Would you know how to recognise Perinatal Anxiety (PNA) in parents?

anxiety college depression emotional wellbeing perinatal pna pnd post natal prenatal recovery therapy trauma traumatic birth Jan 07, 2020

Research suggests that PNA is as prevalent as PND in new parents, effecting as many as 20% of parents in the first year. Yet, despite this many HCPs lack the knowledge to identify anxiety in new parents often dismissing what they hear as ‘normal’ worry.*

GAD scores are routinely used by mental health professionals to assess levels of anxiety. Unfortunately HCP, such as GPS, midwives and health visitors, don’t have access to these tools and are one step behind because often the parents they are seeing may not recognise themselves what they are experiencing and are seeking help and guidance in trying to understand their experience.

It’s true that a degree of worry for new parents is a common and normal experience but anxiety on a day to day, every hour basis can be very distressing and disturbing for parents. Long term constant anxiety erodes confidence at a time when new parents need to master new skills, have faith in their abilities to nurture, and trust that everything will be fine.

Anxiety is always casting doubt, always pulling the rug, always creating a sense of insecurity. Anxiety drives us further into our own inner world, telling us to stay away from others; anxiety will say ‘you can’t trust them either’. This insularity is particularly problematic at the perinatal life stage when support and community are vital for parents to successfully thrive.

Of course, when our minds are consumed with this kind of worry the body senses something is wrong. The fight or flight response is triggered as the autonomic nervous system (ANS) prepares for action. If we think things are unsafe then the ANS job is to get us out of there quick. Rational thinking is suspended, and our options are reduced to very black or white ones as we lose our logic, our ability to see all of the shades of grey. The heart rate increases, pumping blood to the larger muscle groups, breathing becomes shallow and rapid to get more oxygen to the muscles via the blood. When physical action doesn’t happen and the muscles don’t use that extra oxygen, then carbon dioxide builds in the blood and this can tip anxiety into a panic attack.

The problem with the ANS frequently triggered into fight or flight is the accompanying hormones that are counterproductive to parenting. Increased adrenalin and cortisol prepare us for war not nurture. Oxytocin is the hormone needed for bonding, essential in that first year of baby’s lives.

As a therapist now listening out for anxiety, I recognise it in the catastrophizing thoughts (‘it’s the worst thing’), the black and white thinking and the myopic perspectives that folk bring. It’s revealed in the disturbed sleep, the errant coping mechanisms (alcohol and other drugs), the physical tension and frequent bouts of illness.

Having experienced this kind of anxiety myself as a new parent 14 years ago what I regret most now is never being able to enjoy my son’s babyhood or pre school years. My mind was always rushing ahead and seeing danger; in the park, or socially with others, or at home at mealtimes, or at bedtime. Everything was a huge obstacle to traverse, days to get through, milestones to tick off.  To everyone else my anxieties probably seemed like normal, new mum stuff but to me it felt exhausting and shameful.

One of the reasons I began to study hypnotherapy 13 years ago was in an effort to understand my own experience with it. Even just 13 years ago there was so much more stigma around emotional health than there is now, that I would never have dreamed of talking to my GP about it. Which makes me feel desperately sad for all the parents out there who have tried to seek help with anxiety and have been dismissed or abandoned by their HCPs because they thought it to be ‘normal’.