Pregnancy and mental health
How can pregnancy affect mental health?
Pregnancy can be a time of great change. While it can be joyful and very exciting, it can also place extra stress on both women and men, which can lead to an increased risk of mental health problems.
Mental health conditions such as anxiety and depression can occur to anyone at any stage of life. However, they can be more common during pregnancy and early parenthood.
Around 9% of women are affected by depression during pregnancy. [1] It is not clear how many women experience an anxiety disorder, but symptoms of both conditions often occur together.
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Anxiety
A feeling of tension, nervousness and dread about future events. It can trigger physical symptoms such as a rapid pulse or breathing difficulties.
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Stress
The word ‘stress’ can have a variety of meanings, but generally describes the physical and mental responses of the body to a demand placed upon it. Often used to describe conditions where the demand is high or unable to be resolved and creates anxiety and tension.
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The beyondblue national postnatal screening program prevention and early intervention 2001–2005 final Report. Vol 1: National screening program. Beyondblue. Accessed 24 November 2014 from
External link
Depression and anxiety
The signs and symptoms of depression and anxiety during pregnancy are the same as those that occur during other times of life. They can often occur at the same time.
Symptoms of depression can include:
- Low mood, feeling numb, empty or miserable;
- Increased crying or feeling close to tears;
- Anger and irritability;
- Not being interested in things you normally enjoy;
- Difficulty coping with your normal routine;
- The inability to sleep (insomnia), or sleeping more than usual;
- Changes in appetite (overeating or not eating enough);
- Feelings of inadequacy, guilt, hopelessness, or of being a failure;
- Lack of energy, feelings of exhaustion;
- Difficulty concentrating or feeling forgetful, and;
- Thoughts of self-harm or suicide.
Symptoms of anxiety can include:
- Worry, fear and stress that continually interrupts your thoughts and interferes with your activities;
- Persistent muscle tension, chest tightness or heart palpitations;
- Difficulty relaxing and sleeping, and;
- Panic attacks.
The physical and hormonal changes that occur in pregnancy can make it difficult to recognize signs and symptoms of depression and/or anxiety.
Depression and/or anxiety may be a problem for you if symptoms are:
- Persistent and lasting for more than two weeks, and;
- Disrupting your life or are distressing.
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Anxiety
A feeling of tension, nervousness and dread about future events. It can trigger physical symptoms such as a rapid pulse or breathing difficulties.
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Panic attacks
An acute episode of extreme and overwhelming anxiety.
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Stress
The word ‘stress’ can have a variety of meanings, but generally describes the physical and mental responses of the body to a demand placed upon it. Often used to describe conditions where the demand is high or unable to be resolved and creates anxiety and tension.
Risk factors
Anyone can experience depression or anxiety during pregnancy. Usually there is no one cause, but a range of contributing factors.
Factors that can increase the risk include:
- Having a history of mental health problems prior to pregnancy;
- Having a family history of mental health problems;
- Problems with alcohol and drug use;
- A history of physical, psychological or sexual abuse;
- An unwanted or unexpected pregnancy;
- A lack of practical and emotional support, or serious relationship difficulties;
- Recent major life-events that have caused stress, such as losing a job, or the death of a family member or close friend;
- Other medical conditions including severe morning sickness;
- A general tendency to be anxious and worry;
- A tendency to be a perfectionist or self-critical;
- Multiple pregnancy, and;
- Pregnancy during adolescence.
Pregnancy can cause stress and feelings of worry and fear.
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Anxiety
A feeling of tension, nervousness and dread about future events. It can trigger physical symptoms such as a rapid pulse or breathing difficulties.
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Psychological
Relating to, arising in, or affecting the mind.
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Stress
The word ‘stress’ can have a variety of meanings, but generally describes the physical and mental responses of the body to a demand placed upon it. Often used to describe conditions where the demand is high or unable to be resolved and creates anxiety and tension.
Other mental health problems that can be related to pregnancy
Baby blues
The baby blues refer to symptoms that can occur in many women in the week after birth. They can include rapid changes in mood, crying, anxiety and sleep problems. The exact cause of the baby blues is not clear, but they are thought to be linked to rapid hormone changes after birth, as well as the stress of dealing with labor and caring for a newborn.
In most cases, the symptoms of the baby blues improve without treatment within days to weeks. It is important to ensure that you have strong family and friend supports around during this period of change.
Postpartum depression
Postpartum or postnatal depression can also occur after birth, but involves symptoms of depression that are more severe and can last much longer than the baby blues.
The symptoms of postnatal depression are similar to those during pregnancy and:
- Can be serious and very distressing;
- May interfere with the developing relationship between a mother and her baby;
- May include anxieties or fears about the baby, and;
- May include thoughts of self-harm, suicide or harming the baby.
Postnatal psychosis
Sometimes also known as puerperal psychosis or postpartum psychosis, this is a rare mental health condition that usually develops within a couple of weeks of childbirth, although it can occur up to 12 weeks after childbirth. Sometimes early symptoms may occur during pregnancy.
Symptoms can include confusion, hallucinations and delusional or irrational beliefs. Women with postnatal psychosis may have symptoms of depression or mania (extremely high mood and energy).
Postnatal psychosis is a serious mental health condition that requires immediate treatment. Women with postnatal psychosis can be at increased risk of harming themselves or their baby.
Grief following the loss of a pregnancy or baby
The grief experienced following loss of a pregnancy through miscarriage, stillbirth or other causes can lead to depression or anxiety.
Mental health issues for expectant fathers
Pregnancy can be a challenging and stressful time for expectant fathers and this may lead to a higher risk of anxiety and depression. Research has also shown that new fathers are at an increased risk of experiencing depression when their partners have depression.
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Anxiety
A feeling of tension, nervousness and dread about future events. It can trigger physical symptoms such as a rapid pulse or breathing difficulties.
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Hormone
A chemical substance secreted in one part of an organism and transported to another part of that organism, where it has a specific effect.
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Labor
Signals the end of a pregnancy and the process of giving birth to a baby from the uterus to the outside world.
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Psychosis
An abnormal mental state characterized by a loss of contact with reality.
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Stillbirth
The death of a fetus after 20 weeks of pregnancy.
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Stress
The word ‘stress’ can have a variety of meanings, but generally describes the physical and mental responses of the body to a demand placed upon it. Often used to describe conditions where the demand is high or unable to be resolved and creates anxiety and tension.
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Hallucinations
A false perception of something that is not actually there. The perception can be visual or aural.
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Postnatal depression
Depression that develops in a mother following childbirth, usually due to a combination of factors such as hormonal and psychological changes and fatigue.
Methods for diagnosis
If you are thinking about self-harm, suicide or harming your baby (or someone you know is showing these signs), getting help quickly is important and can help to save lives.
In situations where there is immediate danger of suicide or harm to a child, you can call 911 for help.
Other ways of getting help for a mental health problem include:
- Speaking to a doctor, midwife or mental healthcare provider, and;
- Calling an appropriate mental health crisis helpline.
Women are often routinely 'screened' or asked about any mental health problems they may be experiencing during pregnancy by their doctors and midwives. By asking you about your symptoms, your healthcare provider can assess how severe they are.
Blood tests may be recommended to identify any medical conditions that may cause similar symptoms to depression and anxiety. These can include anemia and thyroid conditions (hypothyroidism and hyperthyroidism).
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Anxiety
A feeling of tension, nervousness and dread about future events. It can trigger physical symptoms such as a rapid pulse or breathing difficulties.
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Blood tests
During a blood test, blood can be drawn using a needle or by a finger prick. Your blood can then be analyzed to help diagnose and monitor a wide range of health conditions.
Treatments
Depending on how severe your symptoms are, your doctor may recommend psychological therapy or medication. There are also lifestyle steps you can take to help deal with depression and anxiety.
Education
Understanding what to expect with pregnancy can help to reduce worry and depression. It can also help you to learn about depression and anxiety. Doctors, midwives and other health professionals can answer your questions and help provide reassurance regarding issues you might be worried about.
Education can help couples cope with any pregnancy concerns.
Psychological therapies
Psychological therapy is sometimes referred to as 'talking therapy' and describes the process of treating a mental illness by helping people to understand their condition and manage their symptoms.
Medications
For women with severe symptoms, medications may be recommended. Antidepressants can be effective in reducing symptoms of both depression and anxiety, which can have a negative effect on the baby's development and the mother's wellbeing. However, all medications are prescribed with caution to limit potential side effects to the unborn or newborn baby. Your doctor can discuss the risks and benefits of medications and find the best option that suits you.
If you have been taking medication for a mental health condition and become pregnant, it is important to speak to your doctor or psychiatrist as soon as possible - and before stopping any of your medications. If you suddenly stop taking medications, it can cause withdrawal symptoms or may make your mental health condition worse. Medical professionals can advise what treatment options will be most suitable for you during pregnancy.
Complementary treatments (such as St John's Wort) are sometimes suggested for depression and anxiety; however, they may not be safe during pregnancy. Your doctor can advise you on the safety of complementary treatments.
Lifestyle measures
Looking after your general health and wellbeing is very important during pregnancy and a range of lifestyle measures can help to relieve symptoms of anxiety and depression.
These can include:
- A healthy diet;
- Focusing on reducing stress, and;
- Regular appropriate physical activity.
You can check with your doctor or midwife prior to making any changes to your lifestyle that might affect your pregnancy (for example, making sure exercise is safe and suitable for your situation).
A healthy diet is important during pregnancy for both physical and mental wellbeing.
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Anxiety
A feeling of tension, nervousness and dread about future events. It can trigger physical symptoms such as a rapid pulse or breathing difficulties.
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Psychological
Relating to, arising in, or affecting the mind.
Potential complications
Depression and anxiety during pregnancy can make it more difficult to look after your health and if they are untreated, they can affect the baby's health and development.
Depression and anxiety can contribute to:
- Poor nutrition during pregnancy;
- Increased use of alcohol and tobacco, and;
- Reduced attendance at antenatal care appointments.
Anxiety and depression during pregnancy have also been related to:
- Lower birth weight;
- An increased risk of premature birth, and;
- Changes in hormones that may affect the long-term development and health of the baby.
Women who have untreated depression during pregnancy may be more likely to experience postnatal depression after the baby is born.
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Anxiety
A feeling of tension, nervousness and dread about future events. It can trigger physical symptoms such as a rapid pulse or breathing difficulties.
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Postnatal depression
Depression that develops in a mother following childbirth, usually due to a combination of factors such as hormonal and psychological changes and fatigue.
Prognosis
In some cases, mental health conditions such as anxiety and depression can persist for a long time and affect many aspects of a person's life. However, effective treatments are available and they can help you to feel better and get on with enjoying your life and your new baby.
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Anxiety
A feeling of tension, nervousness and dread about future events. It can trigger physical symptoms such as a rapid pulse or breathing difficulties.
Prevention
Anyone can get anxiety and depression. Understanding the signs and symptoms and seeking help early can help to prevent the symptoms from becoming worse. As it can often be difficult to recognize early symptoms of depression and anxiety in yourself, your partner, family members and friends can provide vital support and guidance.
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Anxiety
A feeling of tension, nervousness and dread about future events. It can trigger physical symptoms such as a rapid pulse or breathing difficulties.
Support services
If you or someone you know needs help, please call or visit:
WellMama: Pregnancy & Postpartum Depression Hotlines Call: 1.800.896.0410
National Suicide Prevention Lifeline Lifeline Call: 1-800-273-8255
The Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals.
References
- The beyondblue national postnatal screening program prevention and early intervention 2001–2005 final Report. Vol 1: National screening program. Beyondblue. Accessed 24 November 2014 from link here
- About PND. Accessed August 14 2014. link here
- Addressing Depression and Anxiety among New Fathers | Medical Journal of Australia. Accessed August 15 2014. link here
- Antenatal Depression - Antenatal Depression - In Pregnancy & Postnatal - Depression - Black Dog Institute. Accessed August 15 2014. link here
- Anxiety & Pregnancy | The Royal Womens Hospital. Accessed August 14 2014. link here
- Anxiety during Pregnancy and Early Parenthood. Accessed August 15 2014. link here
- Baby Blues | The Royal Womens Hospital. Accessed August 15 2014. link here
- Bipolar Disorder & Pregnancy | The Royal Womens Hospital. Accessed August 15 2014. link here
- Depression & Pregnancy | The Royal Womens Hospital. Accessed August 14 2014. link here
- Depression during Pregnancy and Early Parenthood. Accessed August 15 2014. link here
- Depression Explained: Postnatal Depression (PND) - Postnatal Depression (PND) - In Pregnancy & Postnatal - Depression - Black Dog Institute. Accessed August 15 2014. link here
- Depression in Pregnancy & Postnatal: Fathers - Fathers - In Pregnancy & Postnatal - Depression - Black Dog Institute. Accessed August 14 2014. link here
- Depression in Pregnancy and Postnatal - Baby Blues - In Pregnancy & Postnatal - Depression - Black Dog Institute. Accessed August 15 2014. link here
- Depression in Pregnancy and Postnatal: Treatment Issues - Treatment Issues - In Pregnancy & Postnatal - Depression - Black Dog Institute. Accessed August 15 2014. link here
- Eating Disorders in & after Pregnancy | The Royal Womens Hospital. Accessed August 15 2014. link here
- Life Factors That Increase the Risk of Mental Health Conditions. Accessed August 15 2014. link here
- Mental Heath Conditions during Pregnancy and Early Parenthood. Accessed August 8 2014. link here
- Postnatal (puerperal) Psychosis - Postnatal (puerperal) Psychosis - In Pregnancy & Postnatal - Depression - Black Dog Institute. Accessed August 15 2014. link here
- Safetyofantidepressantsinpregnancyandbreastfeeding.pdf. Accessed August 14 2014. link here
- Schizophrenia & Pregnancy | The Royal Womens Hospital. Accessed August 15 2014. link here
- Symptoms of Anxiety during Pregnancy and Early Parenthood. Accessed August 15 2014. link here
- Symptoms of Depression during Pregnancy and Early Parenthood. Accessed August 15 2014. link here
- The Baby Blues. Accessed August 15 2014. link here
- Treatment for Depression and Anxiety during Pregnancy and Early Parenthood. Accessed August 15 2014. link here
- The beyondblue National Postnatal Screening Program Prevention and Early Intervention 20012005 Final Report. Vol 1: National Screening Program. - Final Report Volume I Final Version 180705.doc - bw0075-Report-Beyondblue-National-Research-Program-vol2.pdf. Accessed November 24 2014. link here (Buist A & Bilszta J (2006) The beyondblue National Postnatal Screening Program Prevention and Early Intervention 20012005 Final Report. Vol 1: National Screening Program. Melbourne: beyondblue: the national depression initiative)
10 Most frequently asked questions (FAQs)
How are pregnancy and mental health related? Pregnancy can be a time of great change. While it can be joyful and very exciting, it can also place extra stress on both women and men, which can lead to an increased risk of mental health problems. Mental health conditions such as anxiety and depression can be more common during pregnancy and early parenthood. Around 9% of women are affected by depression during pregnancy. What are the symptoms of mental health problems in pregnancy? The physical and hormonal changes that occur in pregnancy can make it difficult to recognize signs and symptoms of depression and/or anxiety. Some symptoms that may be experienced include: anger and irritability; low mood, feeling numb, empty or miserable; increased crying or feeling close to tears; worry, fear and stress that continually interrupts your thoughts and interferes with your activities; persistent muscle tension, chest tightness or heart palpitations; difficulty relaxing and sleeping, and; panic attacks. Depression and/or anxiety may be a problem for you if the symptoms are persistent and lasting for more than two weeks, and are disrupting your life or are distressing. What factors increase the risk of mental health problems during pregnancy? Anyone can experience depression or anxiety during pregnancy. Usually there is no one cause, but a range of contributing factors: having a history of mental health problems prior to pregnancy; having a family history of mental health problems; problems with alcohol and drug use; a history of physical, psychological or sexual abuse; an unwanted or unexpected pregnancy; a lack of practical and emotional support, or serious relationship difficulties; recent major life-events that have caused stress, such as losing a job, or the death of a family member or close friend; other medical conditions including severe morning sickness; a general tendency to be anxious and worry; a tendency to be a perfectionist or self-critical; multiple pregnancy (twins or triplets), and; teen pregnancy. The 'baby blues' is a term for symptoms that can occur in many women in the week after birth. They can include rapid changes in mood, crying, anxiety and sleep problems. The exact cause of the baby blues is not clear, but they are thought to be linked to rapid hormone changes after birth, as well as the stress of dealing with labor and caring for a newborn. In most cases, the symptoms of the baby blues get better without treatment within days to weeks. It is important to ensure that you have strong family and friend supports during this period of change. What is postnatal depression? Postpartum or postnatal depression can also occur after birth, but involves symptoms of depression that are more severe and can last much longer than the baby blues. The symptoms of postnatal depression are similar to those during pregnancy and: can be serious and very distressing; may interfere with the developing relationship between a mother and her baby; may include anxieties or fears about the baby, and; may include thoughts of self-harm, suicide or harming the baby. What is postnatal psychosis? Sometimes also known as puerperal psychosis or postpartum psychosis, this is a rare mental health condition that usually develops within a couple of weeks of childbirth, although it can occur up to 12 weeks after childbirth. Sometimes early symptoms may occur during pregnancy. Symptoms can include confusion, hallucinations and delusional or irrational beliefs. Women with postnatal psychosis may have symptoms of depression or mania (extremely high mood and energy). Postnatal psychosis is a serious mental health condition that requires immediate treatment. Women with postnatal psychosis can be at increased risk of harming themselves or their baby. Is pregnancy-related depression serious? Prenatal and postnatal depression can be very serious. In some cases they may increase the risk of self-harm or suicide and, after the baby is born, harm to the baby.
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