Emotional Health in Pregnancy and After Birth

Postpartum Depression & Anxiety

Depression and anxiety can occur anytime during pregnancy or after the birth of a baby. Feeling very depressed or anxious is not normal. Depression occurs in about 15 per cent of women in pregnancy or after birth. Anxiety can be more common.  Paternal depression affects 10 per cent of men after the birth of a baby.

Partners can get depressed too.

You are more at risk for depression or anxiety with:

• a history (or family history) of depression or anxiety
• a pregnancy or delivery complication
• poor sleep
• few supports (family, friends)
• work or relationship stress
• stopped medication used to treat depression or anxiety
• early breastfeeding challenges

Symptoms to Watch for:

• depressed or irritable mood
• lack of interest in activities
• changes in sleep or appetite
• low energy or poor concentration
• feeling guilty or worthless
• worry that is difficult to control
• feeling panicky, restless or tense
• intrusive repetitive thoughts (e.g., fear of baby getting germs) or repeated rituals (e.g., hand washing, checking)
• flashbacks or nightmares of a trauma
• thoughts of suicide or harming yourself or your baby

You should seek help as soon as possible. Symptoms can last for many months and lead to:

• not taking care of yourself, your pregnancy or your baby
• effects on the physical health of your pregnancy
• trouble bonding with your baby
• difficulty in relationships or work
• using substances such as drugs or recreational alcohol
• suicide

Take Care of Yourself

• Take one day at a time.
• Ask for help from your health care provider.
• Share your feelings with your partner.
• Sleep when you can.
• Eat healthy foods and keep hydrated.
• Plan one thing to look forward to every day.
• Be active! Go outside for a walk.
• Go to a local support and parenting program.

Anxiety Disorder

Individuals commonly have signs of anxiety along with postpartum depression. Anxiety and depression can also happen on their own.

Tell your doctor or nurse if you are feeling any of following signs. It may be difficult to talk about your thoughts and feelings with your health care providers. But they can support you in getting the help you need. The sooner you get help, the better you will feel.

Anxiety Disorder

Anxiety is a normal human emotion that everyone experiences at times. Anxiety disorders, however, are different. They can cause such distress that it interferes with a person’s ability to lead a normal life.

Common Symptoms of Anxiety

• excess worry
• scary or upsetting thoughts
• racing heart
• feeling on edge, restless or irritable
• avoiding people, places or activities
• difficulty concentrating
• trouble falling or staying asleep
• shortness of breath
• dizziness or light-headedness
• sweaty or clammy hands

Panic Disorder

A sudden feeling of intense fear or discomfort making you feel “out of control”. Some individuals think they are having a heart attack or nervous breakdown.

Common Symptoms

• racing heart, chest pain
• sweating, hot or cold flashes
• shaking, loss of feeling or a tingling sensation
• shortness of breath, a feeling like you are choking
• stomach upset
• dizziness
• fear of dying

Obsessive Compulsive Disorder (OCD) – Scary Thoughts

Unwanted thoughts that can come and go involving harm to yourself or your baby. They can feel very real but when these thoughts happen after having a baby, individuals usually know that these thoughts are not real and will not act on them.

Common Symptoms

• unwanted, repetitive thoughts, impulses or images
• repetitive actions (e.g. washing hands over and over again, checking the baby all the time)
• scary thoughts or visions of the baby being harmed

Post Traumatic Stress Disorder (PTSD)

PTSD can happen after a distressing event such as a difficult or traumatic labour and birth, an accident, natural disasters, death of a loved one, abuse or sexual assault, or war.

Common Symptoms

• thoughts and dreams of the event
• feeling numb and detached from the world
• hard time sleeping
• lack of bonding with the baby
• sexual problems
• more likely to miss doctor visits
• avoiding further pregnancies
• avoiding places that remind you of the trauma

Postpartum Psychosis

Postpartum psychosis is rare and happens in 0.1 to 0.5 per cent of persons. It is a medical emergency.

Common Symptoms

• confusion
• feeling paranoid
• hearing voices
• having unusual thoughts of harming yourself or your baby

If you notice any of these signs in yourself, in a friend or partner, contact a doctor and go to a hospital emergency right away.