If you have had in the past, or now have, severe psychological health problems, you are more likely to become ill during pregnancy or in the first year after giving birth than at other times in your life. Severe psychological 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 psychological health problems may also become more problematic during these times, though this might not necessarily happen to you. Everyone is different, with different triggers for becoming unwell. You may also worry about becoming unwell.
Discussion should include:
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" 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. However, pregnancy and birth can trigger more serious depression in some women. Symptoms that may indicate you are depressed include:
Find out more about symptoms of depression.
Because your Genral Practioner will continue to treat you after your pregnancy is over, he or she will always be involved in your psychological health care. However, if your illness is severe, your Genral Practioner will refer you to the local perinatal psychological health team for specialist care. This team can help develop a care plan for you. In some areas you may be referred to your local community psychological health team.
If you're taking antidepressants already, you should continue to take them. Consult your doctor or psychiatrist as soon as you decide to start trying for a baby, or as soon as you learn you are pregnant, to discuss any risks associated with taking or stopping your medication during pregnancy and while breastfeeding.
Some drugs that are used to stabilise mood may increase the risk of physical defects and development problems in the unborn baby. After talking to you, your doctors may decide to change or stop the medication you are taking, but you should not alter your drug treatment or stop taking treatment without specialist advice, especially during pregnancy.
If you have mild depression, your doctor may suggest other treatments such as counselling. These may also be offered if you develop depression after the birth.
Developing depression after your baby is born is called postnatal depression (PND). It usually begins some time during the first six months after the birth. PND can last for more than a year if untreated, but the earlier it is diagnosed and treated the quicker you will recover.
Your health visitor should discuss how you're feeling after the birth, but warning signs to watch out for include:
If you think you may be depressed, talk to your doctor or health visitor as soon as possible, as they can arrange suitable care for you.
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.
Try to avoid:
The website of the Royal College of Psychiatrists has more information about postnatal psychological health, including puerperal psychosis. Click on "postnatal psychological health" in the list on the RCP's Problems and Disorders page.
You can also read guidelines from the National Institute for Health and Care Excellence (NICE) on psychological health problems during pregnancy and after giving birth.
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