Emotional Health in Pregnancy and After Birth
Low energy or changes in appetite or sleep can be normal in pregnancy and these symptoms may be confused with depression. However, symptoms in pregnancy can lead to postpartum depression or anxiety.
Up to 80% of mothers feel very teary, irritable and worried for up to 10 days after delivery. These “baby blues” are very common and do not usually need treatment other than understanding, rest and support.
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% of women in pregnancy or after birth. Anxiety can be more common. Paternal depression affects 10% of men after the birth of a baby.
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
Take Care of Yourself
Women 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 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
A sudden feeling of intense fear or discomfort making you feel “out of control”. Some women think they are having a heart attack or nervous breakdown.
- 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
- 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, mothers usually know that these thoughts are not real and will not act on them.
- 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.
- 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 is rare, but a medical emergency.
- 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.
Video: Identification and Awareness.Couples share their struggles with identifying their postpartum difficulties and depression.