Pregnancy

I would just concentrate on three main psychiatric disorders associated with child birth.

Postnatal Blues

These are very common and can effect as many as 50% of ladies after child birth. These usually start between day 3 and 5 after childbirth. Usual symptoms are tearfulness and confusion. These are usually self limiting and do not lead to post partum depression. Management is reassurence and support from friends & family.

Postnatal Depression

What Is It

Postnatal Depression is depression after having a baby which can last for weeks or months. It usually starts after 4-6 weeks of child birth but may begin as late as 6 months after.

What are the symptoms

The symptoms are similar to depression
You feel sad, unhappy and misrable for much or all of the time.It can sometimes seem that life is not worth living. You may get irritable with your husband and occasionally, with your baby. 
All new mothers get pretty tired, but depression can make you feel exhausted without having done much work. You find you can't fall asleep or wake up earlier than your usual time.
Depressed mothers usually loose interest in eating but you may find yourself eating for comfort. You find that you can't enjoy or be interested in anything, especially sex. Depression changes your thinking, making you see things in a negative light. This then produces feelings of guilt and self-blame that you are responsible for your illness and not a good enough mother. You may start feeling detached from your baby. You worry excessively about your baby's safety.Sometimes, you may even worry that you might harm your baby.

How common is it

About 10-15% of ladies suffer from PND. Putting it another way, upto 1 in 10 childbirths can result in PND

What causes it

You are more likely to have PND if you:

  • have a history of depression (especially PND)
  • have a family history of PND
  • do not have a supportive family especially husband
  • have a premature or sick baby
  • have experienced severe life stresses recently

However you can still have PND even if none of the statements apply to you. Conversely a lady with all of the above may escape developing PND.

Treatment

This includes support, counselling and antidepressants. Antidepressants should be used, keeping breastfeeding in mind. Only some antidepressants can be safely given during breastfeeding. The full discussion on this subject is beyond the scope of this website. Older antidepressants like imipramine and fluoxetine appear to be safe.

Postpartum Psychosis

This is a serious condition, which affects around 1 in 500 women, usually within 2-4 weeks of childbirth. Symptoms are similar to mania. You may have rapid mood swings, strange or bizarre beliefs or hear voices and can behave in odd and unpredictable ways. It requires urgent treatment as both mum and baby can be at risk.