Elnaz Rafiee was just months into her first pregnancy when she started feeling not quite right.
The now-30-year-old had suffered with depression most of her life, but this was different.
“I started to struggle more than I ever had before,” she told 7NEWS.com.au.
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It wasn’t until Elnaz felt she was at breaking point and sought help that she was diagnosed with perinatal anxiety.
“I felt like I actually had no control anymore,” she said.
Unfortunately, Elnaz’s story is not uncommon.
Noticing something wasn’t right
When Elnaz found out she was pregnant with her son, Kian, it was a massive shock.
She had previously been told it would be very difficult for her to have a child.
Having struggled with depression for most of her life, Elnaz, from Langwarrin in Melbourne’s southeast, knew there was a high chance she would also suffer with some kind of pregnancy-related depression.
However, nothing could have prepared her for how bad it actually was.
While Elnaz began struggling four months into her pregnancy, it wasn’t until May last year — when she was six months pregnant —that she started to spiral out of control.
With no family to support her and her relationship going through a rocky patch at the time, Elnaz said the uncertainly she felt about the future scared her.
“I didn’t know what was going to happen with my son and with me,” Elnaz said.
“I was so exhausted from just crying and not wanting to leave my bed and putting on this fake, brave smile every day going to work.”
When it all got too much, Elnaz called a helpline attached to The Alfred Hospital.
A psychiatrist was sent to her home the next day and Elnaz was diagnosed with perinatal anxiety.
“I’d never had (anxiety) before,” she said.
“So that kind of shocked me a little bit.”
According to Beyond Blue, perinatal anxiety can occur at any time during pregnancy or during the postnatal period (usually up to six weeks) after the baby is born.
The symptoms are similar to the anxiety one might experience at other times in life, but the worries are generally more focused on the baby and the woman’s perceived competence as a parent.
“New parents with anxiety often fear they are losing control or ‘going crazy’,” Beyond Blue said.
“Many try to do everything without any help (eg keep the house immaculate) and often worry that what they’re doing with their baby is not ‘right’ or ‘good enough’.”
Elnaz said she was left with a box of antidepressants, however, she was reluctant to take them given the stigma she felt was attached to the medication.
“I was always told that I wasn’t allowed to go on anti-depressants and that I didn’t need them,” Elnaz said.
“(That came) from my parents, from mainly my mum, because it was just such a taboo. It was so frowned upon.”
She said taking medication felt “almost like you’re accepting defeat in a way”.
But as the days went on and the anxious thoughts continued, the box of medication sat there — almost staring at her.
She ultimately decided she needed the medication to get through her pregnancy.
After experiencing a traumatic labour giving birth to her son, Elnaz was then diagnosed with postnatal depression.
The feelings of overwhelming doom and dread continued.
“I had this major fear that my son was going to suffer the same way I am,” she said.
‘I should just be grateful’: Feelings of guilt and shame
According to women’s mental health organisation The Liptember Foundation, one in 10 Australian women is currently facing a severe mental health issue.
Its latest research showed young mothers in particular are suffering, with 45 per cent of mothers younger than 30 likely to face a severe disorder.
Positive Minds Australia director and mental health expert Madhavi Nawana Parker said perinatal anxiety and postnatal depression often go undiagnosed in young mothers due to the embarrassment and shame attached to the conditions.
“People don’t like to talk about it, people don’t want … to tell someone they’re struggling,” she said.
“Frankly, from everyone who talks to me, they feel embarrassed that they’re struggling because everyone tells you ‘Oh, you’ll just know what to do, (motherhood) is the most natural thing in the world — people have been doing this forever’.
“When you love your baby and feel sad at the same time, it’s really confusing.”
Elnaz said she felt like a “horrific” mother even before giving birth, because of the thoughts she was having, and agreed the guilt mothers feel often stops them from seeking much-needed help.
“As a mother you’re like ‘I’ve got this miracle growing inside of me, so many people can’t have this — I should just be grateful’,” she said.
“So you just keep your mouth shut because it feels like the easiest thing to do.”
The Liptember Foundation’s research highlighted a host of triggers which could lead to mothers suffering from a mental health disorder.
The most common include low self-esteem, financial stress and self-criticism/increased pressure on one’s self.
For mothers younger than 30 in particular, Parker said the mental load of motherhood and having to take responsibility for a life other than your own could often be challenging.
“Taking on the enormous responsibility of caring for another little person, a lot of that care is emotional care, it’s cognitive care … but this is all done with a lot of sleep deprivation,” she said.
“Youth means inexperience as well. So, you know, at 30 that’s sort of the start of many of the challenges in life that don’t involve just being responsible for yourself.”
While a pre-existing mental health condition is a risk factor for developing perinatal anxiety or postnatal depression, Parker said the fluctuation of hormones that occurs during pregnancy has a significant impact.
“Naturally there is going to be some mood shifts but, for a person who has significant hormonal shifts and changes, that can lead to actual anxiety or depression,” she said.
After the baby is born, women then experience another hormonal change which can turn into the “baby blues”.
Parker said this commonly occurs three days after the birth.
“For some people that just settles, and some people don’t even get that,” she said.
“For most people it will settle but if you’ve got hormones that really do shift back and forth on top of … if you’ve got a pre-existing condition, it’s more likely to come out,” she said.
“With postnatal depression, you then actually have a real life human in front of you demanding all of your time and attention 24 hours a day, seven days a week.
“You actually cannot rest … the mental load is quite unbelievable.”
A new purpose
Elnaz’s son Kian has just turned one.
A year postpartum, she is still taking the medication she was given during her pregnancy.
Some days are tough, but Elnaz said her son has given her a new purpose in life.
“It’s really quite incredible how I just wanted to die every day that I was going through it, but now I’ve never wanted to be more alive because of my son,” she said.
Elnaz is also now dedicated to telling her story to ensure all women know they’re not alone and they can get through whatever they are going through, no matter how hard it seems.
“If you’ve gone through any type of trauma, and you’re healed from it, it is our duty as human beings to help the next person,” she said.
“However that looks, who that reaches, whoever hears the message, I’m going to do that until the day that I feel like I don’t need to do it anymore, which is probably the day I die.”
Throughout September, The Liptember Foundation’s annual campaign encourages women across Australia are encouraged to wear bright-coloured lipstick to help start conversations and raise awareness about women’s mental health.
Women can sign up as a fundraiser through Liptember’s website, and Liptember lipstick can be purchased from Chemist Warehouse, with the proceeds going to the foundation.
Liptember’s flagship fundraising campaign has raised more than $14 million since its inception in 2010.