PERI/POSTNATAL MENTAL HEALTH
While many people are aware that you can become depressed after having a baby, it's less well known that many women experience anxiety during and after pregnancy. In fact, it's common to experience depression and anxiety together.
Depression and anxiety are the most common mental health challenges during pregnancy, with around 12% of women experiencing depression and 13% experiencing anxiety at some point; many women will experience both. Depression and anxiety also affect 15-20% of women in the first year after childbirth. During pregnancy and the postnatal period, anxiety disorders, including Panic Disorder, Generalised Anxiety Disorder (GAD), Obsessive-Compulsive Disorder (OCD), Post-Traumatic Stress Disorder (PTSD) and Tokophobia (an extreme fear of childbirth), can occur on their own or can coexist with depression.
Perinatal anxiety and depression are mental health challenges experienced during pregnancy or in the year after childbirth. You might hear it called:
- Perinatal or antenatal anxiety and/or depression if you experience anxiety during pregnancy.
- Postnatal anxiety and/or depression if you experience it after giving birth.
Perinatal mental health challenges are those which occur during pregnancy or in the first year following the birth of a child. Perinatal mental illness affects 12-20% of women, and covers a wide range of conditions. If left untreated, it can have significant and long lasting effects on the woman and her family. Perinatal mental health challenges can also have long-standing effects on children’s emotional, social and cognitive development.
There are different types of depression and anxiety that can happen during and post-pregnancy:
- Postpartum ‘blues’: (affecting 60-80% of all new mothers) is often expressed as frequent and prolonged crying, anxiety, irritability, poor sleep, quick mood changes and a sense of vulnerability. It usually occurs within the first three days following birth, continues for up to two weeks and is usually self-limiting.
- Postpartum depression & anxiety: (affecting 15-20% of all new mothers) is more debilitating and longer lasting than the ‘blues’ and is characterized by despondency, tearfulness and more intense feelings of inadequacy, guilt, anxiety and fatigue. There may also be physical symptoms such as headaches and rapid heart rate. A lack of feeling for the baby is of special concern. These feelings can appear any time during the first few months to one year after the birth. Unfortunately, women experiencing this form of depression rarely seek treatment although almost all respond well.
- Postpartum post-traumatic stress disorder (PTSD) following childbirth: is usually triggered by trauma during the time leading up to, during delivery or shortly afterwards. It can effect up to 6% of mothers. The trauma leads the women feeling that either her life or the life of her baby is at risk.
- Postpartum psychosis:(found in 0.1% of new mothers) is a serious, but relatively rare disorder, with reactions such as extreme confusion, refusal to eat, delusions, auditory hallucinations, hyperactivity and rapid or irrational speech. Most of these reactions occur within 3-14 days following the birth. Psychosis is serious and requires immediate medical attention and at times medication and hospitalization.
How do I know if I have perinatal or postnatal depression or anxiety?
A mother may:
- Feel constantly tired
- Cry often for no apparent reason
- Feel panicky
- Worry excessively about her own or the baby’s health
- Have a lack of feeling for the baby
- Have difficulty sleeping or eating
- Have problems concentrating
- Have frightening thoughts or fantasies
- Feel an overwhelming sense of loss
What are the treatments?
There are a range of treatment options for depression and anxiety, any of which you might find useful to treat perinatal and postnatal anxiety and/or depression.
- Talking treatments. You're likely to be offered cognitive behavioural therapy (CBT) or your local mental health services may run specific counselling or group programmes for anxiety. You can speak to your doctor, or contact your local services to find out what they offer.
- Self-help resources. Your doctor could give you access to online CBT programmes, or prescribe self-help books to help you learn to manage your anxiety.
- Medication. There are several different drugs that can be helpful in managing anxiety. If you have any concerns about taking medication during pregnancy or breastfeeding, you can always discuss this with your doctor.
You may be offered a combination of medication and a talking treatment. Many people find that taking medication helps them feel stable enough to get the most out of a talking treatment. However, other people find medication or talking treatments alone are more helpful.
If there are long waiting lists for talking treatments in your area, your doctor may recommend that you try an antidepressant to help you manage your mental health in the meantime.
What can I do to help myself?
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 (check out our Who Can Help page)
- make time to rest
- eat well
- find time to have fun
- organise small treats every day, such as a workout or a coffee with friends
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
- moving house
- being too hard on yourself or your partner
If you're looking for other women's pregnancy challenges, here's a link to a life story about a woman who suffered with post-natal anxiety.
Who can help?
- Anxiety UK - was established to promote the relief and rehabilitation of persons suffering from agoraphobia and associated anxiety disorders, phobias and conditions, in particular, but not exclusively, by raising awareness in such topics.
- No Panic - No Panic is a registered charity which helps people who suffer from Panic Attacks, Phobias, Obsessive Compulsive Disorders and other related anxiety disorders including those people who are trying to give up Tranquillizers.
- The NHS - has useful information and tips on how to cope with perinatal and postnatal depression and anxiety.
- Tommy's - are an organisation that provides accredited midwife-led pregnancy health information for parents-to-be, and funds research into the causes of pregnancy loss.
- PANDAS - Pre And Post Natal Depression Advice and Support (PANDAS) help support and advise any parent who is experiencing a perinatal mental illness. They also inform and guide family members, carers, friends and employers as to how they can support someone who is suffering.
- CPSL MIND - Mind have lots of helpful advice and information online about the different kinds of support you can get and they also run lots of workshops and courses. If you would like to self refer to Mind, We have added their Referral Form here and a link to their different services and referral forms!
- CPSL MIND have several services available, for example:
Connecting Mums, 6 week short intervention courses for mums who are socially isolated, this course also offers tips and tools on management and prevention for mental wellbeing. Mums can bring along their babies to the sessions and we have volunteers on hand to help look after the children while mum interacts in a group environment, babies are in the same room as mums. We deliver these from a number of different children’s centres in Peterborough.
Mums Matter, 8 week targeted intervention course, this course is for Mums who are that bit more poorly, we deliver the courses in children’s centres and pay for a crèche for the children, the crèche is always in the same building as the mums and we work with the mums in a separate room, this course is designed to help mums manage the everyday and dispel the myths. We use tools such as CBT, mindfulness, meditation and work on self-esteem.
We are launching a Mums Monthly Peers Support group that will be starting on the 2nd July 2018, this will be held at First Steps Children’s Centre, it will take place on the first Monday of each month from 1000 – 1200, this is a peer led support group and the volunteers that lead the group have accessed our services. Mums can bring children along to the group.
CPSL MIND can accept Mums who are pregnant and have a child who is up to 2 years old, Mums can self-refer by contacting them on 01733 362990 or they can accept professional or other organisations referrals.
Local Support - Cambridgeshire and Peterborough Local Authority Support:
Health Visiting service– The health visiting service is a universal-progressive, needs-led, evidence-based service for children to age 5 years and their families, delivered by specialist community public health nurses.
Family Nurse Partnership- The Family Nurse Partnership (FNP) is a structured home visiting parenting programme, delivered by specially trained family nurses, from early pregnancy until the child is two years old to vulnerable teenage mothers. The family nurse and the young parent(s) commit to an average of 64 planned home visits over two and a half years.
Peterborough Connecting Mums- Cambridgeshire, Peterborough & South Lincolnshire MIND (formerly Peterborough & Fenland MIND) deliver perinatal mental health programmes. Peterborough City Council have commissioned this organisation to deliver 5 perinatal mental health programmes per annum (Connecting Mums & Mums Matter), which have been specifically designed, piloted and evidenced by CPSL MIND.
Presently, the programmes only operate in Peterborough and have an annual reach target of 45 women, although some partners/family members are also supported in a 'supporter' session, which is part of the Mums Matter course. From a commissioning perspective, the local authority are continuing to invest in this for the 2018/19 financial year, however ongoing funding is unclear; it is anticipated that this need will be picked up through the Better Births transformation.
Early Help Hub - Single point of contact for all Early Help Assessments, Family Plans and Reviews that have been completed by any agency. Here's the Cambridge County Council Support Hub website.
Child & Family Centres/Children’s centres- Deliver evidence-based parenting programmes and targeted support for Domestic Abuse in conjunction with the Early Help offer.
Health Improvement antenatal- Address lifestyle/behavioural factors- smoking, diet & obesity, physical activity, drugs & alcohol, sexual health. Delivered by Everyone Health in Cambridgeshire and Solutions for Health in Peterborough.
Mental health challenges are common but help is available and with the right support many people recover completely. Check out our Who Can Help Page for lots of services who are local and national!
*Some information gathered from www.nhs.uk and the services listed.