Understanding Perinatal Mental Health Conditions

by Suzie Booth (Counsellor/Psychotherapist, MSc. MBACP accred.)

Pregnancy, birth and life with a new baby can bring all the emotions. Last week we explored the common but often overwhelming feelings that many women experience during this time. Those shifts in mood are normal, expected, and part of the huge transformation happening in both body and mind.

Sometimes though, those feelings stop being temporary visitors and instead settle in, becoming heavier, more intense, or harder to shake. That’s when we move into the territory of diagnosable perinatal mental health conditions.

Perinatal refers to pregnancy, birth, and the first year after a baby is born, and this period is a particularly vulnerable one for mental health.

Perinatal Depression

Perinatal depression includes both:

• Antenatal depression (during pregnancy)

• Postnatal depression (after birth)

Symptoms usually mirror those of general depression:

• Persistent sadness or hopelessness

• Low energy and motivation

• Feeling overwhelmed or disconnected

• Loss of interest in things you usually enjoy

And there can also be struggles that feel specific to motherhood:

• Difficulty bonding with your bump or baby

• Feeling indifferent or even hostile towards your partner or baby

• Intense guilt linked to “not feeling how I’m supposed to feel”

• Frightening or intrusive thoughts, including fears of harming the baby

Many new mums experience the baby blues in the first couple of weeks after giving birth: tearfulness, mood swings, exhaustion. Baby blues tend to pass on their own within two weeks. If symptoms continue beyond that, or begin later in the first year, it may be postnatal depression.

Perinatal Anxiety

Perinatal anxiety covers antenatal and postnatal anxiety, OCD-like symptoms, and postpartum PTSD.

It often looks like:

• Constant tension, nervousness or dread

• Intrusive thoughts about something terrible happening

• Compulsive behaviours to try to keep the baby safe

• Excessive checking (breathing, temperature, rashes, milestones)

• Feeling unable to trust others to look after your baby

• Panic if separated from them, even briefly

Postpartum PTSD can appear after a traumatic birth experience, with:

• Flashbacks or nightmares

• Hyper-vigilance

• Avoidance of anything that reminds you of the trauma

• Ongoing anxiety and distress

Postpartum Psychosis

Postpartum psychosis is the rarest and most severe perinatal mental health condition, affecting around 1 in 1,000 births. It typically appears suddenly in the days or weeks after birth.

Symptoms can include:

• Rapid mood swings from high energy and euphoria to deep lows

• Confusion and disorientation

• Severe sleep disturbance

• Hallucinations or delusions

• Feeling detached from reality

This condition is a medical emergency and immediate support is essential.

You're Not a Bad Mum

Struggling with your mental health during pregnancy or new parenthood doesn’t mean you are a bad Mum. It shows just how profoundly your life, body and identity are shifting.

Help is available. Recovery is possible. Speaking up is an act of strength, not shame.

If this resonates with you or someone you love, reaching out to your GP, midwife, health visitor, or a perinatal mental health specialist can be the first step toward feeling like yourself again.

You deserve support as much as your baby does. You are already doing something brave by acknowledging how you feel.

Next week we will look at causes and prevention.