Why we need to address perceptions around perinatal anxiety and depression

A must read article published by Emma Brancatisano in the Huffington Post Australia. 

The confusions and perceptions surrounding perinatal anxiety and depression are preventing new and expecting mums from seeking help.

“I’m looking down at my baby on my chest and I’m feeling nothing, whilst my husband was besotted with her. He was so overwhelmed with joy and I didn’t have that. I wasn’t feeling how I should.” Sara Gerritsma

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Bearing the shame of this illness can prevent new parents like Gerritsma from seeking help early and can leave them suffering in silence for longer.

Read the full article here and learn more about the curent Australian 

 

 

Campaigning for mental health and other collaborations

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perinatal mental health

One in three migrant women from low- and middle-income countries has symptoms of perinatal depression

Migration and perinatal mental health in women from low- and middle-income countries.

In this systematic review and meta-analysis the authors summarising the prevalence, associated factors and interventions for perinatal mental disorders in migrant women from low- and middle-income countries (LMIC).

Even though they found that the prevalence of perinatal depression is very high among migrant women, the data they found was insufficient to assess the burden of anxiety, post-traumatic stress disorder or psychosis in this population.

Furthermore the authors stress, that given the adverse consequences of perinatal mental illness on women and their children, further research in low-resource settings is a priority.

Read the abstract in the BJOG – International Journal of Obstetrics and Gynaeocology

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Interested in mental illness among displaced, migrant and refugee women in South Africa? Read our Issue Brief

Are you caring for moms or dads suffering from perinatal depression?

Our new collection of resources might be of interest to you.

resources-for-social-and-health-care-workers

A Beginner’s guide to finding a therapist – #DignityInMind post

Mental Health First Aid: Beginner’s guide to finding a therapist

Source: A Beginner’s guide to finding a therapist – World Mental Health Month

Documentary Film Festival: spotlight on mental health care

#DignityInMind – Raising Awareness on World Mental Health Day

On Monday 10 October 2016 people across the globe will commemorate World Mental Health Day, and in Cape Town, South Africa, it’s no different.

With four screenings of various documentary films focusing on mental health in South Africa, the #DignityInMind Documentary Film Festival aims to educate and empower Capetonians to speak up about mental health.

The festival forms part of the #DignityInMind campaign spearheaded by the Alan J Flisher Centre for Public Mental Health (CPMH). This year’s campaign brings together mental health organisations from across the entire country to share their ideas and support one another’s activities for an even bigger campaign and an online hub where information and events are shared.

The #DignityInMind Festival will be taking place at the Labia on Orange in Cape Town. This will include he much-anticipated Cape Town premiere of Doc-U-Mentally, a documentary looking at the physical and mental challenges five doctors on a 30-hour shift at Ngwelezane Hospital in Empangeni, KwaZulu-Natal face.

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Other documentaries to be screened, include Voices from the Edge. This short film investigates the work of the Programme for Improving Mental Health Care in South Africa and Nepal and takes the viewer on a journey of 2 Nepalese and 2 South African families personal experience of living with, or supporting a family member living with mental illness.

Caring for Mothers confronts viewers with the massive challenges South African mothers with perinatal mental health problems face every day and it shows how the Perinatal Mental Health Project aims to relieve this burden.

Normal is a short documentary looking at a day in the life of Dr John Parker, a psychiatrist at Lentegeur Psychiatric Hospital and the director of the Spring Foundation.

Shows rotating these films will be screened at 11:30, 13:45 and 16:00. The Doc-U-Mentally premiere will take place at 18:15. Entry for all four shows will be R40 and can be booked by calling 021 424 5927. Ticket will also be available at the door.

For a full programme, please visit the #DignityInMind campaign website at bitly.com/mentalhealthsa.

The Alan J Flisher Centre for Public Mental Health (CPMH) grew out of a shared vision and commitment to collaboration between members of the Department of Psychiatry and Mental Health at the University of Cape Town (UCT), and the Psychology Department at Stellenbosch University (SU).

Contact details

For queries and interviews, email us on media@cpmh.org.za and visit http://bit.ly/mentalhealthsa.

This year’s initiative is possible thanks to the following partners:

Adding their voices to this year’s call for dignity in mental health, are the Perinatal Mental Health Project (PMHP), Programme for Improving Mental Health Care (PRIME) and the Mental Health Innovation Network Africa (MHIN Africa) – all from UCT – and  Cape Mental Health (CMH), the South African Federation for Mental Health (SAFMH), RuReSA & the Rural Mental Health Campaign (RMHC), LifeLine Western Cape, Khuluma, the Ithemba Foundation & the Mental Health Information Centre (MHIC).

Bush Radio is a proud media sponsor of the #DignityInMind campaign.

Maternal depression and mental health in early childhood

Depression during and after pregnancy is affecting up to one in five women globally.

Previous studies from around the world suggest that depression during and after pregnancy affects the bonding between mother and child and can have direct implications for infant survival and early childhood development.

In this new review, the authors focused mainly on low and middle income countries and are calling for urgent interventions for mothers and children.

There is a substantial lack of research specific to women in poorer countries, where interventions such as cognitive behavioural therapy may not be available

– Prof Vivette Glover, Imperial College London

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Previously, research into perinatal depression has focused on high income countries. But current studies suggest that the problem is more common in low- and middle-income countries, some even suggest that up to 50% of women living in adversity are experiencing depression during or after pregnancy.

Therefor more resources are needed to support expectant and new mothers. Urgent investment is needed in research and the development of appropriate low cost interventions that are specific to these areas.

The Lancet review full text: Maternal depression and mental health in early childhood: an examination of underlying mechanisms in low-income and middle-income countries

Caring for the Carers – Do you have a support system – someone to talk to?

This week’s #DignityInMind blog, written by LifeLine WC’s Chairperson, addresses how mental health carers should look after themselves as well.

Are you able to ask for help?

Do you have a support system – someone to talk to?

Are you aware of your stress levels and do you manage them adequately?

Many of us in the caring industry as well as individuals who care for a family member or friend struggling with mental health will have answered ‘no’ to at least one of the above questions and it is probably for this reason that caregivers are at high risk for compassion fatigue and burnout. One of the main reasons for this is that we are most likely innate rescuers. We spend our lives throwing out lifelines, helping, healing and making a difference but often ignore the impact that all of this has on our own lives. Enter burnout.

Source: Caring for the Carers – World Mental Health Month

Mental Health First Aid: A beginner’s guide to being on happy pills

In this latest #DignityInMind campaign blogpost, Kate gives us an insight into her relationship to anti-depressants.

I popped my first anti-depressants ten years ago, and I count myself lucky that in all the years since, no-one has ever given me a hard time about being on medication for my mental state. Frankly, if anyone did, I wouldn’t care.

People (not me obviously) find it hard to talk about, and even harder to find help for. My oversharing, it seems, might be a public service.

happy-pills

Source: World Mental Health Month – #DignityInMind

Why we should care about maternal mental health

Empathic engagement with mothers

Image: Graeme Arendse

When I examined Johanna*, I noticed that Johanna was very quiet during the examination. Although everything was fine with the pregnancy, I knew that something was wrong. Johanna had filled in a mental health screening questionnaire, which is routinely offered in our clinic. She had a high score. When I approached Johanna to offer a referral to the PMHP counsellor, she started crying. When I asked what was wrong, Johanna said I can’t talk about it. She did, however, want to see a counsellor.

This is only one of many stories we hear from our nurses and midwifes at at one of our service sites. So why is it important that we train health and social workers and advocate for routine mental health screening in all maternity units in the country?

Read about Johanna’s way out of an abusive relationship and how the counselling empowered her to seek help here

What is perinatal mental health?

Some people may be confused about some of the words used in relation to maternal mental health, like ‘intrapartum’, post-partum’, ‘ante-natal’, ‘post-natal’. The time during pregnancy, may be called the ‘antenatal’ or ‘prenatal’ period. ‘Postnatal’ refers to the time after birth. In the mental health field, postnatal may refer to 6 months or 12 months after the birth. Intrapartum usually refers to the labour and delivery time. ‘Perinatal’ refers to the time from the beginning of pregnancy to the end of the first year after the birth.

It is important not to confuse the ‘baby blues’ with postnatal depression. The ‘baby blues’ occurs in about 60-70% of mothers. Feelings of being overwhelmed and tearfulness occur on the third or fourth day after the birth and these resolve usually within a week. Depression or anxiety are more serious conditions and usually require some form of treatment. Depression or anxiety may occur during pregnancy, after pregnancy or in both time periods. The symptoms of these conditions may be confused with the usual physical symptoms of pregnancy such as sleep and appetite changes, aches and pains, tiredness or changing emotions. However, depression and anxiety affects a person’s mood, thoughts and how they function in most areas of their lives.

‘Psychosis’ is when a person becomes out of touch with reality. Postpartum psychosis is actually rare. It occurs in about 1 in every 1000 women (0.1%) who have a baby. This illness, if rapidly and effectively managed, usually resolves completely so that mothers may return to being well and fully functional.

Find more definitions on perinatal mood disorder here

Why should we care about it?

Perinatal depression and anxiety are significant mental and public health problems with well-documented consequences for mothers, children, and families. In developed countries, suicide is a leading cause of maternal death.

Because of the stigma of mental illness and a lack of understanding, many women who suffer from depression and anxiety, and their families, are not aware that these conditions require treatment (like any other health condition) and that they can be managed (often with relatively simple methods) so that they can recover fully.

Mental health care usually starts with some form of ‘talking therapy’. This can provide the necessary support to empower a women to identify resources and personal capabilities. A therapeutic relationship can enhance a woman’s resilience to difficult life circumstances and support her to nurture her children optimally. Caring for mothers is thus a positive intervention for long-term social development. Many women may also safely benefit from antidepressant medication which effectively treat both depression and anxiety.

How many are affected?

According to the World Health Organisation, worldwide about 10% of pregnant women and 13% of women who have just given birth, experience a mental disorder, mainly depression. In developing countries this is even higher, i.e. 16% during pregnancy and 20% after child birth.

In South Africa, studies show that at least one in every five women suffering during or after pregnancy.

1 in 5 women suffering from depression

Why is mental illness during and after pregnancy so common in South Africa?

Pregnancy and the postnatal period is a psychologically distressing time for many women, particularly for those living in poverty, or with violence, abuse, HIV/AIDS or an unintended pregnancy. Many women in South Africa live in these circumstances.

Several studies on prevalence of common perinatal mental disorders in low and middle income countries are collated on our website.

Who is at risk?

Infographic: Anisha Gururaj and Ashley Pople

Perinatal mental health is connected to a wide range of issues faced by women and although many of the risk factors are common for all women, they can vary from country to country. See the infographic below for comparative risk factors between India and South Africa.

Women in South Africa are particularly at risk when faced by:

  • Domestic violence – violence contributes to poor mental health, and poor mental health makes it more difficult for women to negotiate relationships where there is conflict
  • HIV/AIDS– HIV puts people at greater risk of mental health difficulties, while poor mental health makes it less likely that those who are HIV positive to adhere to treatment
  • Refugee issues– women who are refugees are more likely to suffer mental health difficulties due to their past experiences and to a current lack of support
  • Substance abuse – poor mental health makes women more likely to use substances such as alcohol in an attempt to feel better, but in turn, these substances and the circumstances around using them, lead to worse mental health
  • Teen pregnancy – teenagers with poor mental health are more likely to engage in risky behavior and become pregnant, while pregnancy brings increased social and emotional pressures which then affect mental health

What can we do about it?

Education is key and it is important that mothers and families are sensitized. Informing mothers about perinatal mental health will go a long way in helping them manage depression, anxiety and related illnesses. This education must include information about how to get help and support.

The support may be emotional, practical or financial. Partners should pay attention to the needs of the mothers as well as their own mental health. Seeking help when it is necessary for either or both parents, is a useful way to cope with difficult circumstances. This may be from family, community, health or social workers or faith-based organisations.

Find out where you can receive help in South Africa here

*The PMHP is committed to client confidentiality in keeping with the ethical requirements of professional mental health practice. The client stories reflect common scenarios or sets of circumstances faced by many of our clients. Pseudonyms are used and details are changed. The stories are not based on any one particular woman’s experience, unless an individual explicitly chooses to share her story with or without her name attached.  

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