Being pregnant and having a baby should be a time for celebration, but what if it isn’t?
During pregnancy and in the year after birth women can be affected by a range of mental health problems, including anxiety, depression, obsessive compulsive disorder, post- traumatic stress disorder and postpartum psychosis. These are known as perinatal mental health problems.
Around one in five women will experience a mental health problem during pregnancy or in the year after giving birth. This might be a new mental health problem or another episode of a mental health problem you’ve experienced before.
Anyone who has had a baby will know that how hard it is to adjust to becoming a parent. Having a baby is a major life event, and it’s natural to experience a range of emotions and reactions during and after your pregnancy. But if they start to have a big impact on how you live your life, you might be experiencing a mental health problem.
It can be particularly hard to talk about how you are feeling – especially at a time when everyone else expects you to be happy. Feeling ill at this stage of your life can seem very isolating and women who experience it often feel unable to make sense of their feelings or seek help. Feeling down and admitting that you might need help does not mean you’re a failure or a bad parent. Depression and anxiety during pregnancy is even less talked about but in the same way that mums suffer from swollen ankles or high blood pressure during pregnancy, others can suffer from depression and anxiety. If you have had feelings of low mood or anxiety before or during pregnancy you are more likely to experience depression after birth.
Many new mums can experience a short period of feeling emotional and tearful, which has become known as the “baby blues”. The ‘baby blues’ can start a couple of days after birth and last a few hours or days with weepiness and sad feelings being the most common symptoms. The baby blues, unlike postnatal depression, does not normally require special treatment. Understanding and emotional support will help.
Feeling depressed or anxious can happen gradually or all of a sudden, and can range from being relatively mild to very hard-hitting. It can start within one or two months of giving birth, although it can also be several months after having a baby before symptoms start to appear.
It can affect a new mum regardless of age, religion, ethnic group, her family or personal circumstances. You may have managed happily with your first baby and yet become depressed after your second, or the other way around. There is no single answer as to why some new mums are affected by perinatal mental health problems and not others but there are a number of different possibilities.
The earlier it is spotted and treated the quicker the recovery. For some new mothers just admitting how they feel and talking is enough to help, for others anti-depressants are more effective. Counselling and psychotherapy are another option and offer you the opportunity to talk about how you feel, look at the underlying factors that have contributed to how you are feeling, as well as helping you to change the way you feel and start to enjoy motherhood.
Possible Causes of developing a Perinatal Mental Health Problem
There are different theories about why you might develop a mental health problem in the perinatal period but no-one knows for sure.
Strain of becoming a parent
Becoming a parent can be both rewarding and fulfilling. However, the stress and daily pressures of being a new parent and suddenly being responsible, 24-hours a day, for another human being can be daunting. Feeling totally exhausted at the same time as getting to grips with a new baby can be a shock to the system.
Being under additional strain for any reason, can also increase the likelihood of becoming depressed. The cause could be an illness or death in the family, or moving house or changing job. It could also be the result of longer-term difficulties, such as being unemployed, financial worries, general lack of support or relationship difficulties
Lack of support
Lack of support from a partner or other family members can put you at risk of developing a mental health problem in the perinatal period. New mums can find themselves alone at home, with no adults to talk to. Lacking a support network can increase your risk of developing a mental health problem.
Previous experience of mental health problems
If you have experienced a mental health problem in the past, being pregnant or having a baby can put you at risk of experiencing another episode. If you have a diagnosis, or know you struggle with your mental wellbeing, it’s important to understand what might trigger an episode and what can help you look after yourself.
If you experienced a perinatal mental health problem around the birth of one child, you are at increased risk of developing one around the birth of your next child. However, you may have coped well with your first child but struggled with your mental health after your second, or the other way around. Your experience of your mental health, and of becoming a parent, will be personal to you.
Difficult childhood experiences
There is good evidence to show that going through difficult experiences in your childhood can make you vulnerable to mental health problems later in life. This could be:
- physical, sexual or emotional abuse
- loss of someone close to you
- traumatic events
- unstable family situation
These experiences can have a big impact on how you feel about becoming a parent. If you experienced abuse while growing up, for example, you may now find it hard to relate to others, including your baby.
If your own parents did not have good parenting skills, you may find it hard to adapt to your new role as a parent. For example, you may feel unsure how to interpret your baby’s needs. You may even fear that you are going to harm your baby somehow, because you are unsure how to take care of them.
Signs and Symptoms of Perinatal Mental Health Problems
Every mum experiences their problems differently but symptoms may include:
- Feeling very low, or despondent, that there is no light at the end of the tunnel, and that there is no hope. Feeling tired and very lethargic, or even quite numb. Not wanting to do anything or take an interest in the outside world.
- Feeling a sense of inadequacy or unable to cope.
- Feeling guilty about not coping, or about not loving their baby enough.
- Being unusually irritable, which makes the guilt worse.
- Wanting to cry/cry a lot or even constantly.
- Having obsessive and irrational thoughts which can be very scary.
- Loss of appetite, which may go with feeling hungry all the time but being unable to eat.
- Comfort eating.
- Having difficulty sleeping: either not getting to sleep, waking early, or having vivid nightmares.
- Being hostile or indifferent to their partner and/or baby.
- Having panic attacks, which strike at any time, causing rapid heartbeat, sweaty palms and feelings of sickness or faintness.
- Having an overpowering anxiety, often about things that wouldn’t normally bother them, such as being alone in the house.
- Having difficulty in concentrating or making decisions.
- Experiencing physical symptoms, such as headaches.
- Having obsessive fears about baby’s health or wellbeing, or about themselves and other members of the family.
- Having disturbing thoughts about harming themselves or their baby.
- Having thoughts about death and/or suicide.
Sadly, some mums suffer from postpartum psychosis, which is a more serious (and very different) illness that affects around one in every 1,000 women. The symptoms include hallucinations, delusional thinking and disruption of perception, emotions and behavior. Medical help should be sought as a matter of urgency if this is suspected.
Post-Traumatic Stress Disorder
Some women, unfortunately, can have a difficult labour with a long and painful delivery, an unplanned caesarean section or emergency treatment. As a result, they may suffer from a form of post-traumatic stress disorder (PTSD). If you or your partner are suffering from trauma following childbirth (symptoms include flashbacks, nightmares, anxiety and avoiding things which remind you of what happened), it’s important to seek help. If the symptoms persist for more than four weeks, you may have developed PTSD. This can be treated with various forms of talking therapy. If left untreated, it can have a negative impact on people’s lives and relationships for many years, so do seek help.