Mental health has been a major concern in recent years and with good reason, more than 300 million people worldwide live with depression, according to the World Health Organization. The figure increased by 18.4% between 2005 and 2015.
In the meantime, “as many as 1 in 5 women have mental health problems in pregnancy or after birth,” said The Royal College of Psychiatrists. Although it is common to feel worried during pregnancy it is important to consult with your doctor if you feel something is not going right, early treatment and monitoring can make all the difference.
Mental health problems or worries?
Worry is common among pregnant women. Changes in your life role, fears of health problems during pregnancy, doubts related to being a good mother or fear of childbirth are common among many women. Talk honestly with your doctor, so they can guide you on the best treatments or lifestyle changes.
Although it is a joyful time for families, not every moment of pregnancy will necessarily be a happy journey. This is a difficult time for your body, including with hormonal fluctuations. Taking care of yourself and your baby is critical. Having a support network is important, too; support for mothers enables the healthy development of babies and ensures a better future. The key is to get help.
Emotional changes do not necessarily indicate a mental health problem, these changes are part of the process. However, warning signs should not be ignored.
What mental health problems are common during pregnancy?
Mental health problems can happen to anyone. Pregnant women are particularly vulnerable at this stage because of hormonal and lifestyle changes, with depression and anxiety being the most common mental health problems during pregnancy and postpartum.
“Antenatal anxiety and depression are prevalent and serious problems with changing courses. Continuous assessment over the course of pregnancy is warranted. Identifying and treating these problems is important in preventing postpartum depression,” published a study in Obstetrics and Gynecology (2007).
Fears of harming the baby are also frequent, according to Aisquel Machado, a psychiatrist based in Venezuela. However, if routines are paralyzed, it is a red flag. When people “start to be deficient in their life, they should go to a mental health expert.
“If they feel unable to take care of themselves, we realize they are unable to keep the life they had before, and possibly it is because of the hormonal change that is conditioning these behaviors,” Machado added that the situation can be aggravated when the pregnant woman refuses to eat or sleep, putting at risk her life and the life of the fetus. This could happen in highly complex cases.
“Although it is not widely known, there is a risk of psychosis and suicide in pregnancy. The physician in charge of the mother’s care during the gestation period should be alert,” Machado said. Puerperal psychosis, a rare but very serious mental health complication, “is more frequent in first-time mothers, single mothers or women with a history of depression before pregnancy,” or other antecedents such as bipolar disorder (whether that’s personal or family history).
The data suggest that pregnancy can be a period of risk for women’s mental health.
“Suicide is a leading cause of maternal death during pregnancy and up to a year after birth (perinatal period),” a study by Frontiers in Psychiatry, in 2022, indicated. These key data are reaffirmed by different studies and organizations around the world.
The treatments
Treatments will depend on each patient “and it’s going to be at the discretion of the treating physician. If the patient has suicidal risks, hospitalization is required, because two lives are at risk,” according to Machado, who added that “every day we have more advanced and less harmful therapeutic options,” so it is possible to have a treatment without harming the baby, benefiting family life.
The recovery of mental health does not depend entirely on the patient’s collaboration.
“(That) may be partly influenced by it, but we can’t ignore that the brain is an organ that also gets sick, as do the kidneys or the heart. In the case of the brain, the consequences are behavioral. It is a change in brain functioning. In those cases, the patient needs medical attention,” Machado said.
Images: Christian Bowen and @__dahc