If you have had in the past, or now have, severe mental health problems, you’re more likely to become ill during pregnancy or in the first year after giving birth than at other times in your life.
Severe mental health problems include bipolar affective disorder, severe depression and psychosis. After giving birth, severe mental illness may progress more quickly and be more serious than at other times.
Other less severe mental health problems may also become more problematic during these times, though this might not necessarily happen to you.
Sometimes – not always – a mental health problem can cause you to miss appointments. If this happens while you are pregnant, it may mean you miss important health checks.
This could increase your risk of pregnancy-related complications that would otherwise have been picked up.
Treatment for mental health problems in pregnancy and after giving birth can include psychological treatments and medication.
You and your doctor should discuss the risk of treating or not treating your illness, as well as the risks to the developing baby of taking medication.
Your discussion should include:
how severe any previous mental health problem was
the risk of you becoming unwell
whether you can cope without treatment
which treatments have helped you in the past, and
the risk to the unborn baby of some of the drugs used in treating mental health conditions
Feeling down or anxious
If feeling down is affecting your everyday life but you don’t have a specific mental illness, you should be offered support to help you manage your feelings.
This support could be from health professionals, voluntary organisations or other services. You may be offered psychological treatment (usually cognitive behavioural therapy or psychotherapy) if you have anxiety or depression.
The ‘baby blues’
The “baby blues” is a time when you may feel low and tearful, and it usually occurs in the first week after the birth.
It’s a result of the normal hormonal changes taking place in your body and affects many new mothers.
But pregnancy and birth can trigger more serious depression in some women.
Symptoms that may indicate you are depressed include:
feeling very sad and hopeless
negative thoughts about yourself
not sleeping well
a lack of interest or pleasure in doing things
loss of appetite
Who’s at risk?
Depressive illness occurs in around 1 in 10 new mothers in the year following the birth of their baby.
Most will only have mild depression, but some develop a severe depressive illness. Other mothers develop severe mental health problems such as postpartum psychosis (a rare psychiatric illness affecting 1 in 1,000 women who have a baby) and require specialist help.
Your health visitor should discuss how you’re feeling after the birth, but warning signs to watch out for include:
feeling irritable and angry
crying or often being on the verge of crying
feeling unable to cope
having negative thoughts about yourself, such as “I am a bad mother”
worrying unnecessarily about things that wouldn’t normally bother you
excessive worry about your baby’s health
being afraid of being left alone with your baby
uncontrollable feelings of panic
overwhelming fears, for example fear of dying
dreams about harming your baby
feeling exhausted and lethargic
lack of interest in your surroundings and appearance, or becoming obsessively tidy
trouble concentrating and feeling distracted
gaining or losing large amounts of weight
loss of pleasure in activities you usually enjoy, including loss of libido (sex drive)
feelings of guilt that you’re a bad mother
If you think you may be depressed, talk to your doctor, midwife or health visitor as soon as possible, as they can arrange suitable care for you.
What you can do
Although the best way to treat depression is to seek help from a healthcare professional, there are steps you can take yourself to reduce your chances of developing depression and help you recover once you’ve been diagnosed.
look for the positive things in your life, however hard that may seem
involve your partner or someone you’re close to in your pregnancy and baby
make time to relax
be open about your feelings
ask for help with practical tasks like grocery shopping and household chores
find out about local support groups (find mental health services near you)
make time to rest
eat well (find out more about healthy diet in pregnancy)
find time to have fun
organise small treats every day, such as a workout or a coffee with friends (find out about exercise in pregnancy and keeping fit and healthy after the birth)
Try to avoid:
doing too much – cut down on other commitments when you’re pregnant or caring for a new baby
getting involved in stressful situations
drinking too much tea, coffee, alcohol or cola, which can stop you sleeping well (find out more about alcohol, medicines and drugs)
being too hard on yourself or your partner
The website of the Royal College of Psychiatrists has more information about postnatal mental health, including puerperal psychosis.