Mental Health

Your Mental Health is Part of Your Overall Health

Hormones, life stages, and mental wellbeing are deeply connected—you shouldn't have to navigate this alone.

At Ovara Women's Health, we understand that women's mental health is inseparable from hormonal health. Depression during perimenopause isn't weakness. Anxiety after childbirth isn't failure. PMDD isn't "just bad PMS." These are medical conditions that deserve proper assessment, treatment, and support.

We provide comprehensive mental health care that considers the whole picture—your hormones, your life stage, your circumstances, and your individual needs.

Why Women's Mental Health is Different

Women experience mental health conditions at different rates and for different reasons than men.

The Hormone-Mental Health Connection

Hormones profoundly affect brain chemistry and mental wellbeing.

Oestrogen influences:

• Serotonin production and function (the "feel-good" neurotransmitter)
• Dopamine pathways (motivation, pleasure, reward)
• GABA function (calming neurotransmitter)
• Stress hormone regulation
• Brain structure and connectivity

Progesterone influences:

• GABA function (calming, anxiety-reducing effects)
• Sleep regulation
• Mood stability

When hormones fluctuate or decline:

• Brain chemistry changes
• Mood regulation becomes more difficult
• Anxiety can increase
• Sleep disrupts
• Cognitive function affected

Times of Hormonal Change = Times of Mental Health Risk

Women are at higher risk of mental health problems during:

• Premenstrual phase (PMDD affects 3-8% of women)
• Pregnancy and postpartum period (1 in 7 mothers experience perinatal mental health problems)
• Perimenopause and menopause (risk of depression doubles)
• After starting or stopping hormonal contraception (in susceptible women)

This isn't coincidence. It's biology.

Premenstrual Dysphoric Disorder (PMDD)

PMDD is not "bad PMS"—it's a serious mood disorder triggered by hormonal changes.

What is PMDD?

A severe form of premenstrual syndrome affecting mood, behaviour, and physical wellbeing.

Affects: 3-8% of menstruating women Often misdiagnosed as: Bipolar disorder, borderline personality disorder, depression

Symptoms

Emotional and behavioural symptoms (at least 5 present, at least 1 from first four):

• Marked mood swings (suddenly sad, tearful, or sensitive to rejection)
• Marked irritability, anger, or increased interpersonal conflicts
• Markedly depressed mood, feelings of hopelessness
• Marked anxiety, tension, feeling on edge
• Decreased interest in usual activities
• Difficulty concentrating
• Fatigue, lack of energy
• Changes in appetite (cravings or overeating)
• Sleep changes (insomnia or sleeping too much)
• Feeling overwhelmed or out of control

Physical symptoms:

• Breast tenderness or swelling
• Joint or muscle pain
• Bloating
• Weight gain
• Headaches

What Makes it PMDD Not PMS

Timing is key:

• Symptoms occur in the week before period (luteal phase)
• Symptoms resolve within days of period starting
• Pattern repeats every cycle
• Symptom-free or minimal symptoms for at least 1 week after period (follicular phase)

Severity is key:

• Symptoms significantly interfere with work, relationships, or daily activities
• Not just uncomfortable—truly disabling
• May include suicidal thoughts (risk increases in premenstrual week)

It's not "all in your head":

• Brain's response to normal hormonal fluctuations is abnormal
• Progesterone metabolites affect GABA receptors differently in PMDD
• Serotonin system dysfunction
• Genetic component (often runs in families)

Diagnosis

Requires symptom tracking for at least 2 consecutive cycles:

• Daily symptom diary or validated questionnaires
• Documents timing relative to menstrual cycle
• Confirms symptoms resolve after period

Must rule out:

• Other mood disorders that worsen premenstrually (but don't resolve)
• Thyroid problems
• Perimenopause (can coexist with PMDD)

Treatment Options

Lifestyle modifications (help some women, not sufficient for most):

• Regular exercise (especially aerobic)
• Stress reduction techniques
• Regular sleep schedule
• Limiting caffeine and alcohol
• Complex carbohydrates in luteal phase
• Calcium and vitamin D supplementation

First-line medical treatments:

SSRIs (antidepressants):

• Most effective treatment for PMDD
• Can be taken daily or just in luteal phase (both effective)
• Work faster for PMDD than for depression (often within days)
• Significantly reduce emotional and physical symptoms
• 60-90% of women respond

Hormonal treatments:

• Combined oral contraceptive pill (continuous dosing, no hormone-free week)
• Certain formulations work better than others
• Suppresses ovulation and hormonal fluctuation
• Effective for many women
• Not as effective as SSRIs on average but good option

GnRH agonists (severe cases):

• Temporarily stop ovarian function (medical menopause)
• Very effective but significant side effects
• Usually reserved for severe cases unresponsive to other treatments
• Requires add-back hormone therapy

Complementary approaches with some evidence:

• Cognitive behavioural therapy (CBT)
• Calcium supplementation
• Vitamin B6 (though evidence mixed)

Living with PMDD

Self-management strategies:

• Track symptoms (helps predict difficult times)
• Plan around luteal phase when possible (avoid major decisions, stressful events)
• Communicate with partner/family about pattern
• Self-compassion during difficult weeks
• Support groups (online and in-person)

When to seek urgent help:

• Suicidal thoughts or self-harm urges
• Inability to function during luteal phase
• Relationship or work significantly impacted
• Previous treatments haven't helped

Perinatal Mental Health

Mental health during pregnancy and the first year after birth.

Pregnancy Mental Health

Pregnancy isn't always joyful—and that's okay.

Mental health challenges during pregnancy:

• Anxiety (often more common than depression in pregnancy)
• Depression
• Obsessive-compulsive symptoms (new or worsening)
• Past trauma resurfacing
• Medication concerns if pre-existing mental health condition

Risk factors for perinatal mental health problems:

• Previous mental health problems (especially depression or anxiety)
• Previous perinatal mental health problems
• Lack of social support
• Relationship difficulties
• Stressful life circumstances
• Unplanned or unwanted pregnancy
• Previous pregnancy loss or trauma
• Domestic violence
• Substance use issues

Why pregnancy mental health matters:

• Affects your wellbeing and quality of life
• Can affect pregnancy outcomes
• Untreated mental health problems don't improve after birth—often worsen
• Early treatment better than waiting

Treatment during pregnancy:

• Some medications safe during pregnancy
• Psychological therapy (CBT, interpersonal therapy)
• Severe untreated mental illness is riskier than medication for most conditions
• Individual risk-benefit assessment essential

Postnatal Mental Health

The reality: the first year after birth is hard, and mental health problems are common.

Baby Blues

Affects up to 80% of new mothers.

Symptoms:

• Tearfulness
• Mood swings
• Anxiety
• Irritability
• Difficulty sleeping (even when baby sleeps)
• Feeling overwhelmed

Timing:

• Starts 2-3 days after birth
• Peaks around day 5
• Resolves within 2 weeks

What helps:

• Rest when possible
• Support from partner, family, friends
• Reassurance that it's temporary
• No treatment needed

Important: If symptoms don't improve after 2 weeks or worsen, may be postnatal depression.

Postnatal Depression

Affects 1 in 7 Australian mothers (and 1 in 10 fathers).

Symptoms:

• Persistent low mood or sadness
• Loss of interest or pleasure in activities
• Difficulty bonding with baby (but not always)
• Excessive worry about baby or lack of interest in baby
• Feeling inadequate as a mother
• Guilt and self-blame
• Anxiety and panic
• Difficulty sleeping (even when baby sleeps) or sleeping too much
• Appetite changes
• Fatigue beyond normal new-parent tiredness
• Difficulty concentrating or making decisions
• Thoughts of harming self or baby (rare but serious)

Timing:

• Can develop anytime in first year (not just immediately after birth)
• Often gradual onset
• Sometimes not recognised until months postpartum

Important distinctions:

• Not the same as baby blues (lasts longer, more severe, interferes with functioning)
• Not failure or weakness
• Very treatable
• Doesn't mean you don't love your baby

Risk factors:

• Previous depression (especially previous postnatal depression)
• Depression or anxiety during pregnancy
• Stressful life events
• Difficult pregnancy or birth
• Premature or unwell baby
• Breastfeeding difficulties
• Sleep deprivation
• Lack of practical and emotional support
• Relationship difficulties
• Financial stress

Treatment:

• Psychological therapy (CBT, interpersonal therapy—very effective)
• Antidepressant medication (many compatible with breastfeeding)
• Support groups (peer support valuable)
• Practical support (help with baby care, household)
• Mother-baby units for severe cases
• Treatment is effective—most women recover fully

Postnatal Anxiety

Often accompanies postnatal depression but can occur alone.

Symptoms:

• Constant worry about baby (health, breathing, feeding, development)
• Intrusive thoughts about harm coming to baby
• Checking behaviours (repeatedly checking baby is breathing)
• Panic attacks
• Physical symptoms (racing heart, shortness of breath, dizziness)
• Difficulty relaxing or sleeping
• Hypervigilance
• Avoiding situations due to anxiety

Intrusive thoughts:

• Distressing thoughts of harm coming to baby (accidentally or intentionally)
• Very common in postnatal period
• Don't mean you'll act on them
• Difference between intrusive thoughts (distressing, unwanted) and psychosis (believing thoughts are real)

Treatment:

• Cognitive behavioural therapy (particularly effective)
• Medication if severe
• Reassurance about intrusive thoughts
• Anxiety management techniques

Postnatal Psychosis

Rare but serious emergency requiring immediate treatment.

Affects: 1-2 in 1000 women Timing: Usually within first 2 weeks after birth (often first 48 hours)

Symptoms:

• Confusion and disorientation
• Hallucinations (seeing or hearing things not there)
• Delusions (false beliefs)
• Paranoia
• Severe mood changes (elation or depression)
• Agitation or unusual behaviour
• Thoughts of harming self or baby

This is a medical emergency:

• Requires immediate psychiatric assessment
• Usually requires hospital admission (mother-baby unit if available)
• Highly treatable with medication
• Full recovery expected with proper treatment

Risk factors:

• Bipolar disorder (highest risk)
• Previous postnatal psychosis (50% recurrence risk)
• Schizophrenia
• First-time mothers at higher risk than subsequent pregnancies

Birth Trauma and PTSD

Difficult or traumatic birth can cause psychological trauma.

What constitutes traumatic birth:

• Perception of trauma is individual (what's traumatic for one woman may not be for another)
• Emergency procedures (emergency caesarean, instrumental delivery)
• Feeling out of control or not listened to
• Fear for own or baby's life
• Inadequate pain relief
• Complications
• Poor communication from healthcare providers
• Previous trauma triggered by birth

Symptoms of birth trauma/PTSD:

• Intrusive memories or flashbacks of birth
• Nightmares
• Avoiding thinking or talking about birth
• Hypervigilance and jumpiness
• Emotional numbness
• Difficulty bonding with baby (baby is reminder of trauma)
• Anxiety about future pregnancies

Treatment:

• Trauma-focused psychological therapy
• Birth debrief (discussing what happened with healthcare provider)
• Support groups
• Addressing fear before subsequent pregnancies

Getting Help for Perinatal Mental Health

Screening:

• Routine screening during pregnancy and postpartum
• Edinburgh Postnatal Depression Scale (EPDS) commonly used
• We ask because perinatal mental health problems are common and treatable

Don't wait:

• Early treatment is more effective
• Suffering doesn't help you or your baby
• Treatment is compatible with pregnancy and breastfeeding in most cases

Support services:

• PANDA (Perinatal Anxiety & Depression Australia): 1300 726 306
• Beyond Blue: 1300 22 4636
• Lifeline: 13 11 14
• Emergency: 000 (if immediate risk to self or baby)

Perimenopause and Menopause Mental Health

The hormonal changes of perimenopause significantly affect mental health.

Why Perimenopause Affects Mental Health

Oestrogen fluctuations affect brain chemistry:

• Serotonin system (mood regulation)
• Dopamine system (motivation, pleasure)
• Norepinephrine system (stress response)
• GABA system (anxiety regulation)

Risk of depression doubles during perimenopause.

Symptoms

Mood changes:

• Low mood or depression
• Irritability and anger (out of proportion to triggers)
• Mood swings (rapid changes)
• Feeling overwhelmed
• Loss of enjoyment
• Crying easily

Anxiety:

• New or worsening anxiety
• Panic attacks
• Constant worry
• Physical anxiety symptoms (racing heart, breathlessness)
• Health anxiety

Cognitive:

• Brain fog and difficulty concentrating
• Memory problems
• Mental fatigue
• Feeling "not yourself"

Distinguishing Perimenopause from Primary Mental Health Problem

Clues it's perimenopause-related:

• Started in your 40s
• Timing corresponds with menstrual changes
• No previous history of depression/anxiety (or long period of wellness)
• Accompanied by other perimenopause symptoms (hot flushes, night sweats, sleep disruption)

May be both:

• Perimenopause can trigger episode in women with history of mental health problems
• Previous depression or anxiety increases risk
• Treatment may need to address both hormones and mental health

Treatment

Hormone therapy (MHT):

• Very effective for perimenopause-related mood symptoms
• Often works when antidepressants haven't
• Stabilises hormonal fluctuations affecting mood
• May be sufficient on its own or combined with other treatments

Antidepressants:

• Effective for depression and anxiety regardless of cause
• May be needed if MHT alone insufficient
• Can be used together with MHT
• Particularly important if severe depression or history of mental health problems

Psychological therapy:

• CBT helpful for anxiety and depression
• Stress management
• Addressing life stage challenges (empty nest, ageing parents, career, relationship changes)

Lifestyle:

• Regular exercise (evidence-based for mood and anxiety)
• Sleep improvement (crucial—sleep deprivation worsens everything)
• Social connection
• Stress reduction where possible

Anxiety Disorders in Women

Women are twice as likely as men to experience anxiety disorders.

Types of Anxiety Disorders

Generalised Anxiety Disorder (GAD):

• Excessive worry about multiple areas of life
• Difficulty controlling worry
• Present more days than not for at least 6 months
• Physical symptoms (muscle tension, fatigue, sleep problems, restlessness)
• Interferes with daily functioning

Panic Disorder:

• Recurrent unexpected panic attacks
• Worry about having more panic attacks
• Avoidance of situations due to fear of panic
• Panic attacks: sudden intense fear with physical symptoms (racing heart, shortness of breath, dizziness, feeling of losing control or dying)

Social Anxiety Disorder:

• Intense fear of social situations
• Fear of judgement or embarrassment
• Avoidance of social situations
• Physical symptoms in social situations (blushing, sweating, trembling)

Specific Phobias:

• Intense fear of specific object or situation
• Avoidance behaviour
• Fear out of proportion to actual danger

Health Anxiety:

• Excessive worry about having serious illness
• Preoccupation with bodily sensations
• Frequent checking or seeking reassurance
• Not reassured by negative medical tests

When Anxiety Needs Treatment

Normal anxiety vs. anxiety disorder:

• Normal anxiety: Proportionate to situation, temporary, doesn't significantly interfere with life
• Anxiety disorder: Excessive, persistent, interferes with work/relationships/daily activities

Seek help if anxiety:

• Is present most days
• Interferes with work, relationships, or activities
• Causes significant distress
• Involves avoidance that limits your life
• Is accompanied by depression
• Involves thoughts of self-harm

Treatment

Psychological therapy:

• Cognitive behavioural therapy (CBT)—gold standard for anxiety
• Exposure therapy (for phobias, panic disorder)
• Acceptance and commitment therapy (ACT)
• Mindfulness-based approaches

Medication:

• Antidepressants (SSRIs, SNRIs)—first-line for anxiety disorders
• Not just for depression—very effective for anxiety
• Take several weeks to work
• Usually continued for 6-12 months minimum

Short-term anxiety medications:

• Sometimes used briefly while waiting for antidepressants to work
• Not suitable for long-term use
• Risk of dependence

Lifestyle approaches:

• Regular exercise (reduces anxiety)
• Limiting caffeine and alcohol
• Sleep hygiene
• Stress management techniques
• Not avoiding feared situations (reinforces anxiety)

Depression in Women

Women experience depression at twice the rate of men.

Recognising Depression

Core symptoms (at least one present):

• Depressed mood most of the day, nearly every day
• Loss of interest or pleasure in activities

Additional symptoms:

• Significant weight or appetite changes
• Sleep problems (insomnia or sleeping too much)
• Psychomotor changes (agitation or slowing down)
• Fatigue or loss of energy
• Feelings of worthlessness or excessive guilt
• Difficulty concentrating or making decisions
• Recurrent thoughts of death or suicide

Depression diagnosed when:

• Symptoms present for at least 2 weeks
• Significant distress or impairment in functioning
• Not due to substance use or medical condition

Severity:

• Mild: Few symptoms beyond minimum, minor functional impairment
• Moderate: Several symptoms, moderate functional impairment
• Severe: Many symptoms, major functional impairment, may include psychotic features

When to Seek Help

See GP if:

• Low mood persists for more than 2 weeks
• Symptoms interfere with work, relationships, or daily activities
• Loss of interest in things you used to enjoy
• Difficulty coping with daily tasks
• Feeling hopeless about the future

Seek urgent help if:

• Thoughts of suicide or self-harm
• Plans to harm yourself
• Feeling unable to keep yourself safe

Crisis contacts:

• Lifeline: 13 11 14 (24/7 crisis support)
• Suicide Call Back Service: 1300 659 467
• Beyond Blue: 1300 22 4636
• Emergency: 000

Treatment

Mild depression:

• Psychological therapy often sufficient
• Lifestyle interventions (exercise, sleep, social connection)
• Watchful waiting may be appropriate if recent onset

Moderate to severe depression:

• Combination of psychological therapy and medication most effective
• Antidepressants (SSRIs, SNRIs most commonly used)
• CBT, interpersonal therapy, behavioural activation
• More intensive support if severe

What helps recovery:

• Treatment (therapy and/or medication)
• Regular routine and structure
• Physical activity (even when you don't feel like it)
• Social connection (even when you want to isolate)
• Sleep regularity
• Not making major life decisions while depressed
• Patience (recovery takes time)

Hormonal Contraception and Mental Health

Some women experience mood changes on hormonal contraception.

The Connection

How hormones may affect mood:

• Synthetic hormones in contraception affect brain chemistry differently than natural hormones
• Suppress natural hormone production and fluctuation
• Individual variation in response (what affects one woman may not affect another)

What research shows:

• Most women don't experience mood changes on hormonal contraception
• Small proportion do experience negative mood effects
• Adolescents may be more susceptible
• Women with history of depression may be at higher risk

Recognising Contraception-Related Mood Changes

May be contraception if:

• Mood changes started after starting contraception
• No mood problems before contraception
• Pattern linked to taking hormones (some women worse during active pills, some during hormone-free week)
• Improves when stopping contraception

May not be contraception if:

• Mood problems predated contraception
• Life stressors present
• Timing doesn't match contraception use

What to Do

If you suspect your contraception affects your mood:

• Discuss with your GP
• Don't just stop abruptly (especially if also using for contraception—unplanned pregnancy won't help mental health)
• Options: Try different formulation, different method, non-hormonal contraception
• May need mental health treatment regardless of contraception choice

Trauma and PTSD in Women

Women are more likely than men to experience PTSD after trauma.

Types of Trauma Affecting Women

• Sexual assault or abuse (childhood or adult)
• Domestic violence
• Birth trauma
• Pregnancy loss or stillbirth
• Medical trauma (procedures, diagnoses, treatments)
• Childhood trauma
• Other traumatic events (accidents, violence, disasters)

PTSD Symptoms

Re-experiencing:

• Intrusive memories
• Flashbacks (feeling like trauma is happening again)
• Nightmares
• Intense distress at reminders

Avoidance:

• Avoiding thoughts or feelings about trauma
• Avoiding people, places, or activities that remind you of trauma
• Inability to remember important aspects of trauma

Negative changes in thoughts and mood:

• Negative beliefs about self, others, or world
• Distorted blame of self or others
• Persistent negative emotions
• Loss of interest in activities
• Feeling detached from others
• Inability to experience positive emotions

Arousal and reactivity:

• Irritability or aggression
• Self-destructive behaviour
• Hypervigilance
• Exaggerated startle response
• Difficulty concentrating
• Sleep problems

Treatment

Trauma-focused psychological therapy:

• Trauma-focused CBT
• Eye Movement Desensitization and Reprocessing (EMDR)
• Prolonged exposure therapy
• Evidence-based approaches focus on processing trauma memories

Medication:

• Antidepressants can help PTSD symptoms
• Usually combined with therapy
• Not a substitute for trauma-focused therapy

What doesn't help:

• Avoiding trauma reminders long-term (maintains PTSD)
• Substance use to cope (worsens symptoms)
• Trying to forget or "just move on" without processing

Important:

• Trauma therapy should be with trained trauma therapist
• You don't have to "relive" trauma to heal (modern approaches are safe and effective)
• Recovery is possible

Body Image and Eating Concerns

Women face intense societal pressure around appearance and weight.

Body Image Concerns

Common struggles:

• Dissatisfaction with appearance
• Preoccupation with weight or shape
• Comparing self to others (especially social media)
• Feeling defined by appearance
• Impact on self-esteem and relationships

When it becomes problematic:

• Constant preoccupation with perceived flaws
• Avoiding social situations due to appearance concerns
• Extreme measures to change appearance
• Body dysmorphia (distorted perception of appearance)

Disordered Eating and Eating Disorders

Spectrum from disordered eating to clinical eating disorders.

Disordered eating:

• Restrictive dieting
• Binge eating
• Compensatory behaviours (excessive exercise, fasting)
• Chaotic eating patterns
• Food rules and rigidity
• Not meeting full criteria for eating disorder but causing distress

Eating disorders:

Anorexia nervosa:

• Restriction of food intake leading to significantly low body weight
• Intense fear of gaining weight
• Distorted body image
• Denial of seriousness of low weight
• Medical complications can be severe

Bulimia nervosa:

• Recurrent binge eating (eating large amounts with feeling of loss of control)
• Compensatory behaviours (vomiting, laxative use, excessive exercise)
• Self-evaluation overly influenced by weight and shape
• Medical and dental complications

Binge eating disorder:

• Recurrent binge eating without regular compensatory behaviours
• Eating more rapidly than normal
• Eating until uncomfortably full
• Eating large amounts when not hungry
• Eating alone due to embarrassment
• Feeling disgusted, depressed, or guilty after
• Marked distress about binge eating

Other specified feeding or eating disorder (OSFED):

• Significant eating disorder symptoms that don't meet full criteria for above
• Just as serious and deserving of treatment

Risk Factors

• Societal pressure and beauty standards
• Diet culture
• Weight-focused sports or activities
• Childhood trauma
• Perfectionism
• Anxiety and depression
• PCOS (disordered eating more common)
• History of dieting

Getting Help

Warning signs:

• Rapid weight loss or fluctuations
• Preoccupation with food, calories, weight
• Avoiding eating with others
• Excessive exercise
• Bathroom use immediately after meals
• Physical signs (hair loss, feeling cold, dizziness, menstrual changes)
• Mood changes and social withdrawal

Treatment:

• Multidisciplinary approach (GP, psychologist, dietitian)
• Psychological therapy (CBT, family-based therapy for adolescents)
• Nutritional rehabilitation
• Medical monitoring
• Treatment of co-occurring mental health problems
• Hospital admission if medically unstable

Recovery is possible:

• Earlier treatment = better outcomes
• Full recovery achievable for most people
• Doesn't require hitting "rock bottom" before seeking help

Getting Help for Mental Health

When to See Your GP

See your Ovara GP if:

• Mental health symptoms affecting daily life
• Mood or anxiety problems lasting more than 2 weeks
• Difficulty coping with stress or life circumstances
• Concerned about your mental health
• Need Mental Health Treatment Plan for subsidised psychology
• Medication review needed
• Screening for perinatal mental health
• Assessing if hormones contributing to mood symptoms

What we can do:

• Assessment and diagnosis
• Mental Health Treatment Plan (Medicare rebate for psychology)
• Prescribe medication if needed
• Coordinate care with psychologist, psychiatrist, other providers
• Assess hormonal contributions (PMDD, perimenopause, postpartum)
• Ongoing monitoring and support
• Referral to specialist services if needed

Psychological Therapy

Types of therapy with good evidence:

• Cognitive behavioural therapy (CBT): For depression, anxiety, eating disorders, PTSD, PMDD
• Interpersonal therapy: For depression, especially perinatal
• Dialectical behaviour therapy (DBT): For emotion regulation, borderline personality disorder
• Acceptance and commitment therapy (ACT): For anxiety, depression, chronic pain
• Trauma-focused therapy: For PTSD and trauma

Accessing psychology:

• Mental Health Treatment Plan from GP provides Medicare rebate for up to 10 psychology sessions per year
• Private psychology (without rebate)
• Community mental health services (free but often waiting lists)
• Employee assistance programs (through employer)
• Online therapy programs

Medication

Common misconceptions:

• "Medication means I've failed": No. Medication is legitimate medical treatment for medical conditions.
• "I'll be on it forever": Many people use medication temporarily. Some need longer-term treatment. Both are okay.
• "It will change my personality": Medication treats illness symptoms, doesn't change who you are.
• "It's a crutch": No more than insulin for diabetes is a crutch. It's treatment that allows you to function.

What to expect:

• Most antidepressants take 2-6 weeks to work fully
• Side effects often improve after first 1-2 weeks
• May need to try different medications to find what works
• Usually continue for at least 6-12 months after feeling better
• Stopping should be done gradually under GP supervision

Crisis Support

If you're in immediate danger or having thoughts of suicide:

• Call 000 (emergency services)
• Go to hospital emergency department
• Call Lifeline: 13 11 14 (24/7)
• Call Suicide Call Back Service: 1300 659 467
• Text Lifeline: 0477 13 11 14

Other support services:

• Beyond Blue: 1300 22 4636
• PANDA (perinatal): 1300 726 306
• QLife (LGBTQIA+): 1800 184 527
• Kids Helpline (up to age 25): 1800 55 1800
• Mensline: 1300 78 99 78
• 1800 RESPECT (domestic violence): 1800 737 732

Self-Care and Prevention

Supporting your mental health between and alongside professional treatment.

What Actually Helps

Physical activity:

• One of most effective non-medication treatments for depression and anxiety
• Doesn't have to be intense (walking counts)
• Regular movement more important than intensity
• Outdoors in nature provides additional benefit

Sleep:

• Critical for mental health
• Poor sleep worsens depression and anxiety
• Depression and anxiety disrupt sleep
• Prioritising sleep hygiene important

Social connection:

• Isolation worsens mental health
• Connection protective even when you don't feel like socialising
• Quality more important than quantity
• Online connection helpful but not substitute for in-person

Routine and structure:

• Particularly important for depression
• Regular sleep, meals, activities
• Getting dressed and out of house (even when you don't want to)
• Small accomplishments build momentum

Limiting alcohol:

• Alcohol is depressant
• Disrupts sleep
• Worsens anxiety (especially next day)
• Interferes with medication
• May provide temporary relief but worsens problems long-term

What doesn't help (despite being commonly suggested):

• "Just think positive": Depression and anxiety aren't choices
• "Others have it worse": Suffering isn't comparative
• "Just relax": Anxiety doesn't respond to being told to relax
• "Snap out of it": Mental health conditions are medical conditions
• Avoiding all stress: Building resilience and coping skills more helpful than avoidance

Mental Health Through Life Stages

Your mental health needs change across your lifespan.

Adolescence and Young Adulthood

• Higher risk for onset of mental health conditions
• Hormonal changes, brain development, identity formation
• Academic and social pressures
• Early intervention important

Reproductive Years

• PMDD, perinatal mental health, contraception effects
• Balancing multiple roles and responsibilities
• Fertility struggles and pregnancy loss
• Body image and societal pressures

Midlife

• Perimenopause mental health challenges
• Life transitions (children leaving, ageing parents, career changes)
• Relationship changes
• Health concerns emerging

Later Life

• Menopause transition completion
• Empty nest and retirement
• Grief and loss (friends, partners, parents)
• Chronic health conditions
• Changing roles and identity

Frequently Asked Questions

"How do I know if I need help or if I'm just having a hard time?"

If symptoms persist for more than 2 weeks, interfere with work/relationships/daily activities, or cause significant distress, seek help. You don't need to be at breaking point to deserve support.

"Will my mental health history affect my ability to get pregnant or be a good mother?"

Having mental health problems doesn't prevent you from having healthy pregnancies or being a good parent. Proper treatment and support are key. Many women with mental health conditions have successful pregnancies and are excellent mothers.

"Can hormones really cause mental health problems or am I just using that as an excuse?"

Hormones genuinely affect brain chemistry and mood. Hormonal contributions to mental health are real and deserve treatment. Not an excuse—a medical explanation.

"I'm already on antidepressants but perimenopause is making things worse. What can I do?"

HRT can often be added to antidepressants for perimenopause mood symptoms. Discuss with your GP—you may need both hormonal and mental health treatment.

"Will taking medication for mental health make it harder to get off it later?"

Most people can successfully stop antidepressants when ready (with gradual tapering). The goal is feeling well, whether that requires ongoing medication or not.

"I'm worried about taking antidepressants while breastfeeding."

Many antidepressants are compatible with breastfeeding. The risks of untreated maternal mental illness usually outweigh the small risks from medication. Individual assessment with your GP needed.

Book Your Mental Health Appointment

Your mental health deserves expert, compassionate care.

Our Ovara specialists provide comprehensive mental health care that considers your hormones, life stage, and individual circumstances. We're here to listen, assess, and create a treatment plan that works for you.

You don't have to struggle alone. Book your appointment today.

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