how to manage anxiety in pregnancy and postpartum psychosis

Every year we work with hundreds of mums and mums-to-be, supporting their emotional and physical wellbeing through all stages of motherhood, including pre-conception, pregnancy and life as a new mum.

Mother and Baby Magazine asked us for our expert advice on maternal mental health. In this interview, David James Lees’ offers his guidance on how to understand and deal with anxiety in pregnancy and the symptoms of postpartum psychosis.

I believe that it is beneficial for both baby and mother to have an anxiety and stress-free pregnancy and to fully enjoy this amazing period together…”

Extracts from this interview were featured in the April 2017 online edition of Mother & Baby Magazine.

full interview

anxiety in pregnancy: the symptoms & solution

Can you get anxiety while pregnant?

Yes, anxiety is a description of an emotional feeling, which can be experienced during pregnancy, as with any other time of your life.

What are the signs?

Unpleasant physiological feelings such as restlessness, palpitations, fatigue, muscular tension, tiredness and problems with concentration.

In relation to your mindset and thoughts, it can include a mental projection of possible negative future outcomes, or worrying about difficult scenarios that would be challenging to deal with if encountered.

Can anxiety during pregnancy harm my baby?

This is a debatable point. There is no direct unrefuted evidence of any short or long-term harm to the baby in the womb, although it is a subject of ongoing research and testing.

I do, however, believe that it is beneficial for both baby and mother to have an anxiety and stress-free pregnancy and to fully enjoy this amazing period together.

How do I reduce anxiety in pregnancy?

Planning for a healthy and anxiety-free pregnancy should begin before conception. Just as you would get yourself physically fit for pregnancy by ensuring you eat, sleep and exercise well, it is equally important to create a strong emotional self-care regime. Prevention is always better than cure!

So, the first steps should be taken prior to pregnancy, to ensure that the mother has no emotional issues or upsets left unresolved that relate to any part of the pregnancy, birth or her ongoing support.

It is sometimes also wrongly believed that the arrival of a new baby will be the solution to any existing life or relationship problems. The reality is that the baby frequently highlights them. It’s therefore important that these broader issues should also be worked through to pave the way to an emotionally balanced and harmonious pregnancy and motherhood.

The second step, once in pregnancy, is for the mother to continue to take the time to nurture her physical and emotional health. Along with an appropriate physical routine to encourage suppleness and flexibility, I would strongly recommend simple mindfulness meditation.

Mindfulness practice can be used during pregnancy, childbirth and beyond, as a supportive and healing tool that benefits both mind and body. It can take just ten minutes a day and will allow a mother to calm and relax her mind and regain control of her thinking if it is overdrive or negative thoughts are arising. For busy mums, mindfulness can even be practised whilst waiting for the kettle to boil – you don’t need a special time or place to do it!

Mindfulness meditation can also be combined with positive visualisations. This will help a mother manage and reduce any unwanted and unhelpful thoughts around a particular future situation (for example, childbirth) by creating more inspiring and meaningful scenarios and outcomes in her mind.

postpartum psychosis: what you need to know

What is postpartum psychosis?

This is a diagnosis of a severe mental illness that can affect around one in every 1,000 women who give birth. It manifests in delusional thinking and hallucinations, which are symptoms of psychosis. Sufferers may also experience out of character experiences such as high or low moods, loss of inhibitions, restlessness or agitation, and sometimes confusion.

What causes it and who’s at risk?

Again, the jury is out on this. Current thinking is that it stems from the disruption in hormones after the birth of your child, which is made worse by a lack of sleep or disrupted sleep patterns.

It can happen without warning to the unfortunate 1 in 1,000. There are, however, certain risk factors that could increase the chances of developing it. These include: if you have suffered from bipolar disorder/manic depression; if you have previously suffered from postpartum psychosis before; if you suffered from severe mental illness during your pregnancy, or if there is a family history of mental illness.

First-time mums are at higher risk of developing this condition particularly if the birth has been complicated or traumatic. It is important to state that having any of the above risk factors does NOT mean you will become ill after the birth of your child. I have worked with many mothers with these risk factors who have not developed this condition after childbirth.

Can postpartum psychosis be cured?

Yes! …BUT quick early action is required because it responds so very well to early treatment. It will not improve by ignoring it or hoping it will go away.

Treatment will depend on both the nature of the condition and the patient. Most mother’s symptoms will clear up after a few weeks with no reoccurrence.

Do not be concerned about speaking out and asking for help. Your midwife and G.P. will not judge or criticise you, rather they will give you professional guidance and medical support during this rare occurrence.

Will I get ill again?

Chances of reoccurrence are low, but, because your risk factors have now increased, your G.P. and midwife should be aware of your previous circumstances so that they can advise you on the correct approach.

Mothers and their partners can develop a birth and after-care plan based on the knowledge and experience of what worked best for them the last time, just in case they encounter something similar after their current birth.

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