Women and Newborn Health Service
Health Professionals
King Edward Memorial Hospital
About Perinatal Mental Health
Perinatal mental health can be defined as:
The "emotional and psychological wellbeing
of women,
encompassing the influence on infant, partner and family,
and commencing from preconception through pregnancy
and up to 36 months postpartum."
- State Perinatal Reference Group (2003)
Common perinatal mental health issues include the 'baby blues', depression, anxiety and puerperal psychosis.
The 'Baby Blues'
The 'baby blues' is the most common and least serious condition found in the postnatal period, affecting up to 80% of new mothers. It usually lasts for one or two days and up to a week at most.
Symptoms include:- feeling tearful and sad
- feeling anxious and irritable
- having a 'low' mood
- feeling unwell
- having difficulty sleeping
However, if the symptoms continue longer than two weeks, it's a good idea to see what else might be affecting the mother: for example, symptoms of anxiety and/or depression.
More information can be found in the Manual below
Depression in the Perinatal Period
Depression during the perinatal period is the same as clinical depression at other times.
Symptoms persist for at least 2 weeks and can include:- Low mood
- Lack of interest or pleasure in usual activities
- Feelings of inadequacy, failure, hopelessness, guilt and shame
- Sleeping a lot or having difficulty sleeping; nightmares
- Significant changes in appetite or weight
- Decreased energy and motivation
- Decreased concentration
- Persistent thoughts of death and/or suicide
Prevalence rates for antenatal depression range from 8% to 15%, and for PND, from 10% to 15%. Mild to moderate cases of depression are sometimes unrecognised. If left untreated, depression in the perinatal period it can develop into a long-lasting depression, or return with subsequent pregnancies.
More information can be found in the Manual below.
Research articles on depression in the perinatal period can be found on our publications page.
Anxiety in the Perinatal Period
Anxiety in the perinatal period has the same symptoms as anxiety at other times. The prevalence is not clear, however some studies have shown that anxiety is more common postnatally than depression.
Anxiety is a core protective emotion which is helpful in situations of realistic danger. For some people anxiety can reach clinical levels and interfere with daily life. People may fear that they are going crazy or losing control. It may seem like the anxiety occurs for no particular reason, and the anxious reactions may be very difficult to contain.
Symptoms can include:- feeling restless, nervous or nauseous
- finding it hard to relax
- having a 'racing' mind
- having a churning stomach
- feeling a sense of dread
If the anxiety is particularly debilitating it may meet the criteria for an anxiety disorder. These include Generalised Anxiety Disorder, Panic Disorder, Social Anxiety Disorder, Obsessive Compulsive Disorder, Post-Traumatic Stress Disorder and the numerous Phobias. The anxiety disorders can be present in the perinatal period.
More information can be found in the Manual below.
Research articles on anxiety in the perinatal period can be found on our publications page.
Puerperal (Postnatal) Psychosis
Puerperal psychosis is the most serious and least common mental health issue found in the postnatal period. Only one or two mothers out of a thousand are affected by this condition. It is most likely to present in mothers who have a personal or family history of mental illnesses such as schizophrenia or bipolar disorder.
Symptoms usually begin abruptly in the month following childbirth, and can include:- confused or erratic behaviour
- hallucinations and delusions
- severe mood swings
- significantly reduced need for sleep
Recurrences are common in subsequent pregnancies (25% to 75% of cases). It is important to note that puerperal psychosis is treatable, especially with early intervention.
More information can be found in the Manual below.
Manual
The Statewide Obstetric Support Unit has developed a comprehensive manual for health professionals on perinatal mental health. The manual covers screening, diagnosis, prevention, management and referral processes for a range of mood and anxiety disorders in the perinatal period.
Download Perinatal Depressive and Anxiety Disorders Manual (pdf, 484kb).
Download Perinatal Depressive and Anxiety Disorders Quick Reference Guide (pdf, 836kb)
Hard copies of the Quick Reference Guide are available from WAPMHU. Call (08) 9340 1798 or email wapmhu@health.wa.gov.au to obtain one.
Reference
Pope, S. and Watts, J. (2007). Becoming a Parent: Adjusting to the Changes. Perth: Department of Health.
(For more information on this book please see our Resources page)
