Am I at risk? Perinatal mental health risk factors

A time of increased risk

For women, there are obvious changes to your body during pregnancy, birth, and early parenthood. Both parents will experience changes to daily routines, sleep patterns, priorities, financial commitments and relationships (just to name a few).  This all takes a lot of adjusting to.  The range of factors and degree of adjustment needed all vary from one person to another.

The significance of this adjustment for women makes the perinatal period – pregnancy and the first year following the birth of a baby – the time of life when women are most likely to experience emotional and mental health problems. It also prompts many women to ask, “Am I at risk?”

What are some mental health risk factors?

There are a number of risk factors that may increase the likelihood of experiencing emotional and mental health issues at this time: 

• Past or previous mental health problems
• Having a perfectionistic personality or having a strong need for routine or order in your life
• Previous or current abuse (sexual, physical or psychological)
• Previous or current drug and/or alcohol use
• Recent life stressors (e.g. moving house, financial worries, relationship problems, IVF, multiple birth)
• Being in an abusive or violent relationship
• Lack of practical and emotional support
• Poor relationship with your own mother.

People living with an illness or a disability also face additional challenges which can increase their risk of mental health distress. 

Research has also shown that women of refugee background are at increased risk of experiencing perinatal anxiety and depression due to experiences through both the asylum seeking and resettlement processes. 

Risk can be exacerbated by stressors such as separation from family, cultural differences, language barriers, and navigating a complex health system.

Having one or more of these risk factors does not mean that you will necessarily develop or experience mental health issues. However, it can still be very useful to increase your awareness of these issues and what to look for.

If you have a history of mental health conditions

If you have experienced mental health conditions in the past, this can increase your likelihood that these (or other) mental health conditions may arise in pregnancy (or after having your baby).

This is why often health professionals will ask you if you have ever experienced conditions like anxiety, depression or other mental health conditions in the past, or if mental health problems may run in your family.

This does not automatically mean that you will develop a mental health condition at this time – just that your risk may be higher.

Be aware and stay informed

It is useful to prepare yourself by being aware of your risk and staying informed and informed. One way to do this is by learning about the different signs of and symptoms of anxiety and depression that can arise in pregnancy – as well as being informed about the more serious mental health conditions such as bipolar disorder.

Often women may find it useful to reflect on other times that they may have experienced such a condition or ‘episode’ and try to remember what some of the possible early signs were that this was occurring.

By being aware of what to look and informed – particularly about your own personal ‘cues’ - places you in the best possible position to identify if any symptoms, as soon as possible. Ultimately this will allow you to access safe and effective help and treatments as soon as possible.

By seeking help early, you can work with your health professional reduce your feelings of distress in pregnancy, and you can be in as good a space as possible before the baby arrives.

Mental health risk factors for men

While rates of depression and anxiety are often reported to be high for men, evidence suggests that these rates are not significantly greater than times outside the perinatal (antenatal and postnatal) period. 

That is not to say the stress levels may increase, as this is compounded by change of routines, responsibilities and sleep. Research does, however, tell us that, if a woman is experiencing depression, the rates of depression in men significantly increase.  In fact, men are 50% more likely to develop postnatal depression if their partner has depression at this time.

How to be best prepared for parenthood

In addition to thinking about your ‘readiness for parenthood’, it’s also a good time to reflect on your own personal experiences and circumstances, individually and as a couple.  For example, it’s useful to consider whether you or a family member may have experienced stress, depression, anxiety or other mental health problems in the past and how you managed this.

Parenthood can also bring up your own experiences as a child or with your parents. It can also exacerbate other personal or relationship issues.  Consider other factors in the context of having a baby, such as your access to practical, emotional, social and financial support.

It is also important to consider whether you are taking any medications which may impact on your fertility and/or whether they are safe to use while pregnant.  Some medications (such as for conditions like bipolar disorder, for example) should not be used in pregnancy. Seek advice from a specialist psychiatrist if you are in any doubt.

Being aware and informed gives you the opportunity to be proactive. Educate yourself, become aware of what to look for and get help early.  Like most physical problems, the faster you identify the risk or presence of a problem, the faster you can seek safe and effective help – and recover.

Are you are worried or do you feel distressed at this early stage in your perinatal journey? If so, it can be a good idea to seek help from a professional sooner rather than later. In the same way that you want to be physically healthy, it’s important to be mentally healthy before embarking on one of the biggest journeys you will ever make – the journey into parenthood.