ABOUT PERINATAL ILLNESS
Mental health problems can affect anyone. You can talk to us without feeling embarrassedperinatal mental health support
THE BLUES AND THE PINKS
Third or fourth day blues effect most women after child birth. The Blues are characterised by weepiness, irritability and mild depression, some mothers feel very sad, anxious and tense. Alternatively, some women may feel unusually cheerful, talkative, too excited to sleep, have racing thoughts and find it difficult to concentrate, and feel especially, important or able. It has been suggested that this form of Postnatal illness is associated with rapid but normal hormonal changes in the body in the first few days after delivery. Though disturbing to a new mother, they are not serious and usually resolves after a few days. Women should be allowed to cry and talk about their worries. A mother should not be told to “pull herself together, she needs rest and reassurance.”
Depression and Anxiety
Women may experience anxiety or depression during pregnancy and / or after they have given birth to their baby. Some may experience depression and anxiety together and for some symptoms may not develop until later during their babies first year. Symptoms may include despondency, sleeping and eating difficulties, feelings of guilt and inadequacy particularly, in relation to the new baby. Most depressed mothers will feel tired and lack energy. Often, they feel unable to concentrate and find even simple tasks difficult and confusing. Sometimes a mother will experience anxiety, panic attacks or loss of enjoyment in life, she needs to be encouraged to believe she will get better with time and reassured that the illness is not her fault.
A woman may be prescribed anti-depressants by her GP. Anti-depressants are not addictive, but taken properly for a period of months, help to lift a mother’s mood and set her on the road to recovery. She should be encouraged to look after herself by eating properly and having rest. She may find it helpful to talk to other women who have suffered in a similar way and recovered.
MATERNAL OBSESSIVE COMPLUSIVE DISORDER
Maternal OCD can start during pregnancy. The woman can feel compelled to carry out her ‘ritual’, if not she may believe something really awful will happen. Symptoms can vary widely but can include severe anxiety, obsessions and compulsive behaviours. These can focus around the baby and impact the mother’s ability to enjoy time with her child. Cognitive behavioural therapy (CBT) can be an effective treatment.
PERINATAL ADJUSTMENT DISORDER
This is often mild and does not last as long but can be extremely distressing. It occurs as the mother adjusts to becoming a new parent.
POST NATAL POST TRAUMATIC STRESS DISORDER
Post Natal PTSD can occur after birth or a traumatic event of actual or threatened death. Triggers can be Birth trauma, Emergency Caesarean Section, admittance to high dependency unit, baby admitted to NICU (special care), pre-term birth, severe illness of baby or mother or death of the baby. Symptoms can include intrusive memories, flashbacks, nightmares, anger, self-blame, low mood, suicidal thoughts and isolation. The mother can also re-live the experience including physical symptoms of pain, nausea and sweating. She may wish to avoid people, places and reminders of the trauma and may wish to avoid talking about it. Depression is usually secondary and can include feeling tense, irritable, easily startled and finding it difficult to sleep. The treatment for Post Natal PTSD is usually Cognitive Behavioural Therapy (CBT) or Eye Movement Desensitisation and Reprocessing (EMDR).
BIRTH TRAUMA/ PERCEIVED BRITH TRAUMA
The effects of birth trauma are real, and the symptoms can last for years. It can lead to any of the symptoms of PNI including panic attacks.
During labour some women report than they think either them or their baby will die or be severely injured. This can lead to feelings of helplessness and horror, extreme fear, feeling invisible, out of control, trapped and on occasions feeling that they are being treated inhumanely. Following the birth women can re-experience these feelings in the form of intrusive thoughts, nightmares and flashbacks.
Women can become hypervigilant and they can experience avoidance – so attempting to avoid everything to do with the birth and the place of birth – this can also mean they want to avoid the baby.
Birth Trauma can impact on the relationship between the Mother and baby and the family’s future choices. If a woman decides to have more children, she is placing herself back into the trauma and may likely be highly anxious during the pregnancy and birth. Most women who experience a birth trauma need help to perceive it as something they went through and survived. A debrief at their maternity unit can help.
Primary Tokophobia is the extreme fear of child birth or pregnancy. Secondary tokophobia is the extreme fear of child birth or pregnancy after a previous traumatic birth or post-traumatic stress disorder.
It can be helpful to have the opportunity to talk about these fears with your health care professionals, your partner, family and friends or with us. Using an APP such as Baby Buddy www.bestbeginnings.org.uk/baby-buddy Regular information about how your baby is growing and developing can help you bond with your baby.
POST PARTUM PSYCHOSIS
Postpartum Psychosis (PP) is a severe, but treatable, form of mental illness that occurs after having a baby. It can happen ‘out of the blue’ to women without previous experience of mental illness. There are some groups of women, women with a history of bipolar disorder for example, who are at much higher risk. PP normally begins in the first few days to weeks after childbirth. It can get worse very quickly and should always be treated as a medical emergency. Most women need to be treated with medication and admitted to hospital.
With the right treatment, women with PP do make a full recovery. Recovery takes time and the journey may be tough. The illness can be frightening and shocking for both the woman experiencing it and her family. Women do return to their normal selves and are able to regain the mothering role they expected. There is no evidence that the baby’s long-term development is affected by Postpartum Psychosis.