Expat’s postnatal mental health

As an international or expat living in Denmark having your first child or perhaps second or third child can be an interesting journey. However a topic you might not expect to have to address is the topic of mental illness – particularly post natal depression, anxiety or other postnatal mental illness.

Postnatal mental health should be a high priority in each and every family, but one that is sometimes overlooked when other challenges are present in everyone’s lives. This article provides an introduction to the topic of postnatal mental health, it’s prevalence in the international community and some information about the support available in the Danish and international community.

What is postnatal depression?

The experience of postnatal depression can vary from person to person. In general, though, you might notice changes in your emotions and thinking, behaviour and social life, and general physical wellbeing.

Emotional and thinking changes
You might:

  • be in a low mood a lot of the time
  • feel teary or sad all the time
  • feel like a failure, or hopeless, guilty, worthless and ashamed
  • feel angry or cranky
  • have trouble thinking clearly, concentrating or remembering things
  • be thinking about suicide.

Behaviour and social changes
You might:

  • fear being alone or going out
  • fear being alone with your baby
  • lose interest in activities you normally enjoy
  • not look after yourself properly.

Physical signs
You might have:

  • sleep problems – for example, you can’t sleep or you’re sleeping a lot more than usual
  • changes in appetite – for example, you’re not eating or you’re overeating
  • low energy levels.

How common is it?

Postnatal mental health is not something no one should take for granted – in the general population at least 10-15% of women experience postnatal mental health problems and as many as 10% of men are also likely to develop symptoms of deteriorating mental health following the birth of a child.

These figures are likely an underestimation in the international community because research consistently shows that expats and internationals are at higher risk for developing mental health problems than the general population.  The most obvious explanation for this is social isolation and low social support. But the negative impact of language and cultural differences should also be considered.

Asking for help

Sometimes women don’t know how to describe what they are feeling and need health professionals to ask the right questions.  Language and cultural misunderstandings can make it harder to identify parents who are struggling and make it harder for parents to express your concerns. Often most of the focus is on caring for mothers and the mental health of the father can be overlooked.  It is important for men to receive the same assessment and treatment offered to women.

In Denmark there is a reasonably high level of understanding and education regarding postnatal mental illness and most health professionals involved in postnatal care will be on the lookout for symptoms both during the pregnancy and following the birth. However you should always mention anything you are concerned about.  Don’t wait to be asked.

Your home nurse, called ‘sundhedsplejerske‘, or your General Practitioner are the best ones to tell if you are concerned about your emotional or mental health or adjustment to becoming a parent. Many new parents feel ashamed or embarrassed to tell anyone that they are not coping well. There is still significant stigma attached to mental health problems leading many families to struggle on without the support and help they need.

What support is available in Denmark?

In Denmark you are able to access a number of different supports depending on the seriousness of your difficulties. Initially you may be offered additional visits from your health nurse and you should also talk to your GP about what is happening for you. Your GP may suggest you talk to a mental health specialist such as a psychologist or social worker. Treatment will usually involve counselling or psychotherapy and sometimes medication may be discussed with you. In some cases you may need to see a psychiatrist particularly if medication is required.

The options available to you will vary depending on which municipality you live in. For example some municipalities offer group programs for mother’s struggling with postnatal mental health.

Alternative supports

You can access support yourself through the private sector. You should look for a therapist who has specialist knowledge of postnatal mental health problems and who is able to work with you in the language you are most comfortable speaking. You should talk to your GP before commencing therapy as you may be entitled to some financial subsidy to reduce the cost of the sessions.

Another option to consider are the mother’s groups – offered by the municipality and organized by the home nurse.  These groups might help you feel less isolated and help you establish a wider support network. Unfortunately these groups are usually for Danish mothers.  Sometimes there are opportunities to join a group of international mothers – so be sure to ask your health nurse about this.

Networking and expanding your social circles can also be helpful when looking out for support. In many of the larger cities in Denmark the international community is very well organized and there are several groups within it that are very welcoming and open to anyone looking for support. Keep an eye out for these groups on social media such as Facebook or with local organizations.  You should also look out for other online supports – different Facebook groups for international parents, online forums based in your home country can also be useful particularly if you want to communicate in your own language.

Things to remember

  • Ask for help as early as possible.
  • Don’t ignore your symptoms.
  • If you don’t think your concerns are being taken seriously ask someone else.
  • Don’t stop asking for help until you get the professional support you need.
  • Identify and access your support network as much as you need to.
  • Spend time with friends and family regularly.
  • Stay connected with old friends and make new ones who are going through similar situations as you are.

In case you need further information related to this topic in Denmark please read the different resources as Sundhed.dk

About the author:
Kelly Pacheco
Specialist mental health social worker and systemic family therapist
Experience in the field in Australia, Fiji and Denmark
Founder of Talking Works (Aarhus, Denmark)

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