Perinatal mental health and how we can help

What is perinatal mental health?

‘Perinatal’ refers to the period during pregnancy as well as following birth. Perinatal mental health (PMH) difficulties are challenges which affect parents during this period. PMH conditions are very common, affecting around 20% of mothers and 10% of fathers. The most commonly experienced difficulty is postnatal depression, also known as postpartum depression, but other difficulties, including perinatal anxiety, perinatal OCD, perinatal PTSD and perinatal psychosis can also start during this period. More information on each condition can be found in the section below.

PMH conditions are caused by a variety of factors and are by no means an indication that you are not right for parenthood. It is completely ok, and common, to struggle, and reaching out for help is by no means a statement that you can’t care for your baby - if anything it highlights your determination to be your best self during those early days, weeks and years.

Actions that can help

1. Be kind to yourself - these are normal feelings and you should not feel ashamed about them.
2. Set boundaries - there may be lots of people that want to see you and your baby, but it’s important to allow time for yourself.
3. Reach out to friends and family for help and talk to them about how you’re feeling.
4. Make sure to get plenty of rest, you have been through a lot both physically and emotionally. Rest doesn’t have to be sleeping, but quiet time with minimal other demands.
5. Try to do things that you enjoy, things that you used to do before you had a baby.

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Symptoms

Perinatal depression

Perinatal depression is a form of depression experienced at some stage over your pregnancy or starting within the first year after your baby is born.

It differs from the ‘baby blues’ which describes a low or overly emotional mood experienced for 3-10 days after the birth of the baby. This sensation is usually down to the lack of regular sleep and new emotional demands that comes with a child - it usually goes away on its own. More information on baby blues can be found here.

Symptoms of perinatal depression include:

• Feeling upset and tearful
• Being restless, agitated or irritable
• Feeling empty/emotionally numb
• Unable to enjoy things you usually enjoy
• Hostility/indifference to your partner
• Hostility/indifference to your baby

Perinatal anxiety

Anxiety is also fairly common for the perinatal period. Becoming a mother is a major life change and it comes with hormonal imbalances and poorer sleep - it is no surprise some mothers have struggles with anxiety.

Symptoms can be both physical and psychological and may include:

• Stomach pains
• Pins and needles
• Irregular heartbeat
• Difficulty sleeping
• Feeling unable to relax
• Catastrophising - imagining the worst in each situation
• Feeling like everyone can see how anxious you are
• Worrying that you’re losing touch with reality

Perinatal OCD

Obsessive Compulsive Disorder is a type of anxiety disorder which has two main components - obsessions and compulsions.

Obsessions are unwelcome thoughts or urges that repeatedly appear in your head, causing you mental discomfort. Compulsions are behaviours that you repeat multiple times in order to ease your mental discomfort, even if the action has no actual impact on the unwelcome thought/urge.

Common obsessions in perinatal OCD include:

• Thoughts about hurting or sexually abusing your baby
• Thoughts of accidentally infecting your baby with a disease
• Fears that you will make a wrong medical decision that will harm your baby

Common compulsions in perinatal OCD include:

• Excessive washing of clothes
• Avoiding changing nappies as you’re worried about touching the baby inappropriately
• Keeping your baby away from others in case they contaminate them with illness

Perinatal Psychosis

Perinatal psychosis is a very rare mental health condition which can be experienced after childbirth. It usually consists of a mix of psychosis, depression and mania and can include the following symptoms:

• Rapid mood swings
• Unable to sleep
• Delusions/Hallucinations
• Feeling that you are being followed
• Feeling that people are reading your thoughts
• Feelings of divine experiences

Whilst postnatal psychosis can seem scary, it is very much treatable and it doesn’t need to define your life.

Perinatal PTSD

Also known as birth trauma, perinatal PTSD can develop if you experience traumatic events before or during childbirth. Long, painful birthing experiences, unplanned caesareans, emergency treatment and feelings of being out of control of your care during birth can cause perinatal PTSD. This can make it hard to connect with your baby, but it can be treated.

Symptoms of perinatal PTSD include:

• Reliving aspects of the birth (flashbacks, nightmares, similar physical sensations etc)
• Being on edge (constantly alert, panicky, easily startled, irritable behaviour)
• Avoiding feelings or memories (always keeping busy, refusing to discuss or think about the birth, lack of memory surrounding birth, feeling physically or emotionally numb)
• Difficult beliefs/feelings (unable to trust others, overwhelming guilt and shame, lack of security, feeling that no one understands)

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Treatment

Given how varied PMH conditions can be, there is no one set treatment that applies to everyone. However, talking therapies are recommended for all of the above conditions and it is important to see a specialist who has experience of working with perinatal mental health.

Evidence based therapies such as Cognitive Behavioural Therapy (CBT) are frequently used, sometimes in conjunction with other therapies or medication. If opting for medication whilst pregnant or breastfeeding, it is always advised to discuss options with your doctor.

Other types of talking therapy which may be helpful include: guided self help, counselling, behavioural activation, interpersonal therapy, and mindfulness-based cognitive therapy. Different talking therapies suit different people and one type of talking therapy may be more effective for you than another so it’s important to find which works best for you.

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How to get help

Speaking to your GP is always a good first step if you think you may be experiencing any of the above conditions.

If you’d like to know more about what treatments are available for your condition, or a condition you think you might have, get in touch at hello@helloself.com. Alternatively, more information can be found here.

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Perinatal mental health - Five facts

1. 1 in 5 women experience some sort of perinatal mental health condition.
2. Approximately 10% of new fathers will develop some form of depression in the postnatal period.
3. Mental health struggles affect adoptive parents as well as birthing parents, with 8% experiencing perinatal depression.
4. Perinatal OCD is relatively rare, affecting between 1% - 3% of mothers. Perinatal psychosis is very rare, only affecting one or 2 in every thousand mothers.
5. Extreme sleep deprivation can trigger perinatal depression.

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