Are you just a worried Mum, or is it anxiety?

Are you just a worried Mum, or is it anxiety?

“We can’t sell that car seat, it only has a year left until it’s expiry date – what if the person who buys it has an accident and their baby gets hurt?”

“She’s running too far ahead of me, what if she forgets to stop at the road and gets hit by a car?”

“Why is the school phoning me? My daughter must have had an accident, I hope she hasn’t broken anything.”

These are real, actual thoughts I’ve had at some point over the past few months.

I’m an over-thinker. A worrier. And yes, just a teeny bit anxious.

In my mind, these three things are pretty inter-related. In fact, feeling worry and feeling anxious pretty much exist on a continuum. And my over-thinking tendencies tend to push the needle with regard to where I am on that continuum on any given day.

Personally, my anxiety was never an issue before I became a mother. Certainly my worrier tendencies were always there, but they were pretty low-key and probably no different to most of the general population: that little sinking feeling in my belly if I ever got called into the boss’ office, or that nervous over-preparing that came with a public speaking event.

So I never identified as being an anxious person. Which is perhaps why it took me a few years to recognise my anxiety as a mother. You know that saying they have about the plumber whose home is full of dripping taps? Well that’s kind of my situation. Even though I’ve worked in this field of mental health for years, it took me a little while to realise the issues in myself – probably because they were so mild. I was used to working with people whose mental health concerns were much more compelling, and much more complex. So that led me to put my thoughts down to typical new-Mum worries. But as the years passed I started to realise that many of the quirky little thought processes I had over my six years as a parent weren’t actually your bog-standard run of the mill concerns.

Not so much the thoughts listed above, but how about this one:

“This pathway is a bit secluded, I feel pretty vulnerable. What would happen if someone tried to steal my baby from the pram here? There’s no-one close by to help, no-one would hear me scream. What can I use as a weapon? What should I do?”

This was a thought I had pretty regularly on our daily walk in our small coastal town in Central Queensland – it was hardly Gotham City, and a brazen daylight abduction was highly improbable, but my brain still went there. So, yes, in fact, I actually was meandering a bit further along the anxiety spectrum than I realised. And even though my anxiety was quite mild when compared with others’, and I certainly wouldn’t classify it in a clinical range of anxiety, that didn’t mean that it didn’t deserve my attention.

Anxiety is a sneaky little thing – particularly in emerging or mild cases. It has blurry edges and often disguises itself as something else. It’s rarely cut and dried, and it can be difficult for us to identify. We can tend to explain away our anxiety under the guise of being “safety conscious”, “over protective” or just “a little highly strung”. In fact, in our world worry and anxiety are practically state sanctioned – think of the marketing campaigns from your workplace OH&S rep: “Safety First”, or “Take Five to Stay Alive.” Or popular phrases such as : “Better safe than sorry.” Even the Boy Scouts validate our anxiety with their iconic slogan: “Be prepared.”

Of course, I’ve got my tongue firmly planted in my cheek here. But my point is that, on the surface at least, it’s far more socially acceptable to be anxious than it is to be depressed. And that’s where the difficulty begins. Everyone worries, because the world is a dangerous place. Just turn on the evening news or scroll your Facebook feed for evidence of that.

So if everyone worries – how do you know when it’s too much worry? How do you know if it’s something more than just “worry”. And what do you do about it?

anxiety-vs-worry-pinterest

So here’s a few questions to ask yourself to help you figure out where you sit on the “overthinking vs anxiety” continuum.

1: Are your worries constructive or controlling?

What do you do about your worries? Do your thoughts help to keep yourself safe in productive and socially acceptable ways – for example, making sure you have enough petrol and locking your car doors when driving at night time, or do they force you to make decisions and take actions that diminish your life in some way – for example, cancelling or turning down evening catch ups with friends due to your worries about driving at night. One of the hallmarks of anxiety is that it impacts our ability to undertake everyday activities.

2: Do your worries go away once you’ve taken action to address them?

Worrying thoughts are one way in which our mind alerts us to danger. Generally, once we’ve addressed the worry, it will leave us, but with anxiety, the fear and worry remains, despite all the actions you take to address it. For example, your daughter, who has a peanut allergy, is going to stay with your in-laws overnight. How do you handle this situation – do you give your in-laws one quick reminder about the allergy before you leave, or do you continue to worry about it for the entire night, find yourself unable to focus on the event you’re attending, and constantly wanting to send them another quick reminder text message?

3: Is your worry in your head or in your body?

Overthinking and worrying tends to stay predominantly confined to our brain, whereas anxiety is generally felt all through the body. So are your worries combined with a racing heartbeat, sweaty temples, shaking hands, tapping feet, a surging tummy, or a tightness across your chest? Physical symptoms such as these, when unrelated to physical exertion or another illness, can indicate anxiety.

4: Does your over-thinking affect the way you function day to day?

We touched on this in point one, but there are other ways that anxiety and worry can impact our daily life – more so than just avoiding certain activities. Is your work productivity being impacted by the amount of time you spend worrying, or reacting to your worries? Are your relationships being impacted – do you find you push people away due to your fears, or feel compelled to ‘put on an act’ around others? Are you delegating decision making responsibility at home or at work due to your worries? For parents in particular, are you finding you’re not enjoying your role as a parent as much as you should, because of your worries. Or are your worries affecting the amount of time you spend with your baby or child – eg. do you avoid letting anyone else hold or care for them – even trusted family members, or alternatively, do you relinquish care responsibilities more often than you want to, because you think others can look after them better than you can?

What do do about it

Anxiety is a personal experience, and it can be different for everyone. If you’re concerned you may be experiencing anxiety the most important thing to do is to speak to a GP, your Community Health Nurse, or another health professional involved in your care. A GP will be able to provide an assessment and diagnose an anxiety or depression. They can also refer you for Medicare funded services from a mental health Occupational Therapist (such as myself), a social worker or psychologist, under the Better Access to Mental Health Care program. If you already have someone in mind you’d like to speak with you can let your GP know and he can refer you specifically to that person, as long as they are registered for the program under Medicare.

When it comes to treatment options for mild to moderate anxiety, counselling therapies and lifestyle changes are generally the first course of treatment, with best practice being attempting these prior to prescription of medication if necessary. (Please note this is general information and treatment strategies are always personalised).

As I mentioned earlier though, you don’t have to be at a clinical level of anxiety to have it impact negatively on your life. Common motherhood traits such as excessive worry, stress, overthinking and the infamous “Mummy Guilt” can all impact our wellbeing and experience of motherhood. Which is why I developed my Mindful Motherhood program – a five week online program to help mothers overcome stress, guilt and overwhelm, to live a more meaningful life. You can check it out here

I have PND: Should I see an OT or a psychologist?

I have PND: Should I see an OT or a psychologist?

I’m often asked why someone with depression, anxiety or postnatal depression or anxiety would choose to see an Occupational Therapist (OT) rather than a psychologist when trying to overcome their mental health difficulties.
 
It’s a decision each woman has to make for herself, in conjunction with her GP or other medical practitioner – and the decision may come down to several factors.
Both services are fantastic options and provide a clinically relevant service with many different facets. From a highly generalised perspective, psychologist support will focus primarily on ‘talking therapies’, whereas OT support will have a component of talking therapy, but will have a greater focus on practical strategies and outcomes, such as supporting the woman back into participation of her life roles. This is what we call “occupations” – we use “occupation” both as a treatment modality and as a therapy goal.
Should I see an OTor a psychologistfor support with postnatal depression_
 
The good news is, you don’t have to choose just one or the other. OT and psychology work together really well. A woman may see a psychologist for a period of time to help her make sense of her thinking patterns, and how these affect her mental wellbeing, and may also seek support from an OT, who can work with her to help her re-establish routines and skills to enable her to fulfil her role as a new mother, and to develop habits and practical strategies to support her ongoing wellbeing into the future.
 
A person might see a psychologist for a period of time and then follow that up with OT support, or they might see both concurrently. It really depends on the person’s particular situation and needs.
It’s also important to remember that the relationship between the client and the therapist is an important factor in the success of any therapeutic endeavour. So it’s important that the person seeking support feels comfortable with, and confident in their chosen therapists abilities.
The best course of action if trying to decide between OT and psychologist support is to discuss your options with your GP.
Until next time,
Sarah
Could I have postnatal depression?

Could I have postnatal depression?

I’m taking a huge guess here – but I’m going out on a limb to say that most new mothers have asked themselves this question at some point in the first few years of becoming a mother.

Welcoming a new baby into the world is an experience like no other. Being a new parent brings a whole gamut of emotions, responsibilities and questions. Many of which we’re completely unprepared for.

But what happens when those emotions, responsibilities and questions become too much? When “unprepared” becomes “unable to cope”?

When does new parent overwhelm become postnatal depression?

Is it just the baby blues? Or is it postnatal depression?

Is it just the baby blues? Or is it postnatal depression?

 

Current statistics tell us that postnatal depression (PND) now affects one in 7 new mothers and one in 20 new fathers. But despite the increased incidence of PND in our society, there still seems to be misunderstanding about what PND actually is and how it is treated.

Beyond the “Baby Blues”

In recent years there’s been an increased awareness of the “Baby Blues”, that short period of time after childbirth in which new Mums can feel exceptionally sad or teary for no apparent reason. This episode generally coincides with the new Mum’s breast milk “coming in” and is primarily hormonal in its cause.

However, postnatal depression shouldn’t be confused with the baby blues, because it is something else entirely.

When feelings of sadness, hopelessness, fear and worry extend beyond a period of a few weeks it can signal that the mum is in fact experiencing postnatal depression.

How do I know if it’s PND?

The difficult thing about diagnosing PND is that the early signs and symptoms are so similar to the general experience of many new mums who may be overwhelmed with their new role as a parent.

Feelings of worry, exhaustion, bouts of tearfulness or irritability, feeling inadequate as a mother, feeling unable to cope, blaming yourself when things go wrong, being overly critical of yourself, decreased sex drive, difficulty concentrating, difficulty sleeping, loss of appetite. The majority of mothers can relate to having felt these emotions as a new mother – but they are also classic symptoms of PND. So how do we know if a Mum is just “going through a rough patch”, as opposed to something more serious?

From a health professional’s perspective, we will do an in-depth interview to help each woman determine whether it’s a case of the “blues” or if it’s actually depression.

What we look out for is these types of issues:

  • Difficulty being able to laugh and see the funny side of things
  • Decreased ability to look forward to enjoyable activities
  • Blaming yourself unnecessarily when things have gone wrong
  • Feeling anxious or worried without good reason
  • Feeling like things are frequently “getting on top of you”
  • Difficulty sleeping or sleeping excessively
  • Frequently feeling sad or miserable quite often
  • Frequent bouts of crying
  • Having thoughts of harming myself of others

In particular, we want to know how long these feelings have been experienced, generally if it’s more than a two week period, the likelihood that it’s actually depression is increased. (although with the last point about thoughts of harm, it’s important to address these, no matter how long they’ve been occurring.

With the early stages of depression there is no definitive test you can take which will answer “yes” or “no” to the question of “do I have postnatal depression?”. Which is why I always encourage anyone who might be worried they have PND to seek support from an experienced and understanding health care worker. They can help women work through these issues above.

I think I could have PND – what do I do now?

In my professional opinion, when it comes to seeking help for PND (even if you’re not sure its PND) , it’s a case of “better safe than sorry”. Seeking support and advice early is always recommended, as the types of interventions generally suggested for a woman with mild PND are the sort of things that would also support any mum who is simply overwhelmed. These might include:

  • One to one, or couples counselling
  • Relaxation and stress management strategies
  • Mindfulness and meditation strategies
  • Changes to diet and lifestyle – including sleep and exercise
  • Increased practical support around the home

As with many other things in life, PND generally occurs along a continuum. It is rarely black and white. The experience of PND can range from a mild case with the mother experiencing just a few of the common symptoms for a period of a few months, through to extreme PND where a mother may feel exceptionally hopeless and have thoughts of self-harm or suicide. Both examples would be considered depression, they’re just at different levels of intensity.

Many women put off seeking help for PND due to a number of reasons, frequently downplaying or talking themself out of speaking up. “It’s really not that bad”, “I’ll feel better once I get some decent sleep”, “It’ll get better once my baby is older”. These kind of assumptions can delay women from seeking timely support.

We know that early detection and treatment is the best possible course of action for parents who experience PND. If we can recognise the signs early, parents can access the type of support services listed above, and make lifestyle changes straight away. In many cases this can help to prevent the depression from becoming worse. But when PND is left unaddressed for long periods of time, it can escalate rapidly, meaning more intensive treatment options could be required, including the addition of psychiatric care or antidepressant medication.

For anyone concerned that they, or someone they know, might be experiencing PND, the best course of action is to seek support from a health professional. Speaking to your maternal health nurse, midwife, obstetrician, or GP is generally the first step. But you can also feel confident seeking out a counsellor, mental health OT, or psychologist, which in many cases doesn’t require a referral.

 

For further resources about PND, please visit the following websites:

www.panda.org.au

www.beyondblue.org.au

www.gidgetfoundation.com.au

If you require immediate support, please contact Lifeline on 131 114