00:00 Traditionally we used to talk a lot about postnatal depression only, but by doing that
00:06 we missed the 1 in 10 women who actually begin developing depression during pregnancy and
00:11 of course then this increases to 1 in 7 in the postnatal period.
00:16 So by talking about it more collectively during pregnancy and postnatally, we're able to pick
00:21 up women early and make sure they get the help that they need before the baby arrives.
00:26 And just how severe can the effects be?
00:29 Look it can be very severe if these conditions are not identified or treated and this is
00:35 what leads to perinatal depression being amongst one of the leading causes of maternal death
00:41 is because these conditions aren't identified or treated early.
00:45 We know that up to 74% of women for example have said that they didn't get help until
00:50 they reached the point that they couldn't cope any longer.
00:53 And that's why it's so important that we do things like universal routine screening, just
00:58 like we do for diabetes and ultrasounds, we also must be assessing for mental health conditions
01:03 during pregnancy and postnatally as well.
01:06 And what is it that physiologically happens or not that triggers this?
01:12 Look every part of your life changes when you're having a baby, every part of yourself
01:16 changes.
01:17 Your biology, your hormones, your social life, your work life, your identity, so much is
01:24 changing at this life stage.
01:26 And it's this significant change that puts people at greater risk, particularly if you
01:30 have a history of mental health problems, if you don't have good support networks, if
01:34 you don't have good partner support or you're doing parenting alone.
01:38 These things all increase your risk and likelihood of developing a mental health condition and
01:43 again these are the things that screening will identify, not only the presence of mental
01:47 health problems but also whether you're at greater risk so you can put those supports
01:51 in place early.
01:53 And so what's the incidence in Australia and to what extent has it been increasing?
01:59 Look so we know that for depression alone, one in ten will experience depression during
02:03 pregnancy, this increases to one in seven new mothers.
02:07 We also know that partners are at risk, if the woman experiences anxiety or depression,
02:13 partners are also 50% more likely to develop depression themselves.
02:18 We also know factors like COVID which led to a lot of isolation and a lot of uncertainty,
02:23 a lot of insecurity around jobs and life and increases of domestic violence, all those
02:29 things increased depression and we're still seeing the after effects of that even now.
02:34 And to what extent has awareness of the condition grown and how much of a good thing has that
02:40 been?
02:41 Look, definitely awareness has grown, particularly around depression, less so around anxiety
02:45 which is also even more common affecting one in five women.
02:50 Certainly it is great that awareness is growing and in some ways people are talking more openly
02:54 about it but it's still important that we're doing the screening and by screening we're
03:00 normalising it that this is common, we need to identify it and talk about it.
03:05 If we're not putting things in place like screening it makes it a lot more difficult
03:08 for the woman to bring up the conversation or identify that she might not be coping and
03:12 what the specific signs are.
03:14 So screening is absolutely critical to facilitate that conversation and get these conditions
03:19 identified and help access.
03:22 And what are effective treatments?
03:24 So treatments vary, there's a range of treatments, so there's effective psychological or talking
03:28 therapies.
03:29 These are particularly helpful for people with mild to moderate depression.
03:33 Once someone experiences more moderate to severe illnesses, the National Guidelines
03:38 recommends SSRIs which is a type of antidepressant and importantly these can be safely used
03:44 in pregnancy and when breastfeeding.
03:47 So again having this knowledge about effective treatments and access to this as part of screening
03:52 and care is essential for parents and for health professionals.
03:57 And Nicole, why did you choose this as a field to specialise in and how satisfying has it
04:03 been trying to improve the awareness and the treatment?
04:08 Oh look, it's been my life's work.
04:10 I've found it enormously satisfying.
04:13 You know I've always been dedicated to women's mental health and just that the unique challenges
04:19 that the perinatal period brings, there's so much opportunity to intervene early and
04:25 to also it's a very exciting time with new digital technologies.
04:31 This part of the community is really embracing technology so that's why we have fantastic
04:35 apps like the Ready to Cope app and digital screening to really empower the consumer with
04:41 information that they never had access to before.
04:43 [BLANK_AUDIO]
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