Impact of Preexisting Mental Illnesses on Pregnancy and Motherhood

Mental disorders are very common among women of the reproductive age. In fact, according to the World Health Organisation, 10% to 16% of pregnant women and 13% to 20% of women in the postpartum phase suffer from a range of mental health disorders worldwide, with the most common diagnosis being depression. Studies have also indicated that those who discontinue medications for a psychiatric illness over the course of their pregnancy are particularly vulnerable. A study estimated that the women who discontinued medication were five times as likely to fall back into a relapse when compared to those women who continued with the medication (Cohen, L. S et al., 2006). The bodily changes that may accompany pregnancy and motherhood can increase the vulnerability to developing psychiatric conditions such as anxiety disorders, eating disorders, and depression. Most of these conditions often go undiagnosed as they are attributed to pregnancy-related changes in physiology and temperament. It is important to contact a mental health professional for help if you notice any changes in yourself or a close one.

Until recently, most of the literature focused on the mental health of the mother and child through the postpartum period. However, studies have begun to show that parental anxiety and depression during the pregnancy term can lead to neglectful behaviour such as exposure to tobacco and alcohol. Furthermore, maternal mental health through the period of pregnancy itself can affect the child. Animal studies done on rats prove that babies that are exposed to more stress while in the womb can have highly activated amygdalas which can increase the risk of them developing anxiety disorders (Soares-Cunha et al., 2018). Another study (Dawson et al., 1992) implicated less activity in regions of the brain that control emotions, among babies born to mothers with pre-existing depressive symptoms.. Additionally, studies have highlighted that babies born to mothers with depression or eating disorders during pregnancy tend to have lower birth weight, or may even be born prematurely. One study reported that infants of depressed mothers showed less frequent positive facial expressions and vocalisations and were harder to console (Field et al., 2009).

Depression during pregnancy is often correlated with the use of tobacco, alcohol and other drugs that can harm both the baby and the developing foetus. Untreated depression over the course of pregnancy can also affect the bond between the mother and child. The presence of depressive symptoms through the period of pregnancy even poses a greater risk for developing postpartum depression: a serious depressive disorder that is characterised by physical, emotional, and behavioural changes in the mother, after giving birth.

The prevalence of eating disorders during pregnancy is 4.9%. Although some studies suggest that the severity of the symptoms reduces during the term (due to the mother’s worries about its adverse effects on her unborn child), several others suggest negative consequences such as a greater risk for cesarean delivery and developing postpartum depression due to the accompanying weight gain and change in body shape. Two studies found that while symptoms of bulimia nervosa may improve during the course, anorexia nervosa was most likely to relapse after birth (Rocco et al., 2005; Blais et al., 2000). Evidence-based on whether or not eating disorders impact pregnancy and the foetus is limited and quite conflicting. Overall, the studies imply that women with bulimia nervosa are more likely to suffer from a miscarriage, whereas, those with anorexia nervosa are likely to have smaller babies (Micali et al., 2007). However, a recent Swedish study suggests that anorexia nervosa may not be associated at all with pregnancy outcomes (Ekeus et al., 2006).

Psychoses can have devastating consequences such as failure to obtain adequate prenatal care, neonaticide and suicide. Women with

If a mother has a history of a pre-existing mental illness it is crucial for both them and the baby to continue with the appropriate treatment during the course of pregnancy and postpartum. Psychotherapies such as cognitive behavioural therapy, interpersonal therapy, relaxation techniques, dietary counselling, sleep hygiene, and supportive psychotherapy make for effective treatment options for the same. Medication is also commonly used to control the severity of symptoms that the mother may be showing. However, mothers must make sure to speak to a General Practitioner or obstetrician to make sure that the drugs that have been prescribed are safe to consume over and after the course of their pregnancy.

References

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2. Leight, K., Fitelson, E., Weston, C. and Wisner, K., 2010. Childbirth and mental disorders. International Review of Psychiatry, 22(5), pp.453-471.

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4. MGH Center for Women's Mental Health. 2022. Psychiatric Disorders During Pregnancy. [online] Available at: <https://womensmentalhealth.org/specialty-clinics/psychiatric-disorders-during-pregnancy/> [Accessed 9 April 2022].

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