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.
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 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.