The perinatal period, which includes pregnancy, birth, and after birth, can be a stressful time for you and your family. Perinatal mental health refers to your emotional, psychological, and social well-being during this time. It relates to how you think, feel, and behave.
Perinatal mental illness occurs when your perinatal mental health is affected negatively, causing distress in your everyday life. The time frame for perinatal mental illness can span from pregnancy to as long as one year after delivery. It can also include illnesses that were present before pregnancy or return during the perinatal period—even after some time of not having problems or symptoms.
Depression is one of the most common perinatal mental illnesses, and it may occur after birth (postpartum) and/or before birth (antepartum). Commonly known as postpartum depression, PPD is temporary and treatable with professional help.
In addition, you can experience other forms of mental health illnesses at any point in the perinatal period. Symptoms can range from mild depression and low levels of anxiety, to more severe forms of depression, anxiety disorders, or even psychosis, which is when you lose touch with reality.
Normal: It’s normal to experience changes in mood—including worry, sadness, and fatigue—during pregnancy. A few reasons you might feel this way include fluctuating hormones, changes related to your body, managing symptoms of other health-related conditions, worrying about the pregnancy/birth/baby, keeping up with everyday life, and a lack of sleep. Many parents experience anxious thoughts, including those related to any other children, work, or caring for older parents. These feelings are a normal part of the adjustment process.
Serious: If these feelings of worry or low mood are more intense and don’t go away within a few days to weeks, it can be a sign of something more serious. get in touch with a health provider or support organization, such as pacific postpartum support society, or visit our resources menu for next steps
Mental health issues during the perinatal period affect 1 in every 4 new mothers. The rates of mental health issues in trans and non-binary new parents is not known, but is thought to be similar.
People of any culture, age, income level, and ethnicity can develop perinatal mental illnesses. Postpartum depression can affect anyone in the family, including the mother, partner, and other family members. In addition, each family member can be affected both directly and indirectly by the person with PPD.
New parents are at highest risk for PPD, so family education and support are key to helping the mother cope and recover. However, anyone in the family can be negatively affected by the stress that comes with the life changes that occur during pregnancy and after birth. For this reason, it’s important for each family member to monitor themselves for any symptoms of depression and anxiety.
Postpartum depression (PPD) is a mental illness affecting a new parent’s mood that may start during pregnancy or at any time up to one year after birth. Generally, it includes severe mood swings (specifically, a low mood), exhaustion and a sense of hopelessness. PPD affects a mother’s ability to go about her day. See below for a list of other common symptoms.
PPD affects up to 20% of new Canadian mothers, and in 50% of the cases, depressive episodes actually begin prior to delivery. If depressive symptoms are felt prior to delivery, it’s important to get help and learn ways to manage them in order to decrease the risk of depression after birth. It is thought that rates of PPD is similar in trans and non-binary new parents.
You may have PPD if you are experiencing sadness (low mood) and/or loss of interest in activities that you previously enjoyed. In addition, if you have at least five of the following symptoms for two weeks or longer you should contact a health professional.
Symptoms may also cause significant impairment or distress in social or work life, or in other daily tasks.
Emotional changes are common during pregnancy and early after delivery, usually peaking around the fourth day and then easing up within the next two weeks. Typically known as the “baby blues,” these changes are not the same as, or necessarily signs of, postpartum depression.
About 80% of women experience the baby blues after birth. The rate of the baby blues in trans and non-binary new parents is not known, but is thought to be similar.
The baby blues usually goes away without treatment. However, if symptoms last longer than two weeks or get worse, including having suicidal thoughts, it may be a sign of postpartum depression.
Perinatal anxiety disorders are a group of disorders characterized by too much fear or worry leading to changes in behaviour. Fear is an emotional response or reaction to a real or perceived threat and anxiety is an example of worrying about a future threat.
About 20% of women experience at least one anxiety-related illness during the perinatal period. The rate of anxiety-related illnesses in trans and non-binary new parents is not known, but is thought to be similar.
Common anxiety disorders during the perinatal period include but are not limited to:
Generalized anxiety disorder is persistent and excessive anxiety about any number of events or activities (e.g. health, children, money, etc.) that cause you to feel significant distress. Often there is no one specific reason for worry but it does tend to disrupt how you function day-to-day.
About 2% of women experience generalized anxiety disorder during the perinatal period. The rate of generalized anxiety disorder in trans and non-binary new parents is not known, but is thought to be similar.
Agoraphobia is the anxiety about, and avoidance of, being in places or situations from which escape might be difficult or impossible (e.g. physical, sexual and/ or psychological abuse, natural disaster, accident). For example, you may not want to drive anywhere with the baby out of fear of a possible car accident.
About 2% of women experience agoraphobia during the perinatal period. The rate of agoraphobia in trans and non-binary new parents is not known, but is thought to be similar.
Panic disorder is an unreasonable level of fear brought on by the presence or anticipation of a specific situation, which leads to unexpected and repeated panic attacks. Panic disorders are often accompanied by agoraphobia.
What is a Panic Attack?
A panic attack is a sudden feeling of intense fear or intense discomfort that reaches a peak within minutes. It’s accompanied by physical and/or emotional symptoms, which include pounding or fast heartbeat, sweating, trembling/shaking, chest pain, dizziness, and/or fear of dying.
About 2% of women experience panic disorder during the perinatal period. The rate of panic disorder in trans and non-binary new parents is not known, but is thought to be similar.
Obsessive-compulsive disorder is the presence of obsessions and/or compulsions. Although many parents experience anxious thoughts often related to the baby’s health and happiness, these thoughts can transform into other thoughts or images of harming the baby that are frightening and shameful to the mother. With proper treatment and support, symptoms of obsessive-compulsive disorder can be well managed.
Obsessions: unwanted thoughts that are persistent, repetitive thoughts or mental images related to the baby. These can be very upsetting. For example, you may find yourself intensely worrying that your baby will be harmed due to contamination by germs/dirt.
People who experience obsessive thoughts typically know they are bizarre, and they are very unlikely to act on them.
Compulsions: repetitive behaviour or mental acts that you feel the need to perform to reduce fears/obsessions. For example, you may be washing/cleaning repeatedly and excessively preventing you from doing other things.
About 2% of women experience obsessive-compulsive disorders during the perinatal period. The rate of obsessive-compulsive disorder in trans and non-binary new parents is not known, but is thought to be similar.
Post-traumatic stress disorder is caused by a real or perceived trauma during delivery or the postpartum period. These traumas could include unexpected medical interventions or emergencies, triggering of past trauma during pregnancy or delivery, severe complications of the mother or child and feelings of powerlessness due to poor communication and/or lack of support and reassurance during the delivery.
About 1% of women experience post-traumatic stress disorder during the perinatal period. The rate of post-traumatic stress in trans and non-binary new parents is not known, but is thought to be similar.
Social anxiety disorder is an intense fear of being criticized, embarrassed, or humiliated, even in everyday situations like making small talk. For example, you may not want to attend prenatal classes, especially those in large groups, because you fear being judged by others.
About 5% of women experience social anxiety disorder during the perinatal period. The rate of social anxiety disorder in trans and non-binary new parents is not known, but is thought to be similar.
Some common phobias include fear about a particular object or situation, such as going near an animal, flying on a plane, or getting an injection.
About 2% of women experience a specific phobia during the perinatal period. The rate of specific phobias in trans and non-binary new parents is not known, but is thought to be similar.
Having anxiety increases a mother’s chance of developing depression, even if she didn’t have depression prior to pregnancy. Life stressors (e.g. lack of support, health concerns, etc.) around pregnancy can risk transition from anxiety disorders to postpartum depression.
About 8% of mothers in Canada experience both PPD and anxiety. The rate of both PPD and anxiety in trans and non-binary new parents is not known, but is thought to be similar.
Postpartum psychosis is experiencing a break from reality where the delusions and beliefs make sense to the person but are not real. Most people don’t harm themselves or others, but there is always a risk of delusional thinking and irrational judgement.
Postpartum psychosis tends to come on suddenly, most often within the first two weeks postpartum. It’s usually temporary and treatable with professional help.
Bipolar has two phases: the lows and the highs. The low is clinically called depression, and the high is called mania or hypomania. This cycle is more than the natural moodiness of pregnancy or postpartum period and can look like severe depression or anxiety.
Your healthcare provider will ask you about these phases or “episodes.” They will ask how long these symptoms last during each episode and to what extent you feel in control. For diagnosis, symptoms must last longer than four days and interfere with daily functioning and relationships.