Mental illness continues to be an ongoing concern and struggle for many people, some seeking help and treatment, others suffering in silence. Those with a history of mental illness or with a current severe and persistent mental illness are more likely to become ill or symptomatic during pregnancy. Although, individuals carrying a diagnosis of mental illness may avoid becoming symptomatic during pregnancy they are also more likely to become within the first year after giving birth than at other time in one’s life. Severe mental health problems include but are not limited to chronic and severe depression, bipolar disorder, psychotic disorder, etc. Unfortunately, following the birth of a child some mental illnesses may become progressive and more severe than at any other time.

Notably, other less severe mental illnesses may also become triggered during pregnancy, more pronounced and severe. Hence, it is very important to monitor mood, psychological, and behavioral changes during pregnancy. It is important to partner with a physician to properly isolate behavior and emotional changes associated with hormonal changes due to pregnancy and those associated with mental illness. Regular and consistent appointments with a mental health professional can help pregnant women identify as well as understand the psychological and emotional changes taking place.

Negative stigma’s associated with mental illness is often a motivating factor or a source of fear for many mentally ill pregnant women to avoid treatment or discussing symptoms. Many pregnant women diagnosed with a mental illness fear being labeled as “crazy” or unfit to care for their child, hence the reason they may not seek mental health services. Unlike at any other time in their life, pregnant women may feel more vulnerable and anxious while pregnant and after the birth of a child. Some women may even stop taking psychotropic medications on their own because of fear of harming their unborn child. However, discontinuance of medication should only be done after consulting with a doctor as mental illness may return or exacerbated. Treatment for mental health related problems in pregnancy and after giving birth can include psychological treatments as well as medication. Taking any type of medication during pregnancy, especially some medications in excess can carry risks for your unborn baby, but if you don't take medication that has been prescribed for you, or you stop taking it, there is a risk that you might become seriously unwell and this can be a risk as well.

In an effort to receive appropriate mental health treatment during pregnancy the following is necessary:

• Tell your doctor about any and all medications being prescribed, taken, and those prescribed but you are not in compliance with.

• History of mental health hospitalizations

• Treatment history, i.e., what has worked, what hasn’t worked

• Potential triggers for relapse and or decompensation

• How severe any previous mental health problem has been

• Potential barrier to treatment or appointment compliance

Warning signs during and after pregnancy that may suggest more than “baby blues”

• Interruptions in sleep

• Homicidal/suicidal ideations or thoughts

• Chronic sadness

• Increased feelings of anxiety

• Feelings of hopelessness or helplessness

• Being afraid if being left alone to care for your child

• Angry irritable mood

• Intense feelings of panic

• Constant crying

• Unsubstantiated fears

• Trouble concentrating or easily distracted

• Loss of interest in things once enjoyed.

Sandra & Bill

Sandra and Bill became the proud parents of baby Lily one month ago. Prior to Lily’s birth Sandra has struggled with manic depression most of her life, however for the most part she has been able to manage the symptoms fairly well. However, after Lily’s birth Sandra has had difficulty concentrating, sleeping, and bonding with her daughter. Sandra and Bill’s family and friends have visited the new baby, each noting the changes in Sandra’s mood and behavior. Most people have attributed the changes in Sandra’s mood and behavior to “baby blues”, which will soon pass. However, for the last 2 weeks Sandra has experienced recurrent dreams of harming her baby (which she has not shared with anyone), each becoming more graphic and distinct than the previous. What her friends and family have noticed was her avoidance of the baby, erratic mood, and easy distraction. Are the behaviors and moods exhibited by Sandra more than “baby blues”?

#Pregnancy #Decompensation #Depression #mentalillness #PostpartumDepression #BabyBlues