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Pregnancy and change

Women experience many changes during pregnancy and it is common to find it challenging to deal with all the social, economic, emotional and physical changes that occur at this time. Most women will need some support from family and friends to work through these changes and to get ready for the birth of the baby. Some will find it harder than others, and may need additional support from community groups and health care providers.

The effect of pregnancy on mental illness

In the past, it was thought that pregnancy protected against mental illness. However, we now know that women already diagnosed with a mental illness may still experience symptoms during their pregnancy. Often, women report that their symptoms of

  • Major Depressive Disorder
  • Anxiety Disorders, (including Panic Disorder, Generalized Anxiety Disorder, and Obsessive-Compulsive Disorder)

continue or can have their onset during pregnancy.

Bipolar Disorder and the psychotic disorders, including Schizophrenia, are less likely to have their onset in pregnancy. Symptoms of Bipolar Disorder, especially manic or mixed episodes, are more likely to begin or re-occur in the postpartum period.

This is also true for psychotic disorders where the postpartum period is a time of higher risk for experiencing symptoms of psychosis for those women who are at risk.  

How do I know if I may be experiencing mental illness?

Sometimes, it may be hard to know whether the physical changes of pregnancy are symptoms associated with mental illness because they are so similar. For example, feeling very tired, having difficulty in sleeping, change of appetite, and loss of energy are all common at various stages of pregnancy.  They are also common symptoms of depression .  Talk to your healthcare provider if you are at all concerned and they will help establish the cause of how you are feeling.

Who is at risk?

Women with a personal or family history of mental health disorders may have a higher risk of perinatal mental illness and ideally, should plan their pregnancy. This could include an individualized treatment plan developed by the women and her healthcare providers. The treatment plan may include education of the woman and her family about symptoms to look out for during pregnancy and after the birth, self-care (with an emphasis on good sleep habits, healthy eating, regular exercise, time for oneself, and establishing a support network), and different forms of psychotherapy.

Medications and pregnancy

Women with more serious mental illnesses who have required medication prior to pregnancy, may find it is possible to wean off the medication before or during pregnancy but sometimes, may need to remain on medication. A woman should not suddenly stop taking medications on discovering she is pregnant.  This may result in a re-emergence of her symptoms. It is important that all decisions about medications are discussed between the woman and her healthcare providers to ensure optimal health of both the expectant mother and her baby.

Getting treatment as soon as possible

It is important that women who experience mental health disorders during pregnancy receive treatment quickly so that symptoms do not continue or worsen in the postpartum period. Untreated mental illness in pregnancy and postpartum can have long term consequences for the mother, mother-baby relationship and the baby, including effects on the baby’s cognitive, emotional, and behavioural development.  There are a range of treatments available that do not always involve medications.

If you are concerned at all about your mental health before pregnancy, during pregnancy or after the baby is born, talk to your healthcare provider about how you are feeling.  It is not a normal part of pregnancy to feel emotionally unwell for long periods of time.