Anxiety Disorders
- Rates of anxiety are more common in the perinatal period then non perinatal population and can co-exist with depression
- Up to 8.5 per cent of women will develop an anxiety disorder in the perinatal period
- Signs and symptoms vary depending on the type of anxiety disorder
- Most common perinatal anxiety disorders are general anxiety disorder, panic attack, obsessive compulsive disorder
Most common symptoms:
- Sleep disturbance
- Concentration difficulties
- Excessive worry, fear and distress often over the pregnancy, deliver, fetus/baby.
- Distressful recurrent unwelcomed thoughts or ideas
- Coping and social functioning difficulties
Postpartum psychosis
- Symptoms most often appear with 72 hours to four weeks after delivery
- Postpartum psychosis is an emergency, hospitalization is required
- Women with history of postpartum psychosis have grate then 50 per cent chance of re-developing
- Rare (approx. 1-2 cases per 1000 live births)
Symptoms can include:
- Thinking and acting in unusual ways
- Hallucinating or having strange thoughts, for example that their baby is evil
- Feeling paranoid or thinking others want to harm them
- Believing they have special powers
Bipolar Disorder in the Perinatal Period
- There is no evidence of an increased chance of developing bipolar disorder during pregnancy
- Women with Bipolar Disorder are at a higher risk of experiencing manic or depressive episodes in the perinatal period
- There is an increased risk of the development of bipolar disorder in the postpartum period for women with a personal and or family history of a mood disorder or postpartum psychosis
- The rate of postpartum psychosis for women with untreated Bipolar Disorder is 10 to 20 per cent
Risk Factors
Many risk factors for developing mood and/or anxiety during pregnancy or the postpartum period have been identified.
Major risk factors:
- Current diagnosis of depression or anxiety or past history
- History of perinatal depression or anxiety
- Family history of depression, anxiety or psychiatric illness (especially during pregnancy or postpartum)
Other contributing risk factors:
- Lack of social support
- Life stress – recent move, poor relationships, losses
- Language issues
- Domestic violence
- Excessive anxiety during pregnancy
- Unintended pregnancy
- Ambivalence towards the pregnancy
- Financial stress
- Smoking and caffeine intake
- Single status, living by self
- Health problems or difficult temperaments with baby or other children
- Chronic health problems, pregnancy/delivery complications
- Discontinuing or decreasing antidepressant medication
