Screening New Moms for Stress, Anxiety

March 23, 2006 -- First-time moms may benefit from screening for anxiety and stress, as well as depression, a new study shows.

The study shows that new moms suffering from stress and anxiety weren't necessarily depressed. Focusing only on depression may miss women's postnatal stress and anxiety, write the researchers. They included Renee Miller, a registered psychologist in Melbourne, Australia.

Miller's study appears in BMC Psychiatry. It included 325 women who had had their first baby six weeks to six months before the study. Surveys showed that 94 of those women -- 29% -- had depression, stress, and/or anxiety.

Miller suggests using the term "postnatal distress" for any or all of those conditions. She also has advice for new mothers facing those problems.

Stress, Depression, Anxiety

In an email to WebMD, Miller explains the differences between postnatal depression, anxiety, and stress in patients she's seen in her psychology practice, which focuses on pregnant and postnatal women and their partners.

"Women with postnatal depression often report things like, 'I feel like a terrible mother,' 'I walk around the streets with the pusher [baby stroller] feeling like my life is pointless,' or 'I don't feel any enthusiasm for anything anymore,'" Miller says.

"Women with postnatal anxiety often report things like, 'I have a surge of adrenaline every time the baby cries,' 'I constantly check the baby throughout the night,' and 'I worry about not being able to settle my baby,'" she continues.

"Women with postnatal stress often report things like 'I feel on edge,' 'I just keep doing things and can't seem to wind down,' and 'I feel impatient and touchy,'" Miller says.

She adds that new mothers are on a steep learning curve and are often exhausted. Her study looked beyond those normal ups and downs.

Moms' Mental Health

The women in Miller's study were recruited from mothers' groups, health centers, and doctors' offices in Melbourne, Australia. They were about 32 years old, on average. More than nine in 10 were married or in long-term relationships. Nearly a third had postgraduate degrees, an unusually high number.

The women completed two anonymous surveys and mailed the surveys to the researchers.

The surveys were specifically designed for new moms. For instance, changes in sleep are often used to screen for depression, but sleep deprivation is normal for new moms, so that topic was excluded. The surveys also took into account the normal stresses and emotions of new motherhood.

One survey showed that 80 women were likely depressed.

The second survey double-checked depression. It also covered anxiety and stress. The results:

• 38 women had depression only
• 23 women were anxious and depressed
• 18 women were anxious but not depressed
• 15 women were stressed, but not anxious or depressed.

"In other words, had depression been the only criterion … 33 distressed women would have been missed," write Miller and colleagues.

Anxious, depressed women seemed particularly depressed, compared with those who were depressed but not anxious, the study also shows.

The researchers call for more studies to see if the results apply to other groups of moms, including those with older children. Meanwhile, they suggest checking for anxiety and stress -- as well as depression -- in new mothers.