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Emotional health and wellbeing for parents and carers

Being a parent can come with lots of challenges and is even more difficult if you’re also experiencing your own mental health problems. Children can often pick up on your mood if you’re feeling anxious or low and sometimes this can affect their behaviour too. While many parents are able to give their children safe and loving care, sometimes their mental health problems affect their ability to cope with family life and they may need extra support.

Understanding your emotional wellbeing during pregnancy and after birth

Having a baby is a huge life changing experience. Whether this is your first child or not, becoming a parent can cause a whole range of emotions. You may be feeling happy, sad, tired or tearful, or sometimes can’t describe how you are feeling. You may be worried about becoming a parent and wonder how relationships in the family may change. This could be linked to thoughts of your own childhood or your current family situation.

Many of these feelings are mild and will resolve with time, but sometimes if they are persistent you may need to speak to your health visitor, GP or midwife to get some additional support as it may be that you are experiencing what is known as a perinatal mental illness.

Whilst depression and anxiety disorders are the most common perinatal mental illnesses, you may be experiencing other conditions or, like many people, may have experienced mental health difficulties prior to having a baby. It is important that you feel able to speak to a family member, friend or health professional if you have any concerns.

Antenatal mood

It is normal to have mixed feelings when expecting a baby. You could be feeling happy or worried about becoming a parent and wondering how relationships in the family may change. This can be linked to thoughts of your own childhood and your current family situation. It’s important to remember all of these feelings are normal and it is often hard to know what to expect.

It can feel like you have to know everything about becoming a parent, but remember you don’t. You will learn this together as your family grows.

Early days

Pregnancy and birth are the first steps in getting to know your baby.

Your baby was born to learn from you. Babies tell you how they are feeling and what they want by crying. As you get to know your baby you will notice the changes in their cry, how they look at you, and how they move. This will help you begin to learn what they need.

Postnatal mood

Having a baby is a huge life changing experience. Whether this is your first child or not, becoming a parent can cause a whole range of emotions. You may be feeling happy, sad, tired or tearful, or sometimes can’t describe how you are feeling. You may be worried about becoming a parent and wonder how relationships in the family may change. This could be linked to thoughts of your own childhood or your current family situation. Many of these feelings are mild and will resolve with time, but sometimes if they are persistent you may need to speak to your health visitor, GP or midwife to get some additional support as it may be that you are experiencing what is known as a perinatal mental illness. Whilst depression and anxiety disorders are the most common perinatal mental illnesses, you may be experiencing other conditions or, like many people, may have experienced mental health difficulties prior to having a baby. It is important that you feel able to speak to a family member, friend or health professional if you have any concerns.

Condition Specific Information

Baby blues

Around half of new mothers experience ‘baby blues’ following the birth of their baby. Some of the symptoms can be:

  • feeling emotional, irritable or overwhelmed
  • being tearful without knowing why
  • feeling low in mood
  • feeling anxious or restless

These symptoms are normal if you've just had a baby. They are usually mild and don't stop you leading a normal life. This can be an upsetting time but should usually pass after 10 - 14 days.

Depression and Anxiety

Depression and anxiety can occur in pregnancy and after birth. The latest research shows that around 10-15 in every 100 women and at least 10 in every 100 men may suffer.

If you are depressed you may be feeling a constant sadness or low mood, have lost interest in the things around you and no longer enjoy the things you used to. You may also be feeling guilty, agitated or blame yourself, and may have difficulties in relating to your baby.

You may be feeling anxious, with or without depression, having lots of fears or worries, feeling nervous or on edge, not sleeping well and you may find yourself avoiding certain situations

Obsessive-Compulsive Disorder (OCD)

Perinatal OCD can affect 2-3 in every 100 women. Many pregnant women and new mothers have a normal increase in some obsessive and compulsive behaviours due to wanting to avoid risks in pregnancy or to protect their new baby. You may find you have unexpected thoughts about your baby being harmed and may find yourself trying to carry out rituals or compulsive behaviours to reduce these thoughts and anxieties. This may include cleaning rituals, excessive checking on your baby or repeatedly seeking reassurance from other people. If these symptoms begin to interfere with normal daily life or bother you for an hour or more every day you should speak to a health professional for further support and advice.

Postpartum Psychosis

Postpartum psychosis is a rare but severe mental illness that affects 1 in every 1000 women. Symptoms most often begin within the first few days of giving birth and include feeling:

  • confused or disoriented
  • excited, high, elated, overactive or very energetic
  • talking a lot, being unable to go to sleep
  • very anxious, paranoid or suspicious
  • hearing, seeing or feeling things that are not there (hallucinations)
  • having unusual beliefs that are not true e.g. that you have special powers or that your baby needs to be protected from something
  • heightened senses e.g. colours appearing more visit than usual

If you or your partner is experiencing what you think might be postpartum psychosis it is important than your see urgent help from your GP or CRISIS line on 111 Option 2, or via A&E.

Most women with postpartum psychosis will become ill very quickly and will require immediate treatment provided by the Specialist Perinatal Mental Health Team and will usually be admitted to a special Mother and Baby Unit.

Birth Trauma

Post-traumatic stress disorder (PTSD) following birth, otherwise known as birth trauma, can affect 1 in every 25 women. Partners who have witnessed a traumatic birth may also experience PTSD.

You may have experienced birth as traumatic if you felt a loss of control, if you felt unsupported or afraid, if your pain relief was not effective, if you were worried that something was going wrong, if you needed an emergency forceps delivery or caesarean section, or if your baby had to be taken to intensive care.

You may be experiencing symptoms such as flashbacks or nightmares and may be feeling jumpy, over-anxious, angry or irritable and having difficulties concentrating or sleeping. You may feel very over-protective of your baby or be experiencing difficulties with feeding or responding to your baby and may be worried you don’t feel a bond with your baby.

You might find it helpful to make an appointment with the Birth Afterthoughts service at the hospital where you had your baby  where you can discuss your birth experience; or find support from the Birth Trauma Association https://www.birthtraumaassociation.org.uk/

Other perinatal mental illnesses

Other conditions such as tokophobia (a fear of pregnancy and childbirth), bipolar disorder, schizophrenia and eating disorders can affect mothers and fathers from all backgrounds and may make it more difficult for you to relate to your baby or respond to their physical and emotional needs. They can also make relationships between you and your partner more challenging as your partner may not know how best to support you.

Although it might feel lonely and frightening it is important to remember that there is support and effective treatment available. Treatment options can range from self-help advice to talking therapies, psychological therapies, medication or inpatient treatment. Most perinatal mental health problems respond well to treatment and have a good recovery rate.

‘Out of the Blue’ is a series of videos that may help  you to understand your mental problems better; to realise that there is nothing you need to feel ashamed about and that you are not the only one feeling this way.

Ideas you might find helpful

  • Speak to your GP, health visitor or midwife about how you are feeling. It is important to get the right support in place.

  •  Try to establish a daily routine, getting enough rest and sleep as well as time to do something for yourself, even if it’s just having a cup of tea, or a soak in the bath.

  • Try to get some gentle regular exercise, or try meditation, mindfulness or deep-breathing.

  • Try to stick to a healthy diet, stop smoking and reduce your alcohol intake -you’ll be surprised how much difference this makes.

  • Make a list and set yourself small realistic goals for each day -don’t try to be super-mum or dad.

  • Find out what is happening locally so that you can meet other parents and feel less isolated.

  • Join online chats or support groups to find others who can share your experiences.

  • Link to our webpage ‘Emotional Development 0-6 months’ for help in responding to your baby.

  • Try to keep a regular routine with good sleeping habits. See: https://www.nhs.uk/live-well/sleep-and-tiredness/how-to-get-to-sleep/ 

  • Try to stay active –this helps to boost your immune system and can help encourage your children to exercise too. Try walking or if you are not able to get out, sit by a window and get some fresh air.

  • Keep in touch with friends and family and let them know how you’re feeling. Don’t be afraid to ask for help.

  • Don’t try to hide your feelings from your children. Try explaining in a way that they might understand e.g. talking about ‘big feelings’ and reassuring them that it’s not their job to look after you. Children say they are less anxious if they are told the truth.

  • If your mental health problems are getting worse seek advice and support from your GP or other health professional. 

     

Who can help?

  • If you’re worried about your mental health, a health professional in our team will be able to offer advice and support. You can Call Us on 0300 029 50 50 or Text Us on 07520 649887 to start a conversation. **Monday to Friday 9.30am - 4.30pm excluding bank holidays.**
  • You can refer yourself to the Psychological Wellbeing Service if you are  aged 17 and over and are suffering from mild to moderate depression or anxiety disorder including generalised anxiety, social anxiety, post-traumatic stress, health anxiety, panic, phobia or obsessive compulsive disorder. Call 0300 300 0055 or complete an online referral: http://www.cpft.nhs.uk/services/pws/psychological-wellbeing-service.htm.
  • For severe or complex mental health needs your health visitor or GP can refer you to the Specialist Perinatal Mental Health Service for further assessment and treatment.
  • If you are  in a mental health crisis and need urgent help please call the First Response Service on 111 and select Option 2.
  • You might be in crisis if:
    • You are thinking of hurting yourself or your baby or suicide seems the only option
    • Someone you know has made threats to hurt you or someone else.
    • You are experiencing extreme distress that seems overwhelming.

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