Pregnancy Anxiety and Postpartum Depression During COVID-19

We are — all of us — living in unprecedented times. At the best of times, my research team and I would encourage pregnant women and their loved ones to take extra care to be emotionally healthy during pregnancy. Now, as we go through COVID-19, it is more important than ever. Read on to find out how you can deal with pregnancy anxiety and postpartum depression during COVID-19.

You may be wondering, why? Here is what we know:

• We know that 1/5 women who struggle with anxiety or depression will continue to experience symptoms across their lives.
• Women are more at risk for experiencing anxiety or depression during pregnancy than at any other times in their lives due to new challenges and increased vulnerability.
• Prenatal depression and anxiety can continue for years: in fact, for over 20 years, based on recent research of over 3000 Australian women.

Even if you have given birth recently and are already experiencing symptoms of postpartum depression, you can still benefit from actively alleviating the stress, anxiety, and depression symptoms by prioritizing the care of your mental health.

Around the world, we hear of people struggling with their mental health, with those already at risk (e.g. those with a history of mental health struggles) being triggered. This is understandable. Almost overnight, our routines and society as we know it have turned upside down. The uncertainties of the situation and stay-at-home mandates have presented unique challenges for our families. Humans are social by nature, and when we are not getting regular social contact, our mental health suffers.

For pregnant women, women about to give birth or new moms, COVID-19 presents an extra unique set of challenges, especially if certain supports that usually promote healthy mental health in moms and families are missing (e.g. social support from family and doulas).

Source: Unsplash/Dr Dawn Kingston

Some of the things we hear from women that are stress and anxiety triggers are:

• Stay-at-home mandates
• Wondering when the pandemic will be over and when life can go back to normal
• Worrying about catching the virus or a loved one catching it
• Worrying about transmitting the virus to your baby
• Hospitals limiting or banning birth support persons (e.g. partner, doula)
• Having to rethink and re-engineer your expectations about your birth experience and days after delivery
• Worrying about picking up COVID-19 while in the hospital
• Being pregnant and having other young children to care for so that you have little time for rest or relief

All these additional concerns and stressors can make a new mom more vulnerable to both prenatal and postpartum anxiety and depression.

Recognizing that you are experiencing perinatal anxiety and depression is the first step to taking control of your recovery.

The symptoms are similar to regular anxiety and depression and can include:

• Sleeping more, or less
• Eating more, or less
• Irritability, constant fatigue and difficulty concentrating
• Losing interest in things that used to bring you joy

While it is easier to prevent postpartum anxiety and depression by taking action during pregnancy, many new mothers with postpartum anxiety or depression also find relief with these strategies. Taking action to reduce the effects or prevent pregnancy anxiety and postpartum depression during COVID-19 is one of the best ways toward recovery for your long-term emotional health and the wellbeing of your child/family, partly because it reduces the feeling of being out-of-control.

Source: Unsplash

Here are some things you can control on the journey to recovery:

Engage in lots of baby cuddles:

Simply holding and stroking the babies “nullified” the effects of prenatal depression. In particular, the infants of the mothers who held and stroked their babies more (four or more times every day) showed better emotional and physical health than infants who were not stroked and held as much by their mothers (three or fewer times every day). Infants who had been held and stroked more frequently were less reactive, less fearful, and more on track with their behavioural development.

Limit your media intake:

Try not to watch the news right when you wake up or about to go to bed. Make use of reliable information sources that do not sensationalise the news. This is a preventative action you can take to coping with pregnancy anxiety and postpartum depression during COVID-19. Limit the amount of time that you spend each day listening to news reports. If your province or state gives a daily update, that may be the one piece of trustworthy, non-sensationalized news to listen to.

Recognize that it is healthy to feel stress over finances and routine change due to the virus:

Studies show that two coping extremes — avoiding problems and thinking of them over and over — actually increase our stress. Give yourself permission to feel, rather than dismissing them. Talk through how you’re feeling with trusted support.

Postpartum Depression Essential Reads

The Potential Cost of Honesty in Perinatal Screening

Maternal Minds Matter

The battle of anxiety is won (or lost) in the mind:

While you can’t control the coronavirus situation, you can control your mind. A good habit is to identify when you are focusing on worry and flip it around to a point of gratitude (e.g. little things such as getting excited over the first signs of spring). It can feel tough at first, but as you start to use new brain pathways it will get easier. Imagine if you gained the positive effects of reducing pregnancy anxiety and postpartum depression during COVID-19 and came away from the pandemic with a healthier brain!

Sleep:

Did you know that one of the best ways to fight pregnancy anxiety and postpartum depression during COVID-19 is prioritizing quality sleep? While this is (understandably) harder for pregnant women and postpartum moms who get up regularly throughout the night for feedings and to calm crying babies, try to establish bedtime rituals to relax and establish a sense of routine and calm. Nap when your child naps. Even if you are tempted to stay up to clean the house after your child has gone to bed, it is better to unwind and sleep.

Sleep is important because of the short- and long-term impact of sleep deprivation — on ourselves, our productivity, and our relationships. We believe that one day, things will turn around and allow us to catch up on our sleep. But, it takes four hours of good sleep to repay the sleep debt from one hour of lost sleep.

Challenge yourself to complete one task each day:

E.g., washing the dishes. If nothing else gets done, you can feel a sense of victory over accomplishing your One Big Thing for the day.

Reframe negative thoughts with positive coping strategies:

E.g. Feeling isolated? See this as an opportunity to schedule video calls with other moms for "Mommy and Me" dates from home.

Get creative with enjoying nature:

Do you have a backyard? Or a balcony? Here’s a fun way you can reduce the effects of pregnancy anxiety and postpartum depression during COVID-10. Even with stay-at-home mandates, it is possible and can be extremely therapeutic to get some vitamin D, for both you and your baby while being home.

Sit on your front porch for half an hour and breathe in the smells of spring, feel the sun on your face, talk to your baby about the birds and flowers you see. Can you grow something? Even if you don’t have a garden, urban gardeners are having great success with container gardening. Nature can be extremely therapeutic, reminding us that seasonal cycles are still occurring.

Source: Unsplash/Dr Dawn Kingston

Take heart: The effects of pregnancy anxiety and postpartum depression during COVID-19 can be reduced.

Taking care of our emotional needs and adapting to new ways to stay socially connected can not only help you stay calm and be happier but can also reduce unnecessary pressure on your immune system. Remember other hardships you have overcome and that you are resilient, strong, and adaptable individual. We are in this together, we will get through it together and some kind of normalcy will eventually return.

If you’re wondering how much anxiety in pregnancy is normal, find out here.