Definitions

Perinatal period

refers to the period of time from conception to the end of the first year after the birth.

Mental health

refers to a person’s emotional wellness and ability to enjoy life.

Mental illness or disorder

is a psychological or emotional condition which prevents a person from functioning normally, over a period of time.

Mental distress

is when a person experiences a range of possible symptoms that are troubling, confusing or out of the ordinary. It differs from mental illness/disorder in that it  lasts for a shorter period of time and may be less severe.

Baby blues

is a temporary psychological state. It usually starts on the third day after delivery and is probably linked to hormonal changes. It involves sudden mood swings (feeling very happy, then very sad), crying for no apparent reason, feeling impatient, unusually irritable, restless, anxious, lonely and sad. These symptoms last only a few hours or as long as one to two weeks after delivery, and resolve with compassionate support.

However, if these emotions and feelings continue and become so bad that they interfere with a woman’s daily life, and she has difficulty with carrying out her usual daily tasks, then it is possible that she is suffering from a mental illness. The ‘baby blues’ needs to be monitored carefully as about 20% of women who experience the ‘baby blues’ will progress to having postnatal depression.

Depression

is characterised by low mood, loss of interest and enjoyment, as well as reduced energy for at least two to four weeks. Other common symptoms of depression include:

  • Extreme sadness, tearfulness
  • Difficulty in concentrating, forgetfulness
  • Disturbed appetite or sleep (too much or too little)
  • Thoughts that one is worthless (low self-esteem)
  • Feelings of guilt
  • Helplessness
  • Irritability
  • Extreme tiredness
  • Loss of sex drive
  • Many physical symptoms such as body aches and pains
  • Ideas or attempts of self-harm or suicide.

In severe cases, depressed people may have symptoms of a psychotic disorder.

Anxiety

is characterised by an abnormal and great sense of uneasiness, worry or fear. Symptoms of anxiety include emotional symptoms such as:

  • Nervousness
  • Worry
  • Panic
  • Irritability
  • Feeling of dread
  • Tiredness
  • Fear of being alone.

Physical symptoms of anxiety include:

  • Sleep disturbance
  • Physical tension
  • Sweating
  • Increased pulse
  • Muscle tightness
  • Body aches or stomach problems (for example, feeling sick, diarrhoea)
  • Difficulty concentrating.

These symptoms are normal if there is a real threat present. However, when someone suffers from these symptoms in response to ordinary events, and the symptoms interfere with daily tasks, then it is known as an anxiety disorder.

Post-Traumatic Stress Disorder

is a common anxiety disorder where a traumatic event or extreme hardship from the past is repeatedly re-experienced emotionally. The traumatic event is usually associated with serious physical, emotional or psychological harm, or the threat of harm.

Women who have experienced rape, sexual or emotional abuse, crime, torture or war, or previous traumatic birth experiences (such as previous emergency Caesarean section or stillbirth) are particularly at risk of developing PTSD during or after pregnancy. Pregnancy can act as a trigger for negative memories of past traumas.

Obsessive-Compulsive Disorder

is one of the more common mental illnesses occurring during the perinatal period. Women already suffering from OCD are likely to experience a worsening of symptoms during pregnancy.

OCD is characterised by obsessive thoughts. In addition, compulsive behaviours are present to relieve the stress associated with the obsessive thoughts. Symptoms can range from mild to severe. Persons with OCD experience ‘obsessive’ or unwanted thoughts that occur repeatedly in their mind. For example, a woman with OCD may have:

  • constant fears that harm can come to herself or a loved one
  • an unreasonable concern with becoming sick or infected with a disease
  • an overwhelming need to do things correctly or perfectly.

The woman experiences the disturbing thoughts again and again. They are unpleasant and they produce high levels of anxiety. These obsessions cause the woman to act out repetitive or compulsive (acting from compulsion, against one’s conscious wishes) behaviours, such as:

  • washing hands often because of fear of contamination
  • checking and re-checking things
  • storing things unnecessarily or excessively
  • counting
  • making lists
  • repeating phrases to herself
  • following certain patterns of behaviour like a ritual.

Risk factors

is something that increases the chance of a person developing a particular illness or disease. Therefore, a risk factor will increase the likelihood or chance of suffering from an illness, harm or loss.

NOTE
Smoking is an example of a risk factor as it is associated with an increased likelihood of lung cancer. However, not all people who smoke develop lung cancer while not all people with lung cancer smoked.

For more information on risk factors specific to the perinatal period see our MMH facts pages.

 

More mental health related definitions

Co-morbidity

refers to the presence of two or more mental or physical disorders at the same time. Often co-morbid disorders affect each other negatively.

It is possible for a woman to suffer from both depression and another mental disorder at the same time, such as anxiety or alcohol and substance use disorder. In this case, a combination of symptoms from different disorders will be present. All of them must be addressed and treated to improve the woman’s mental health.

 

Phobias

are common anxiety disorders. They are classified as an unreasonable fear of a certain object or situation. People experiencing phobias will go to great lengths to avoid the feared object or situation. If it cannot be avoided, the individual experiences great distress and anxiety.

Tocophobia

is an abnormal and persistent fear of childbirth. It occurs in all cultures and social groups and affects one in seven women. It can be related to previous traumatic birth experiences, sexual abuse or rape, or exaggerated stories of painful labour and birth. Sometimes, it can lead to a frightening or traumatic delivery. In such cases:

  • The mother may be uncooperative – panicking or displaying aggression.
  • She may experience an obstructed or prolonged labour.
  • She may be at increased risk of needing a Caesarean section.

Manic episodes

are periods of extremely elevated mood, that lasts at least for one week. There is usually a decrease in the need for sleep and an increase in racing thoughts and ideas which causes an impairment in normal functioning. 

Bipolar affective disorder

also known as manic-depressive illness, is a disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. These moods range from periods of extremely elated and energized behavior or irritable/aggressive behavior (known as manic episodes) to very sad or hopeless periods (known as depressive episodes).

 

Psychosis

is a symptom of mental illness  whereby a person loses touch with reality and can experience hallucinations (seeing/hearing things that are not real) or delusions (thinking/believing things that are not real). Psychosis  is used to describe unusual or out of the ordinary behavior, thinking or speech that is not connected to reality.

Schizophrenia

is a chronic, severe mental disorder in which people interpret reality abnormally. Symptoms like hallucinations, delusions, and extremely disordered thinking and behavior can occur. Schizophrenia does not mean a split personality or multiple personality.

Alcohol or substance use disorders

is the recurring harmful use of alcohol or other substances despite its negative consequences. Alcohol or other substance use among pregnant women is associated with poor physical and mental health outcomes for mothers and children during and after pregnancy.