Your Wellbeing

Your Wellbeing

The mental well-being of women and their families is as important as the physical well-being of the woman and developing baby.

Emotions during and after pregnancy can range from love, pride and joy, to worry, sadness and frustration. It is natural to feel stressed or anxious at times during pregnancy – or when you have a new baby and up to one year on. There emotions are quite normal.

Maternal Well-being

During and after pregnancy

Affects 1 in 5 people

Women and Men can be affected

Lincolnshire Perinatal Mental Health Service

Remember, if you are struggling, always ask for help

If you admit to feeling depressed, anxious or having distressing thoughts (for example, about harming yourself or the baby) you may fear that your baby will be taken away. But it’s only in very rare cases that parents are separated from their children, and there’s lots of support available to help you make sure that never needs to happen.

It’s important to ask for help because you don’t need to cope with these difficult experiences alone.

Contact your GP, Midwife or Health Visitor and voice your concerns

What kind of perinatal mental health problems are there?

You can experience any kind of mental health problems during and after pregnancy, but there are some that are particularly common or are specifically linked to pregnancy and childbirth.

Perinatal depression is depression experienced during pregnancy (known as ante or prenatal depression) or after childbirth (known as postnatal depression). Many people are aware of postnatal depression (PND) but it’s less commonly known that you can experience depression during pregnancy as well.

How you might feel? How you might behave?

· sad and low

· tearful for no apparent  reason

· worthless

· hopeless about the future

· tired

· unable to cope

· irritable and angry

· guilty

· hostile or indifferent to your husband or partner

· hostile or indifferent to your    baby

· lose concentration

· have disturbed sleep

· find it hard to sleep – even when you  have the opportunity

· have a reduced appetite

· lack interest in sex

· have thoughts about death

Some of these experiences – like lack of concentration, disturbed sleep and lack of interest in sex – are all common after becoming a parent, but it’s still important to mention them to your doctor if you’re concerned you might have PND.

What are the treatments?

You may be offered:

  • talking treatments – such as short term therapies like, cognitive behavioural therapy (CBT) or interpersonal therapy (IPT)
  • medication – this is most likely to be an antidepressant. 
  • a combination of both – many people find that taking medication helps them feel stable enough to get the most out of a talking treatment. However, other people find medication or talking treatments alone are more helpful.

If your depression is very severe, and isn’t responding to other treatments, your doctor may suggest electroconvulsive therapy (ECT). As ECT can work very quickly, doctors may suggest it can help you to care for and bond with your baby as soon as possible. 

Perinatal anxiety is anxiety experienced during pregnancy or in the year after childbirth. You might hear it called:

  • prenatal or antenatal anxiety if you experience anxiety during pregnancy
  • postnatal anxiety if you experience it after giving birth

While many people are aware that you can become depressed after having a baby, it’s less well known that many women experience anxiety during and after pregnancy. In fact, it’s common to experience depression and anxiety together.

How you might feel physically?

How you might feel psychologically?

· tense muscles and                        headaches

· pins and needles

· feeling light headed or dizzy

· faster breathing

· sweating or hot flushes

· a fast, thumping or irregular heartbeat

· raised blood pressure

· difficulty sleeping

· needing the toilet more frequently, or less frequently

· churning in the pit of your              stomach

· experiencing panic attacks

·feeling tense, nervous and on edge

· having a sense of dread, or fearing the            worst

· feeling like the world is speeding up or              slowing down

· feeling like other people can see that you’re anxious and are looking at you

· feeling your mind is really busy with              thoughts

· dwelling on negative experiences, or    thinking over a situation again and again (this is called rumination)

· feeling restless and not being able to                concentrate

· feeling numb

What are the treatments?

There are a range of treatment options for anxiety, any of which you might find useful to treat perinatal anxiety.

  • Talking treatments. You’re likely to be offered cognitive behavioural therapy (CBT) or your local mental health services may run specific counselling or group programmes for anxiety. 
  • Self-help resources. Your doctor could give you access to online CBT programmes, or prescribe self-help books to help you learn to manage your anxiety. 
  • Medication. There are several different drugs that can be helpful in managing anxiety. 

You may be offered a combination of medication and a talking treatment. Many people find that taking medication helps them feel stable enough to get the most out of a talking treatment. However, other people find medication or talking treatments alone are more helpful

Obsessive-compulsive disorder (OCD) is a type of anxiety disorder. The term is often misused in daily conversation – for example, you might hear people talk about being ‘a bit OCD’ if they like things to be neat and tidy. But the reality of this disorder is a lot more complex and serious.

Perinatal OCD is when you experience OCD during pregnancy or in the year after giving birth.

Obsessions

Compulsions

· intrusive thoughts about hurting your baby, by suffocating them or throwing  them down the stairs, for example

· disturbing thoughts of sexually        abusing your child

· intrusive thoughts of                          accidentally harming your baby        while you’re pregnant by eating        dangerous foods or taking the          wrong medication

· fear of being responsible for               giving a child a serious disease         such as HIV

· fear of making the wrong                   decision – for example, about           vaccinations or medical                     treatment

· excessive washing of clothes, toys or bottles

·avoiding changing soiled nappies              out of fear that you might                          accidentally touch your baby                      inappropriately

· keeping your baby away from other         people in case they hurt them or               contaminate them

· constant checking on the baby – for          example, waking them up when                they’re asleep to check on them

· repeatedly asking people around               you for reassurance that your baby           hasn’t been hurt or abused

· mentally going over what happened          each day to reassure yourself that             you’ve not been responsible for                 harming your baby

What are the treatments?

The main treatment for OCD is cognitive behavioural therapy (CBT), particularly a specific form of CBT called exposure and response prevention (ERP). This is a talking treatment that helps you understand how your OCD works and what you need to do to overcome it. Your therapist will help you confront your obsessions and learn how to resist the urge to carry out compulsions.

You may also be offered medication to treat your anxiety. Some people find that taking medication alongside a talking treatment can help them get the most out of their therapy. If there are long waiting times in your area for talking treatments, your doctor might suggest that you try medication while you wait

Postpartum psychosis (PP) is a serious, but rare, diagnosis occurring in around one in 1,000 births. You’re likely to experience a mix of:

  • depression
  • mania
  • psychosis

Symptoms usually start quite suddenly within a few weeks after giving birth. PP is sometimes called puerperal psychosis.

Postpartum psychosis can be an overwhelming and frightening experience for you and your loved ones, and it’s important to seek help as soon as possible. With the right support, most women fully recover.

How you might feel?

How you might behave?

·  excited or elated

·   severely depressed

·   rapid mood changes

·   confused or disorientated

·   restless

·   unable to sleep

·   unable to concentrate

·   experiencing psychotic symptoms,              like delusions or hallucinations

What are the treatments?

You are most likely to be offered an anti-psychotic drug to manage your mood and psychotic symptoms. You may also be offered an antidepressant.

If your symptoms are very severe, and don’t respond to other treatments, your doctor may offer you electroconvulsive therapy (ECT). 

Will I have to go into hospital?

Your doctor may decide that treating you in hospital is the best way to get you the help you need. If it’s possible, you should be admitted to a mother and baby unit (MBU), where you can stay with your baby while getting treatment

You may develop post-traumatic stress disorder (PTSD) if you experience:

  • a difficult labour with a long and painful delivery
  • an unplanned caesarean section
  • emergency treatment
  • other shocking, unexpected and traumatic experiences during birth

This is also called birth trauma. The impact of these experiences is often underestimated, as people may feel that the baby is adequate compensation for the trauma and that, as a new mother, you will soon forget it in the joy of motherhood.

However, a traumatic childbirth and developing PTSD can impair your relationship with both your baby and your partner. You may feel acute disappointment that childbirth was not the experience you were hoping for, and feel angry with the medical staff if you felt that the delivery wasn’t handled well. If you develop PTSD, you’re likely to also experience flashbacks or unwanted memories of the traumatic birth.

Re-living aspects of the trauma

· vivid flashbacks (feeling that the trauma is happening all over          again)

· intrusive thoughts and images

· nightmares

· intense distress at real or symbolic reminders of the trauma

· physical sensations such as pain, sweating, nausea or trembling

Alertness or feeling on edge

· panicking when reminded of the trauma

· being easily upset or angry

· extreme alertness

· disturbed sleep or a lack of sleep

· irritability and aggressive behaviour

· lack of concentration

· being easily startled

· self-destructive behaviour or recklessness

Avoiding feelings or memories

· keeping busy

· avoiding situations that remind you of the trauma

· repressing memories (being unable to remember aspects of the      event)

· feeling detached, cut off and emotionally numb

· being unable to express affection

· using alcohol or drugs to avoid memories

What are the treatments?

The treatments for PTSD are primarily talking treatments:

  • Trauma-focused cognitive behavioural therapy (CBT) which is specifically designed to treat PTSD. 
  • Eye movement desensitisation and reprocessing (EMDR). In this treatment you are guided by a therapist to make rhythmic eye movements while recalling the traumatic event. The eye movements are designed to stimulate the information-processing system in the brain. The aim of the treatment is to help you process the traumatic events, and speed up re-adjustment and recovery.

Medication is not normally offered to treat PTSD but, as it is common to also experience anxiety and depression alongside PTSD, your doctor might offer you medication to treat this. Your doctor might also offer you medication to support you to feel more stable and able to care for your baby, or if there’s a long wait for talking treatments in your area

How can I look after myself?

Build your support network

Talking to other new mothers and fathers, and finding that other new parents share the anxieties and frustrations you are experiencing, can be very reassuring. It can also give you a chance to share skills and experiences, to realise that you are not alone and, above all, to get some emotional and practical support. It can help to affirm you in your new role.

You could:

  • Go to local parent-and-baby groups – if you’re feeling nervous try something based around an activity, music for example, which might make it easier to start talking to other parents.
  • Contact specialist organisations. Organisations like Home-Start and NCT help new parents to develop their support networks and look after their mental health.
  • Access online support. There are lots of online communities for parents, people experiencing mental health problems and specifically parents experiencing mental health problems. Websites like netmums and mumsnet have forums where you can talk to other parents. Mind runs an online peer support community called Elefriends for anyone who wants support for their mental health. PND & Me connects people with experience of perinatal mental health problems primarily through twitter. 
  • Try peer support. Contact your local Mind to see if they offer any peer support groups. Many organisations run peer support programmes for specific diagnoses. For example, Action Postpartum Psychosis runs a peer support network, and PANDAS runs support groups for perinatal mental health problems.

Manage daily tasks

Coping with household tasks as well as looking after a new baby is a challenge for anyone. Finding some ways to manage them day-to-day can help take the pressure off and help you feel more able to cope with the symptoms of your mental health problem.

  • Accept help. If your friends or family members offer to do the shopping, help cook meals or do some cleaning, say yes! There’s nothing wrong with needing some support, and your loved ones will probably want to do something practical to help you.
  • Cook meals in advance. If you don’t have anyone around who can come and help, you can make planning food easier by batch cooking meals in advance and freezing them. Take advantage of times when you have more energy to cook, so you can have access to fast and healthy meals when you’re feeling worse.
  • Take it slowly. It’s easy to start to feel overwhelmed when you’re looking after a new baby on top of your regular life. Try setting yourself 20 minutes to do what you can of a task, whether that’s throwing things in the washing machine or sorting through your paperwork. Taking things 20 minutes at a time can make tasks feel more manageable and you can take advantage of getting a little bit done whenever you feel able.
  • Don’t pressure yourself. You might want to keep up with all the things you used to do around the house – but looking after a new baby is a full time job, as well as affecting how much sleep you get. Try not to set unrealistic standards for yourself or get frustrated if you don’t do the things you planned to.

Look after yourself

Finding time to think about yourself while looking after your baby may feel like a challenge, but making small changes can help you look after your mental health.

  • Keep active. This could be going for a walk with the pram, dancing to music at home or gentle yoga. Physical activity can boost your mood, and help you feel like you’re getting to do some things just for yourself. See our pages on physical activity and mental health for more information.
  • Try to get some sleep. Getting good sleep with a new baby might sound impossible, but finding time to rest can make a big difference to your mental health. Try sleeping whenever your baby sleeps or, if you can, ask your partner to help with night feeds.
  • Take time to relax. You might feel like you have no time for yourself, or that all you do is sit around at home, but actively taking time to relax can mean more than just watching the TV. Think about what really helps you unwind, whether it’s reading a book, doing some gardening or doing crafts, and try to make a bit of time – even just five minutes – to do something that makes you feel good. See our pages on relaxation for more ideas.

Who to ask for support?

If you admit to feeling depressed, anxious or having distressing thoughts (for example, about harming yourself or the baby) you may fear that your baby will be taken away. But it’s only in very rare cases that parents are separated from their children, and there’s lots of support available to help you make sure that never needs to happen.

It’s important to ask for help because you don’t need to cope with these difficult experiences alone.

There are many health professionals who you can talk to about your mental health, and who can provide you with support in several different ways. These may include general health and pregnancy support services like:

  • your GP
  • antenatal care (with your midwife or obstetrician)
  • your health visitor

There are also more specialist services to support you if you are at risk of becoming (or become) more unwell:

  • perinatal mental health services
  • community mental health teams (CMHTs) and crisis teams
  • hospitals, and mother and baby units (MBUs)

You can also access support and services through:

  • voluntary organisations and charities

Mental Health Support

The mental well-being of women and their families is as important as the physical well-being of the woman and developing baby.

The following services can provide advice, support and guidance.

Steps 2 Change

Offer a range of talking therapies tailored to meet your individual needs. They are free of charge, proven to be effective and helpful and provided by experienced and qualified professionals.

Call: 0303 123 4000

Samartians

Whatever you're going through, a Samaritan will face it with you. Available 24 hours a day, 365 days a year.

Free phone: 116 123

LPFT

Promoting recovery and quality of life through effective, innovative and caring mental health, social care and specialist community services

Call 01522 340160