Does mental illness get worse during pregnancy?

Does mental illness get worse during pregnancy?

Does mental illness get worse during pregnancy?

During pregnancy women with pre-existing mental illnesses have virtually no issues in their pregnancy. But there is a higher chance of your mental illness coming back or getting worse at this time than at any other time of your life. It is important to spot the signs and treat them early if it happens. Symptoms of severe mental illness can come suddenly during pregnancy and that too may appear in the first few weeks or months during the pregnancy or after the birth so it’s important to know what are the signs of mental illness and how to look out for them.

Pregnant women may suffer from several mental illnesses like depression, anxiety, post-traumatic stress disorder, postpartum depression, and many more. These illnesses may happen for the first time during pregnancy or reappear during this time. So, it is better to prepare and make plans just in case you suffer from mental health or it may get worse.

This will make sure you get the proper care and support you need before and after the birth.

How likely is it that the mental illness will get worse during pregnancy?

It is highly likely that your mental illness could come back or you could get new symptoms.

This may be more likely to happen if:

·       You stop taking your mental health medication when you find out that you are pregnant but there are chances of happening if you continue taking your medication.

·       You have bipolar disorder the symptoms may reappear after the birth and it may result in you developing postpartum psychosis, which is a severe illness that needs treatment straight away.

·       You have had postpartum depression in your previous pregnancy.

·       You have had schizophrenia or another psychotic illness before your pregnancy.

How to Spot early warning signs?

It is better to spot the signs of mental illness early on, so then you can get the required help before it gets worse. Here’s how you can spot the signs:

·       You can keep a mood diary which will help you spot any changes in your mood.

·       Enlist the help of your family and friends as they are closest to you. and your family. They can help you spot any changes in your mood if you let them know what symptoms to look out for.

If you or your family notice any changes in your mood or mental health, speak to your doctor or perinatal mental health team immediately. It’s important to get treatment for your mental illness right away to reduce the risk of harm to you and your baby. The health professionals will then treat you accordingly and will check what support you have at home. They may keep the same treatment or change the course of treatment you’re currently taking.

How to plan ahead for mental illness?

You should plan in advance the treatment plan for your mental health problems because symptoms of some mental illnesses, such as postpartum psychosis can come on suddenly. Your team of perinatal mental health, midwife or doctor can help you make a plan for what will happen in case your mental health worsens. They can tell you about the therapists and support groups that would be available to you.

If there’s a chance of you suffering from postpartum depression after birth, it is wise to have a pre-birth plan meeting at 30-32 weeks of pregnancy. This meeting will help you and your health professionals look after your plan and what care you might need before and after the birth. Make sure you have proper support at home too. If you want you can take your partner, a family member or a friend to the meeting.

Advance care planning

Advance care planning is a way for you to be in control of what happens to you if you become mentally unwell. It will reassure your loved ones that they are following your wishes while you recover.

It is important to have a say in what treatment plan you would like when you’re feeling well. You can say what treatment and care you would or wouldn’t like to receive during pregnancy and during childbirth if your mental illness can get in the way of making your decisions at the time. If you don’t want to make your decisions, you can also choose your partner or family to make decisions for you when you are not in the right state of mind.

There are two ways of making an advance care plan: an advance decision and an advance statement.

1.     Advance decision

When making any decisions in advance you should list any treatments you don’t want to have. This could include your birth plan whether you want it to be natural or through c-sections. It’s a good idea to have written documentation of your advance decision and ask your doctor to sign it. Then health professionals will be liable to take your wishes into account by law but also, they are able to give you the treatment you don’t want if it is an emergency.

  • An advanced decision is a written document that states which treatments you do not want in the future.
  • An advanced decision is also known as an ‘advance directive’ or a ‘living will’.
  • And, an advance decision is a legally binding document.

But you need to be over the age of 18 to make an advance decision.

2.     Advance statement

An advance statement allows you to say what care you and your baby would like to receive. For example, if you need treatment after birth and aren’t able to stay with your baby during that time, an advance statement will tell you who you want to look after your baby.

An advance statement like an advance decision isn’t legally binding but regardless health professionals should take it into account. You should make an advance decision or statement before your pregnancy or during pregnancy, before you develop symptoms of any mental health problems

Making any advance decisions and statements include things that may not happen to you. But knowing that what you want will be taken into consideration can help put your mind at rest. If you want it to be legally binding have your doctor sign the decision or statement. You can then keep a copy of the document and give the other copies to members of your healthcare team.

·       In an advance statement you can state who would you like to manage your affairs, such as paying bills or looking after children.

  • Doctors should follow your advance statement even though there is no legal obligation to do it.

What treatment should you have?

If your mental illness symptoms reappear and you get new symptoms, your doctor may refer you to a therapist and support to help you remain mentally healthy and build your relationship with your baby. For mental health medication, your doctor may change the dose you are already taking or give you a different type of medicine.

In case you suffer from bipolar disorder and decide against taking medication for it during pregnancy, your perinatal mental health team will decide what to do. Either they may suggest you start taking it again during the pregnancy or after the birth to help prevent a relapse. And, if you develop severe mania due to bipolar disorder your doctor might change your medication first. But if the medication does not affect you and your mental health, they may suggest taking lithium.
When your symptoms are severe and there’s a chance your baby would be at high risk and could harm your baby, then your doctor may suggest electroconvulsive therapy (ECT). ECT is not a go-to option for any mental illness and is rarely used. But it can help women in maintaining a mental health balance during pregnancy and after the birth. It is always administered in the hospital and involves passing a small electric current through the brain. If you need ECT, your doctor should talk to you about its risks and benefits.

In case of emergency, your doctor might refer you to a mental health professional or perinatal mental health team if you don’t already shave one. You may need to go to the hospital for treatment.

If your baby is under a year old, then your baby should be able to live with you in the mother and baby unit. You would be required to stay in the unit for a few weeks till your mental health improves and you are able to manage your symptoms at home. It is better to visit and see the mother and baby unit in advance if there’s a chance of you using it after delivery. Ask your mental health team and they will give the required information about the unit and you may have a chance to visit in advance. 

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