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World Maternal Mental Health Day

“Being a mother, while trying to repair myself mentally and physically is the hardest thing I’ve done.”

Sandra Erath

What is Maternal Mental Health Day & Awareness Week?

World Maternal Mental Health Day is on May 1st annually, whereas Maternal Mental Health Awareness Week commences on 29th April to 5th of May. It’s a time for mental health clinicians, mothers, and those close to themto talk, reflect, and share stories on the challenges of mental illness before, during, and after pregnancy. It’s also a great opportunity to extend the discussion to those who wouldn’t normally dwell on the issues around maternal mental health. The importance of mothers receiving support and understanding during pregnancy is essential. World Mental Health Day states: “Since 2016 a multidisciplinary group of international maternal mental health activists, academics, clinicians, and people with lived experience are coming together once a year to raise awareness of this topic to demand maternal mental health services for all.”

Perinatal mental illness (the period of pregnancy and a year thereafter) include postnatal depression, severe anxiety, postnatal post-traumatic stress disorder (PTSD), perinatal obsessive-compulsive disorder, antenatal depression, and postpartum psychosis (PP). NHS Nottingham Healthcare reports that: “Perinatal mental health refers to a woman’s mental health during pregnancy and the first year after birth. This affects around 20% of new and expectant mums in the UK each year. This includes mental illness existing before pregnancy, as well as illnesses that develop for the first time, or are greatly exacerbated in the perinatal period.”

At Addcounsel, we recognise and understand how challenging it can be for a mother during pregnancy and thereafter, and how isolating and painful it can be to endure a mental illness at such a sensitive time.

Appreciating the challenges of motherhood post-pregnancy

Motherhood is an exceptionally challenging experience, albeit a wonderful and deeply fulfilling one. For many women, their dreams and hopes for the future (which can be quite overwhelming during the pre-conception period) can be crushed when they are affected by one or more types of mental illness post-partum. This is exacerbated by the fact that there’s still so little awareness and understanding of the various types of perinatal mental illness. There’s frequently a degree of shame and denial for the mother who may find herself desperately trying to live up to the commonly held ideal of the radiant, joyful mother who has bonded with her new infant and is blissfully presenting them to the world.  The reality can be far removed from this and one for which many new mothers find themselves completely unprepared. The challenges associated with the early days/weeks of motherhood are intense and if this is compounded by unexpected feelings of numbness, self-loathing and in some cases a disconnect with the baby it can be deeply distressing and feel like a very lonely place to be.

Let’s explore the different types of perinatal mental illnesses 20% of mothers in the UK experience every day:

Postnatal depression

The symptoms of postnatal depression are similar to those of depression, ranging from low energy to neglecting to exercise basic self-care and struggling to care for the baby. Almost everything feels like a struggle from the most basic of activities such as getting out of bed, showering, preparing food and feeding the infant. Motherhood can feel daunting or impossible and sometimes suicidal ideation will occur, which can be very frightening and confusing at a time when many were expecting feelings of contentment and joy to be all-pervading. Feelings of shame, guilt, self-disgust, and apathy are often present during postnatal depression. 10 to 15 in every 100 women will experience postnatal depression in the UK.

Severe anxiety

Anxiety disorders during pregnancy can cause immense discomfort for a mother. Harvard Health Publishing article How can you manage anxiety during pregnancy? reports: “The rates of generalized anxiety disorder appear to be highest in the first trimester, likely due to hormonal changes. The most common symptoms of anxiety include constant worrying, restlessness, muscle tension, irritability, feeling dread, an inability to concentrate, and difficulties falling asleep due to worries.”

Postnatal post-traumatic stress disorder (PTSD)

When complications (some of which might be life-threatening) arise during or after the birth, trauma will ensue, and this can lead to being diagnosed with postnatal PTSD. Such traumatic events can include intra-uterine death and foetal loss as well as premature birth and emergency surgery. Symptoms of postnatal PTSD can include flashbacks, nightmares, shaking, panic attacks, nausea, isolation and seeking to self-medicate with drugs or alcohol. 

Perinatal obsessive-compulsive disorder

Perinatal OCD is the same disorder as obsessive-compulsive disorder, however it occurs during pregnancy or after birth. Symptoms include obsessively checking on the baby, excessive washing of bottles and toys, repeatedly worrying about harming the baby and isolating the baby from any perceived threats such as germs, people, and environments away from home. An intense fear of contaminating a baby can occur, followed by compulsions and rituals such as avoiding nappy changing, and hiding knives.

Antenatal depression

Antenatal depression (prenatal depression) can occur anytime during pregnancy. While changes of mood can be sudden and sometimes overwhelming during pregnancy such as joy to sorrow, antenatal depression is persistent. Symptoms include a lack of physical energy, feeling detached, diminished interest in the pregnancy, a sense of hopelessness about the future and the mother’s ability to be a good parent, self-loathing, lack of sexual appetite and poor sleep.

Postpartum psychosis (PP)

Postpartum psychosis is a treatable yet severe mental illness which occurs days and weeks after giving birth. The UK charity Action on Postpartum Psychosis writes: “There is still a lot to learn about the causes of postpartum psychosis. Lots of different things are likely to be involved. You are more likely to have postpartum psychosis if a close relative has had it. This means that it may be something to do with your genes. Changes in hormone levels and disrupted sleep patterns after having your baby are also likely to be involved but we don’t know exactly how.” Symptoms of postpartum psychosis include mania, delusions, and hallucinations. It can be extremely disturbing for a mother convinced that her baby has been possessed by the devil, or seeing spiders crawling under her baby’s skin. Feeling paranoid or untouchable is a common symptom too.

Are mental health disorders hereditary?

Many mental health clinicians have recognised that it’s extremely likely that both environment (what one is exposed and subjected to) and genetics (a history of mental illness in the family) are closely associated with mental health disorders. If a mother has an untreated and/or undiagnosed mental health disorder, does this mean her baby is more likely to have a similar experience in childhood and adulthood? Oxford University reports in an article Genes and Mental Illness: “A new study, A structural brain network of genetic vulnerability to psychiatric illness, has revealed a common pattern of connections in the brains of people whose genes predispose them to mental health problems. Findings show that brains ‘wired up’ in this way are associated with not just one but a whole range of mental health conditions, including schizophrenia, autism, depression, anxiety, and bipolar disorder.”

The article continues: “Dubbed a ‘vulnerability network’, this pattern of connections may help scientists to understand why different mental health conditions seem to run in the same families and explain what makes a patient with one psychiatric disorder more likely to be diagnosed with another.” A mother may very well pass on her mental health disorders, but the same applies to the father, and as we know in families with a history of alcoholism, one or two generations may show no signs of addiction, only for the next to be overwhelmed with alcoholics. In other words, just because a mother has a particular mental illness it’s not a given that she’ll pass this on to her offspring. It’s crucial to ensure that no parent or “generation” is blamed for the genes they pass down, if in fact those genes are more susceptible to one or more mental health issues.

Is there a risk of mental health issues in adulthood for the offspring of mothers with perinatal mental illness?

National Library of Medicine (USA) conducted a study, which reveals a table on consequences of maternal depression. It revealed the following:

Prenatal

Inadequate prenatal care, poor nutrition, higher preterm birth, low birth weight, pre-eclampsia, and spontaneous abortion.

Infant

Behavioural: Anger and protective style of coping, passivity, withdrawal, self-regulatory behaviour, and dysregulated attention and arousal.

Cognitive: Lower cognitive performance.

Toddler

Behavioural: Passive noncompliance, less mature expression of autonomy, internalizing and externalizing problems, and lower interaction.  

Cognitive: Less creative play and lower cognitive performance.

School-age

Behavioural: Impaired adaptive functioning, internalizing and externalizing problems, affective disorders, anxiety disorders and conduct disorders.  

Academic: Attention deficit/hyperactivity disorder and lower IQ scores.

Adolescent  

Behavioural: Affective disorders (depression), anxiety disorders, phobias, panic disorders, conduct disorders, substance abuse and alcohol dependence.  

Academic: Attention deficit/hyperactivity disorder and learning disorders.”

While perinatal mental illness has been linked to emotional and cognitive complications in early childhood (as outlined above), more studies are being conducted on the offspring of mothers who had a maternal mental health disorder. In a detailed case study Risk of Depression in the Adolescent and Adult Offspring of Mothers with Perinatal Depression a Systematic Review and Meta-analysis it reports: “The estimated risk of adolescent offspring depression associated with perinatal depression varies across different studies and is associated with its timing. Studies have found that offspring of mothers with antenatal depression were 1.3 to 4.7 times more likely to develop depression. A 4.9- to 7.4-fold increase in the risk of developing depression in adolescence has been reported in the case of maternal postnatal depression. Although some studies did not report this association, longer follow-up studies using the same cohort data suggest otherwise.” The paper concludes: “To our knowledge, this meta-analysis provides the most robust empirical evidence that maternal perinatal depression, especially antenatal depression, could play a substantial role in the onset of depression in adolescence and adulthood.”

In an article Maternal depression during pregnancy and offspring depression in adulthood: Role of child maltreatment published byCambridge University Press it reports:Our study shows that exposure to maternal depression during pregnancy increases offspring vulnerability for developing depression in adulthood. We find that child maltreatment is a putative mediating mechanism in this trajectory. These findings support the notion that exposure to maternal depression during pregnancy and exposure to child maltreatment are part of a single trajectory linking early life insults to risk for adulthood depression. By intervening during pregnancy, rates of both child maltreatment and depressive disorders in the young adults could potentially be reduced.”

Contact us today to start your recovery

Our team at Addcounsel feel it’s of paramount importance that there be zero judgement or blame attached to the often-debilitating incidence of depression and/or untreated addiction during or after pregnancy. We’re acutely aware that self-recrimination and feelings of shame can so easily be experienced by women at this highly sensitive time and that it can feel very exposing to reach out and ask for help. Depression is an illness and addiction is a chronic brain disorder. Combined, they can be frightening and without the appropriate support and treatment can feel completely unmanageable for both the sufferer and her loved ones. We always keep in mind that this a time when a woman is at her most vulnerable, and reaching out for help can seem daunting. We know how difficult this can be, and we’ll offer you the care and understanding so necessary for a full recovery from this distressing condition. You’re not alone.

Addcounsel offers expert private and luxury rehab in London. Our bespoke treatments are delivered with compassion and care by highly skilled mental wellbeing specialists, following our ‘one client at a time’ methodology. This involves dedicated, one-to-one therapy in an individual setting—no groups or other clients, ensuring an unrivalled level of care, and complete anonymity.

When you check in to our discreet central London rehabilitation facility, you’ll be embarking upon a personalised treatment programme tailored to your individual needs. We offer luxury private accommodation for the duration of your stay, with 24/7 access to a team of world-class experts headed by one of the UK’s leading psychiatrists.

Our multidisciplinary team boasts a wealth of mental wellbeing knowledge and expertise in every aspect of your recovery. Dedicated psychiatrists, nutritionists, therapists, and addiction specialists will create a comprehensive process designed specifically for you. Our focus isn’t just on your mind; we understand the important roles that genetics, nutrition and lifestyle can play in the development of depression and/or drug and alcohol dependency, and in the process of recovery. 

Experts will assess the factors that led to your mental health condition or addiction, leverage the world’s most extensive menu of therapy services to help you recover, and create a robust aftercare programme to support re-integration into your family and lifestyle. Contact us today to start your recovery journey.

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