Pregnancy is generally synonymous with happiness for many women: it means that they will bring the world into a new life, made by them.
However, there are many occasions when a woman can suffer from a psychological problem, as pregnancy and motherhood are sources of doubts, fears and, in essence, increase their vulnerability.
The symptoms of all kinds of psychological conditions can be masked by the pregnancy itself, which is why below we will see and understand what they are. psychological problems that can occur during pregnancy.
Common psychological disorders that can appear during pregnancy
Pregnancy is often a time of joy and excitement for most women, eagerly awaiting the arrival of new life in the world. Imagine what name to give her, what clothes to buy for her, what she will want to be when she grows up, if she will look like her father … there are a lot of positive thoughts that can come up when you know you are pregnant and that in a few months, they will give birth.
however, pregnancy is also a intimidating event, Source of a lot of stress, worry and sometimes a real health problem. Emotional ups and downs, temperament and physiological changes, and doubts about whether or not it is better to have a child are issues that can lead to a full-blown mental problem.
In part, the health of the mother is compromised, which is why it is important to know what are the 8 psychological disorders that can arise during pregnancy.
1. Depression in pregnant women
If we say that depression is the most likely disorder that a pregnant woman will suffer from, it surely won’t surprise us. Mood disorders they are the type of disorder most often associated with pregnancy. Many symptoms of depression can be similar to those of a normal pregnancy, such as changes in sleep patterns, changes in appetite, or loss of energy.
About 70% of women show a negative mood during pregnancy, and it has been found that about 14% would meet the diagnostic criteria for depression at 32 weeks. This percentage increases to 17% between weeks 35 and 36. It seems that the first and third semesters are those in which women report being more broken down and depressed, Coinciding with having received the news of her pregnancy and knowing that they will soon give birth.
Risk factors for a pregnant woman to develop depression include: a history of depression, stopping antidepressants if taking them, a history of postpartum depression, and a family history of the disease. too much there are psychosocial correlates that contribute to the emergence of this diagnosis, As negative attitude towards pregnancy, lack of social and family and negative support from partner or family for an unborn new baby.
The effects of depression on pregnant women affect both their health and that of the fetus. It can ensure that a woman does not take her doctor’s recommendations for antenatal care, nutrition and self-management seriously, in addition to putting aside the medications prescribed by the professional or, on the contrary, take medication that she shouldn’t. Thoughts of suicide, autolytic behavior, and damage to the fetus or baby once they are born can also occur.
The treatment used for pregnant women diagnosed with depression is generally the same as for depressed people, but with the added need to ensure fetal safety. Education and family and professional support are essentialSince pregnancy is a unique experience for women, some may not know how the process will play out. In the event that pharmacological treatment is chosen, it will be necessary to assess whether the benefits outweigh the risks.
2. Anxiety disorders during pregnancy
Anxiety disorders are a group of mental disorders related to anxiety and stress. All involve states of hyperactivation of the nervous system and muscle groups, leading the person to be in a state of sustained alertness.
Panic attacks, obsessive-compulsive disorder, generalized anxiety disorder, and social phobia are among the most common. Each of them can occur during pregnancy, some more common than others.
2.1. Panic attacks
Panic attacks are sudden episodes of intense fear that cause severe physical reactionsDespite the absence of real danger or apparent cause. These attacks can cause a lot of fear and make those who suffer from them feel like they are losing control, having a heart attack or even dying.
Some women can have panic attacks during pregnancy. The idea was raised that they could be due to dysfunctions of the thyroid glandBut we must not ignore the possible psychosocial factors likely to favor the appearance of attacks.
Another explanation also of biological origin of panic attacks during pregnancy is the increased resistance of the blood flow in the uterine artery, in addition to changes in cortisol levels in maternal and fetal plasma.
The main treatments for panic attacks during pregnancy include drug therapy, especially benzodiazepines, nighttime sedatives, and antidepressants, although medical approval is required. They can also be treated with cognitive behavioral techniques, relaxation, sleep hygiene and dietary changes.
2.2. Obsessive Compulsive Disorder
Obsessive-Compulsive Disorder (OCD) is characterized by two main symptoms. One is obsessions, which are intrusive and catastrophic thoughts that cannot be removed from consciousness. The other, the compulsions, are repetitive behaviors and rituals that are performed in response to obsessions.
Pregnant women are at greater risk of developing OCD early in pregnancy and also soon after childbirth. In fact, about 40% of pregnant women with this disorder report having started having it early in pregnancy.
It is believed that the onset of OCD during pregnancy is related to the fact that the woman has to worry about an additional reason – the pregnancy itself and how childbirth will happen.
They are very concerned about the health of the baby and they are passionate about being able to control all the variables of pregnancy.But because they can’t, they start having compulsions like pulling their hair, cleaning themselves, eating, putting things away meticulously …
The treatments available are the same as for non-pregnant people, cognitive behavioral therapy and pharmacotherapy. There is also an education, making it clear to the pregnant woman that while she absolutely cannot control everything she does with her pregnancy, there are healthy habits that will positively influence her health and that of the baby.
2.3. Generalized anxiety disorder
Generalized anxiety disorder is characterized by a constant state of alertness, with a tendency to be very irritable by any mild stimulus. Outraged, people with this disorder can easily experience panic episodesSurprise excessively and suffer from seizures, dizziness and profuse sweating.
About 10% of pregnant women meet the diagnostic criteria for generalized anxiety disorder at some point in pregnancy. Between risk factors for developing this disorder during pregnancy presented it before, in addition to a lack of information on how pregnancy can develop, lack of social and family support and a history of child abuse.
Some of the Therapies that may be effective for pregnant women with this disorder are mindfulness, situational acceptance, and behavioral activation strategies.
2.4. Social phobia
Social phobia is an anxiety disorder that involves the patient living extreme shyness and inhibition, accompanied by a lot of anxiety, in the face of social situations. The person feels uncomfortable when they go out on the streets, see other strangers, or have to deal with situations where they have to meet a new person.
There isn’t a lot of data on social phobia during pregnancy. Yes, it has been observed that it can appear in some cases, due to the fear that people will see them his physical changes, especially if there were not many people who knew he was in good shape. too much it may be due to a drop in your self-esteemAs the physical changes that pregnancy involves are usually not viewed as positive.
3. Eating disorders during pregnancy
The prevalence of eating disorders in pregnant women is close to 5%. Among the reasons that push a woman to change her eating habits, we find obsession with not wanting to gain weight, worrying too much about eating whatever the baby thinks the baby needs or simply bring desires to extreme cases. There may even be cases of itching, causing the woman to eat things that are not theoretically edible (eg, wrapping paper, sucking on coins)
Having an eating disorder appears to increase the risk of a cesarean delivery, in addition to suffering from postpartum depression. Also, as can be the case if a woman follows a diet that does not contain all of the necessary nutrients, there is a greater risk of miscarriage or that if the baby is born, she will weigh much less than expected. .
4. Schizophrenia and pregnancy
Episodes of psychosis during pregnancy are a really strange phenomenon, although they can happen. This is especially common in women who already have a history of schizophrenia. Pregnancy is an experience that can cause a lot of mental disorders, being catastrophic in people who do not have it completely.
Some women may experience delusional symptoms of schizophrenia that they may deny being pregnant, even if they show obvious signs of it. This could be understood as the opposite of what a psychological pregnancy is. In the postpartum period, these women may be particularly susceptible to subsequent psychotic episodes.
Find relationships between schizophrenic disorder and premature rupture of the membrane, gestational age less than 37 weeks, and use of incubator and resuscitation. Relationships have also been found between the mother with schizophrenia and premature birth, in addition to being associated with low birth weight.
Treatment mainly focuses on psychoeducation, which could reduce the risk of complications during pregnancy. Brief therapies focused on each individual case may also be helpful for some patients. Regarding pharmacological treatment, clozapine has been tested in pregnant women and women with schizophrenia, as they involve little risk during pregnancy, childbirth and the health of mother and baby.
5. Bipolar disorder
Pregnancy is a time when mood swings are expected. However, if these changes happen very suddenly, they are very frequent and intense, they are cause for concern because it could be called a case of bipolar disorder. The main risk factor for occurring during pregnancy is have a history of this disorder and have stopped medication.
It is common for women who received treatment with mood stabilizers when they become pregnant to give up on it because they consider it harmful to their baby. When you leave them, the sudden mood swings return, manifesting the symptoms of the disorder.
If it is normal that he cannot take mood stabilizers, it will be a decision of the psychiatrist that the woman can consume during pregnancy, Provided that the benefits outweigh the potential risks. Some of the factors to consider when deciding whether or not to prescribe these medications will be the number and severity of manic and depressive episodes, level of insight, family support, and the person’s own desires.
What should be done to avoid them?
Each woman is a world apart and her pregnancy experience is unique. It is not possible to wait until all women, after receiving the same advice or treatment, develop the same type of pregnancy and experience it the same way. It is also possible to reduce the severity of any psychiatric disorders that may appear with adequate monitoring of their psychological state and psychoeducation.
There is no doubt that pregnancy can be a source of psychological distress, especially if it is not managed properly. For this reason, there are many psychologists and psychiatrists who specialize in the mental health of pregnant women, knowing which treatments, both preventive and to treat an emerging disorder, are most appropriate for this population. They are experts in detecting and intervening in psychological problems that pregnant women may manifest.
During pregnancy, one should not only take into account the physiological and temperamental changes that a woman may experience. Outraged, it is necessary to assess whether he is receiving good psychosocial support, How excited she is about the new life she has brought to the world, whether she really wants to have a baby, and how much her environment pushes her to have it or not.
- American Psychiatric Association (2013), Diagnostic and Statistical Manual of Mental Disorders. Arlington: American Psychiatric Publishing.
- The United States Congress of Obstetricians and Gynecologists (2019). Depression and Postpartum Depression: A Resource Overview.