Cost of PNDA in Australia

November 8, 2021 Kylianne Farrell

PNDA affects 1 in 5 mothers and 1 in 10 fathers in Australia, with psychological, social and physical factors increasing risk

Perinatal depression and anxiety (PNDA) is costing Australia $877 million annually, according to a 2019 PwC Australia analysis prepared for Gidget Foundation Australia, entitled, ‘The Cost of Perinatal Depression and Anxiety in Australia’.

PNDA touches not only the parent experiencing the condition but can also have impacts on the child and wider family, with some of these impacts lasting a lifetime. Understanding the cost of PNDA to Australia can ensure that support for families be available during the critical early parenthood stage where it is needed. The estimated cost of PNDA to the health system, economy and wellbeing of those impacted totalled $877m, comprising of:

health costs attributable to PNDA equalling $227m, comprising increased use of primary
and community health services and hospital health care services and increased risk of
certain conditions for both the parent and child
economic costs of $643m are attributable to productivity losses associated with
increased workforce exit, absenteeism, presenteeism and carer requirements
monetised social and wellbeing impacts include increased likelihood of developmental
issues, depression, anxiety and child ADHD diagnoses,
totalling $7m.

Beyond this are estimated lifetime impacts of $5.2b attributable to the increased risk of depression, anxiety and ADHD in the children of parents with PNDA, affecting wellbeing, productivity and health system use.

Perinatal Trauma Related Disorders

November 8, 2021 Kylianne Farrell

A parent (mother or partner) may experience or witness an event they find traumatic in the perinatal period, such as a difficult or complicated labour or birth, a medical emergency for parent or baby after birth, miscarriage, ectopic pregnancy, stillbirth or neonatal loss.

Sometimes, labour or birth may not involve medical trauma, but can still be psychologically traumatic for a parent if they feel disempowered, ignored, ill-informed or out of control.

For some people, this trauma will resolve over time without intervention. Some parents may find it helpful to talk about the event, feel supported and heard by others, and be able to process emotions associated with the trauma. Not all people who witness or experience a traumatic event will develop a trauma-related disorder but some do.

Some, however, may also develop a trauma-related disorder indirectly by hearing or learning about a traumatic event.

Acute stress disorder can occur immediately after a traumatic event and is a short-term condition often lasting only up to a month. A person who has ASD experiences psychological distress and its symptoms are similar to PTSD as explained below. ASD is a temporary condition and treatment focuses on decreasing symptoms, improving coping strategies, and preventing PTSD. In dealing with ASD, talking to family and friends and seeking community support is often enough to deal with the effects of trauma if it is not complicated or perceived as life-threatening. If symptoms are ongoing however it can develop into PTSD.

The most widely-recognised trauma disorder is post-traumatic stress disorder, commonly referred to as PTSD.

Some of the following symptoms may contribute to a perinatal PTSD diagnosis if they are distressing and do not start to recede several weeks after birth:

– Re-experiencing the trauma through vivid and distressing flashbacks or dreams

– Negative thoughts and feelings such as fear, anger, guilt, feeling flat or numb a lot of the time, thinking they are to blame for what happened

– Being in a constant state of ‘alertness’ – watching out for danger to themselves, their baby or other loved ones

– A stress response to noises, smells or sights that remind them of the traumatic event

– Avoiding particular places or situations that may evoke reminders of the traumatic event, for example not wanting to drive near the hospital

If a parent has one or more previous significant experiences of trauma, they are more vulnerable to PTSD in the perinatal period. These include sexual trauma, childhood abuse, bereavement of a significant person and family violence, previous adverse birth or pregnancy-related events.

Effective Professional Help for PNDA

November 8, 2021 Kylianne Farrell

Professional care and treatment options

The mental health system can seem complicated and overwhelming to someone who is already struggling. Medical professionals who can provide initial help with new parents’ concerns about their mental health include:

– Child and Family Health Nurse

– GP

– Midwife

– Obstetrician

These people can provide some initial assessment, information and support around perinatal mood disturbances.

If more specialised support is needed, a parent may be referred to additional services. The type of referral may depend on whether the parent’s distress appears mild, moderate or severe. These are some of the options:

– Perinatal psychologist or counsellor

– Psychiatrist

– Mental Health Social Worker

– Specialist support groups or a specialist telephone support service

– Online support tools

– A mother-baby unit (MBU) within a hospital

Risk Factors for PNDA

November 8, 2021 Kylianne Farrell

Some of the following background factors and circumstances can increase the risk of PNDA:

– A personal history of mental illness

– A family history of mental illness

– Pre-existing misuse of alcohol or other drugs

– Vulnerable personality factors such as low self-esteem or perfectionism

– A personal history of trauma, abuse or other adverse experiences

– Having settled in Australia from another country

– Financial difficulties

– Lack of social and/or practical support network

– LGBTQI+ parents, who can face discrimination and have their family or parenting questioned

– An unsupportive employer e.g. pressure to return to work or lack of flexible options

– Relationship difficulties with partner, mother, father or another key person

– Previous pregnancy, baby or child loss

– Birth of twins or multiples

– Pregnancy or birth complications

– Unplanned pregnancy

– Birth mother younger than 18 years old

– Fertility issues, including IVF or surrogacy

– A rural and remote location

– Culturally or linguistically diverse background

– Aboriginal or Torres Strait Islander background

– Birth mother older than 35

– A recent or significant bereavement

– Other stressful life events

What are perinatal depression/anxiety signs and symptoms?

November 8, 2021 Kylianne Farrell

An episode of perinatal depression and anxiety can be mild, moderate, or severe. It is diagnosed when several of the following symptoms occur for more than two weeks, causing significant distress or impairment:

– Depressed mood, including feeling sad, empty or hopeless

– Crying for no apparent reason

– Loss of interest or pleasure in life

– Physical symptoms: (changes in appetite, headaches, sweaty palms, heart racing)

– Insomnia or excessive sleep

– Moving more slowly or finding it harder to slow down

– Loss of energy or fatigue

– Not feeling attached or bonded with your baby

– Feelings of worthlessness, guilt, feeling trapped

– Impaired concentration or indecisiveness

– Thoughts of death, self-harm or a suicide attempt

– Difficulty concentrating or focussing

– Feeling unusually restless

– Fear that something awful might happen

– Excessive and generalised worry

– Irritability

– Panic attacks

– Muscle tension

– Sleep disturbance

– Appetite disturbance

– Obsessive or compulsive behaviours

– Other physical symptoms such as heart palpitations, sweaty hands, stomach complaints

If symptoms have been present for 14 days, and it is starting to impact a parents ability to have wellbeing and positive functioning it may be time to encourage professional support like The Gidget Foundation.

What is perinatal depression/anxiety?

November 8, 2021 Kylianne Farrell

Pregnancy and the first year of parenthood (the perinatal period) is a unique time and involves major changes in a person’s life. The challenges of this adjustment to parenthood are often underestimated within our society and cultures. All expectant and new parents, including both mums and dads or partners, will have some good days and bad days. Ups and downs are expected and common. But when bad days become the norm, a parent may be experiencing perinatal depression or anxiety.

Perinatal depression and anxiety affect almost 100,000 expectant and new parents in Australia each year. Often, estimates for anxiety and depression are combined because many new parents experience symptoms of both. Sometimes, one may present more strongly than the other.

One in Ten Dads

May 1, 2021 Kylianne Farrell

One in Ten Dad’s will be diagnosed and struggled with perinatal depression and anxiety.

Perinatal depression and anxiety affect almost 100,000 expectant and new parents in Australia each year.

Dads’ roles have evolved in recent decades and some men can find this transition to parenthood challenging as they juggle all of the changes.

So keep on the look out for changes in the Dads around you, and check out The Gidget Foundation for more information on signs and symptoms to look for and how to access their incredible services!

We want to raise awareness that movement, play, adventure and exploration in the outdoors has the power to bring the incredible mental wellbeing benefits.

We want to inspire our community through the power of story telling, to light a fire within them to step outside of their comfort zone.