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Psychological health problems and pregnancy

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:

  • how severe any previous psychological 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 psychological 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. However, 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

Find out more about symptoms of depression.

Managing 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.

Postnatal depression

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.

Who is at risk?

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
  • sleeping problems
  • 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 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.
Try to:

  • 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 psychological 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)
  • moving house
  • being too hard on yourself or your partner

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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