Perinatal mental health

I decided to touch on this topic as it is widely under reported and rarely spoken about, most public media I have seen regarding perinatal disorders are related to accounts of violence. As someone who has an extensive history of mental illness and being pregnant currently I have realised how little is known about this subject.

Perinatal mental health looks at a woman’s mental state from the time of pregnancy until around one year post-partum. Unfortunately, on occasion, pregnancy may exacerbate any pre-existing mental illness or may even induce, cause, or be a catalyst to developing a mental disorder. A lot of women feel they are pressured into portraying themselves as this “blissfully happy” woman who has just birthed her entire lives meaning. Unfortunately due to this a lot of perinatal mental disorders will often go underreported due to these pressures. With less women seeking help for their mental state during this period the 5th most common cause of death during pregnancy or immediately after the birth is maternal suicide.

Anxiety disorders

Anxiety is a completely normal emotional response to most human events, pregnancy included. A lot of mothers feel an unnecessary pressure from their family, friends, partners, and the media to be perfectly happy and to be doing everything by the book! This may increase an already diagnosed anxiety disorder or could potentially induce an anxiety disorder in others. Although anxiety is normal in cases where a disorder may be suspected there may be a constant feeling of doom or fear in regards to the baby, pregnancy, or the birth. In some extreme cases the mother could develop tokophobia; an extreme fear of childbirth. For further information on developing an anxiety disorder in pregnancy, alongside some handy tips to deal with it, click Here.

Peri and post natal depression.

Between 15-20% of women will develop depression during or soon after the birth of their child, often times this comes alongside anxiety. Unlike other depressive disorders there will be symptoms related to the child. These symptoms may manifest as feeling like a bad mother, a failure, or not being able to live up to this perfect image of a mother. As mentioned previously maternal suicide is the 5th most common cause of death in mothers. One Canadian study found that up to one third of new mums experience depression and suicidal ideation and up to half of new mums experience these thoughts and includes their children – or intrusive thoughts of hurting their children. These thoughts then gather a lot of guilt and ultimately worsens the depression due to having these horrific thoughts. Despite depression being one of the most common mental illnesses world wide, even within perinatal mental health, people are so afraid to admit it due to fear of judgment from others.

Puerperal psychosis

Puerperal psychosis only impacts 0.1 – 0.2% of new mothers, generally developing within the first few months of giving birth. Despite being a rare disorder it is generally considered to be high risk in regards to new mothers. When a mother is suspected of suffering from puerperal psychosis she may experience paranoia, delusional beliefs, and act on intrusive thoughts. The majority of women who go on to commit acts of infanticide are thought to experience severe puerperal psychosis. Through my professional career I have witnessed delusional beliefs relating to religion where the mother feels the child is either possessed by demons and death will be their only freedom to events where the mother has delusions regarding the weather and believes her child is freezing to death, despite evidence pointing at the baby becoming too warm. Puerperal psychosis is so underreported but I feel this is due to the most well known cases being women who have murdered their babies, although again this is through illness, which I’ll touch on in my post on forensic mental health.

For more information on puerperal psychosis you can visit the Mind website

Remember that regardless of what the mental disorder is it is vital for a mothers mental wellness to talk openly about any concerns. People are good natured with their suggestions of advice although this may inadvertently worsen episodes of depression or anxiety through making the mum feel guilty or like a failure. As a new mum it can be incredibly overwhelming and even though you may be surrounded by friends and family you may feel like you are in this yourself. These feelings are normal and should not be swept under the carpet or ignored.

Helping those with suicidal ideation

More than 6,000 deaths are due to an individual completing suicide, in the UK. Recently this number has slowly fallen; except in Scotland where it has risen. This means that someone dies from suicide every two hours but the amount of people who have attempted suicide cannot accurately be recorded. In the United Kingdom suicide is the number one cause of death for people aged between 20 – 34. The risk of suicide is significantly higher in young males, around 75% of these deaths are young men. This is due to the stigma and personal feelings of shame associated with mental illness. Educating the masses about services to visit, phone, text, or email is excellent. Giving people a safe space is key to overcoming their demons, although I don’t think this is enough. As a community we need to know how we can do our part in help people going through this. People who have decided to end their life have most likely seen all the information on seeking help but they’ve already decided, so why would they seek help? I feel that, as a society, it is also our job to recognise the signs and know what to do when someone is contemplating ending their life. 90% of people who go on to complete suicide have had no contact with their GP or any associated services up to a year before they completed suicide. Assuring people that they are welcome to open up is a good move forward, but what about the people who care about them? There’s load of things set up to offer help to people but we rarely see anything outlining the signs and symptoms friends, family, or colleagues should be looking for and the actions that should be taken if you suspect someone of having suicidal intent. When people take action on behalf of someone there is a higher chance of saving their life. You’re more likely to complete suicide if no one is aware but9 out of 10 people who have had a failed attempt to end their life do not go on to complete their suicide.

First let’s talk about risk factors! More than 90% of suicides are carried out by people who have a diagnosed mental illness – although those with no diagnoses or involvement with services can go on to complete or attempt suicide.

  • Drug and alcohol misuse
  • Trauma or abuse
  • Unemployment / redundancy
  • Social isolation
  • Poverty
  • Poor social conditions
  • Imprisonment
  • Violence
  • Family breakdowns

How you can help others experiencing suicidal ideation: There are factors that may help people understand or realise how deeply unhappy someone is and who may be contemplating taking their own life.

  • If someone is becoming withdrawn, anxious, or are feeling depressed.
  • If there is a loss of interest in their usual hobbies, their work, their appearance, and their social lives,
  • Feeling as though there is no purpose in life or expressing feelings of hopelessness.
  • Not caring about what may happen to them and acting in dangerous and impulsive ways.
  • Giving possessions to friends, family, or selling them online.
  • Discussing suicide, death, and dying with others.

Although these signs may sound slightly obvious there are more hidden signs of those who go on to complete suicide. People may start discussing how they will “sort everything out” or seem more content because they have made the decision to end their life, so they see their suffering coming to an end.

So here’s what to do if you are worried about someone! Don’t be afraid to say suicide out loud. There’s no shame in directly asking the person if they have considered or are considering suicide or harming themselves. Suicide is not a dirty word! Speak to them about how they feel and don’t forget to listen! Try and find out if they have a direct plan, the more information the more helpful it is. Talking is powerful and the person in question may be overwhelmed with relief that someone has asked and putting the topic out for discussion. Encourage them to seek help. An appointment with the GP, a phone call to NHS24, or even a trip to a&e. If you’re incredibly worried about this person do not be afraid to call the police, either emergency or non-emergency line! It is vital that if someone is in imminent danger to themselves, or others, that the police be informed. Don’t be afraid to reach out to others to get advice on what to do.

*NOTE* if you have exhausted all of this and the individual does complete suicide do not blame yourself. You are only human and should feel accomplished that you tried your best to prevent this. Sadly the above does not always work but it is a selfless and courageous thing to do to try and help someone through the darkest period of their life.