"I'm glad I stuck with it because I feel like I'm back to normal. It's taken the edge of the fear off."
Nicole hasn't suffered a panic attack since she started taking the medication three months ago. She said her quality of life has improved immeasurably, and that she can now fully enjoy being a mum to Lola.
"I drove to the doctor's this morning. That would've been a huge thing for me before. But now I can just get in the car and go. I do still think, 'This is when I would probably be having a panic attack.' But it doesn't happen and I can go about my life without being too scared to leave the house."
Nicole is at pains to say that she isn't blithely recommending the use of antidepressants, but that in some cases a condition can become so severe that it's impossible to carry on without treatment.
"I'm not saying, 'Just take drugs and you'll feel better.' I feel like I tried every other avenue to get on top of how I was feeling, but I just couldn't. I'm grateful that there was another option, because I don't know what I would've done. I'd like to say to other women suffering from post-natal anxiety that there are other options. Those options are there and they work."
Identifying postnatal anxiety
According to Ms Barnes, the following are common signs that you may be suffering from perinatal anxiety – 'perinatal' covers the time before birth and the year following it.
- Constant worry about the birth, your baby, or coping with the day ahead.
- Feeling that something bad is going to happen.
- Racing or obsessive thoughts and you are unable to switch your mind off.
- Significant disturbances of sleep and appetite.
- Unable to rest even when your baby is resting.
- Constantly checking on your baby.
- Physical symptoms like dizziness, hot flashes or nausea.
Your next steps
If you're suffering from low level anxiety, mindfulness strategies can help, says Lisiane Latouche, Director of Social Work and Psychology Services at Tresillian Family Care.
"Some mums are accessing mindfulness apps [such as Mind the Bump, Headspace and Calm] and online postnatal programs. Most mums enjoy the mutual support of other mums and therefore access group programs."
Tresillian plans to start offering mindfulness and wellbeing postnatal groups – check the website for soon-to-be released details.
Ms Barnes said it's important to have small amounts of time away from your baby to recharge, and to talk to your partner about how you are feeling.
"Try to introduce some pleasant activities into your daily routine, such as seeing a friend, listening to music, singing, having a bubble bath, or a date night with your partner."
Fish oil supplements can be good for mood regulation and magnesium for sleep. She also recommends regular exercise and a healthy diet – and not being afraid to ask for help.
If you're not feeling better after a few weeks, ask your GP for a Mental Health Care Plan so that you can access bulk billed counselling or psychologist sessions.
* surname withheld
For immediate help, please contact PANDA on 1300 726 306 (Mon to Fri, 9am – 7.30pm AEST) or panda.org.au
Lifeline - 13 11 14 or lifeline.org.au
Gidget Foundation - 1300 851 758 or go to gidgetfoundation.org.au