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Perinatal mental illness

Factsheet

Pregnancy and the first year of parenthood (the perinatal period) is an exciting time that brings new challenges and responsibilities for expecting parents. 

However, both men and women can experience depression or anxiety during pregnancy (antenatal) and following the birth of their baby (postnatal). Mothers can also develop postnatal psychosis, an acute and rare mental illness. 

Perinatal mental illnesses are treatable. With appropriate care and support, many people with perinatal mental illness go on to have more children.  

The facts 

The myths 

Related: Understanding postnatal psychosis • Getting better • Ten tips for sleep hygiene

Symptoms 

Expecting and new parents experience many emotions during pregnancy and early parenthood. Pregnant women and their partners may feel anxious, scared, sad or nervous about becoming a parent. For new parents, the changes that come with a new baby can bring a number of difficult challenges. Some people develop more distressing anxiety or depression which affects their daily life and functioning.  

The signs of perinatal anxiety and depression include: 

Men’s symptoms may be the same as women’s, or they may be different. Some men may experience agitation and frustration. They may have out of character outbursts of anger or rage, leading to feelings of shame or guilt. These symptoms are signs it’s time to get help, rather than letting let them simmer or keeping them bottled up. 

Postnatal psychosis symptoms 

Symptoms of postnatal psychosis may include:  

Causes 

While there is no single cause for perinatal mental illness, there are a number of risk factors. These include hormonal changes, traumatic pregnancy or birth, financial or relationship stress, social isolation and previous reproductive issues such as infertility.  

Your own previous history or a family history of mental illness can also increase your risk of developing perinatal mental illness.  

You are more likely to develop postnatal psychosis if you have bipolar disorder or schizophrenia.  

Related:  Psychosis • A rollercoaster ride through the darkest places I never wanted to visit

Seeking help, diagnosis & treatment 

Perinatal mental health issues are very treatable. There is an increased awareness in the health sector of perinatal mental health — many GPs, maternal health nurses and maternity doctors are more aware of the risks and signs of mental illness. Many other women and men have come through this experience to enjoy being a parent, and have gone on to have more children. 

Many parents go to great lengths to hide their real feelings because of stigma. If you’re close to a new or expecting parent, know the signs to look out for and ask how they’re really going. Often a partner, friend or family member is the first to notice when something is not right.  

If you suspect that you, your partner or someone you know may have perinatal mental illness, gently encourage them to seek help through their GP or maternal health nurse. They can also call the PANDA (Perinatal Anxiety & Depression Australia) helpline on 1300 726 306. Offer to make the call or go to an appointment with them.  

Treatment for perinatal mental illness often includes therapy with a counsellor, psychologist or psychiatrist. Medication may also be prescribed. There are medications available which are safe to use in pregnancy and while breastfeeding. Your GP will be able to discuss these options with you. 

Social isolation can be a risk factor in developing perinatal mental illness. Your maternal health nurse or GP can help you access services such as parent groups, supported playgroups and other services to help you meet new parents in your area. 

It was a rollercoaster ride through the darkest places I never wanted to visit.

Mel Maginnity

Having more children 

After you have recovered from perinatal mental illness, the thought of having more children may be confronting. However, with planning and support, knowing the signs and symptoms and using strategies developed in your previous recovery period, you will be better prepared to take action early and deal with any recurrence.  

Women who have experienced postnatal psychosis should get advice from a doctor when considering becoming pregnant again. Many women who have had postnatal psychosis choose to have more children. About half of mothers who’ve had postnatal psychosis once will have it again, but even if that happens, with the right care, you’re likely to recover more quickly next time. 

Treatment for postnatal psychosis  

If you think that you or your partner may have postnatal psychosis, seek help immediately by calling 000 for an ambulance or the police. This is a serious mental illness that can be life-threatening for both the mother and baby. Make sure to say that the person’s behaviour is unusual and potentially dangerous, that they have a very young baby and that you think they have postnatal psychosis. 

Often, other people will notice you aren’t well before you notice yourself.  

Women with postnatal psychosis may be admitted to hospital for specialised psychiatric assessment and treatment. They will be given medication and psychiatric treatment to manage the condition. 

Some hospitals have a special psychiatric ward where the baby can stay with the mum (a Mother Baby Unit), but this is not always possible. Access to a mother baby unit may depend on where you, as there are limited numbers of mother baby units across Australia.   

Whilst it is always a priority for a baby to be kept with its mother, in many cases a woman will need to stay in an adult general psychiatric ward. If this is the case, the baby will need to be cared for by her partner or another support person. The length of time the mother can expect to stay in hospital will depend on how quickly she responds to treatment and has the confidence and ability to return home and care for her baby. 

Beyond the immediate treatment period, support and care is required throughout the recovery process. Women generally experience a full recovery with time and appropriate treatment.  

Related: Antipsychotics • Antidepressants • How to speak out about the challenges of parenting

Self-care for family, friends & carers 

Caring for someone with perinatal mental illness can be distressing and confronting. You may feel unsure of how to help or what to say. Partners may feel overwhelmed caring for a person with a mental illness while looking after a new baby too.  

It’s important to remember that perinatal mental illnesses are genuine illnesses. Try not to take any out-of-character behaviour personally. Focus on providing practical help and gentle emotional support.  

Looking after a partner with perinatal mental illness can put you at risk of experiencing it too. Make sure to look after yourself and your own health. This will help you be the best support for your loved one. If you are concerned about your own mental health, talk to your GP.

PANDA can also offer support to carers and partners of someone with a perinatal mental illness.

This SANE resource was created with support from The Vizard Foundation.

This SANE factsheet was reviewed by industry professionals, carers and people with lived experience of perinatal mental health. 

References

Further reading on perinatal mental illness

Perinatal mental illness: Factsheet & Guide
https://www.sane.org/mental-health-and-illness/facts-and-guides/perinatal-mental-illness

This Factsheet & Guide may be freely downloaded, copied and distributed on condition no change is made to the contents. SANE Australia is not responsible for any actions taken as a result of information or opinions contained in the Factsheet.
© SANE Australia www.sane.org.