Postnatal Mental Illness (2)

Question 1

Baby Blues:
When does it occur?

How does it progress?

What are its symptoms?

What can it be due to?

What is a complication of it?

Answer 1

➊ 1st week after birth, particularly in first-time mothers

➋ Not a psychiatric condition, and usually resolves within 1 wk (no treatment required)

➌ Mood swings, Low mood, Anxiety, Irritability, Tearfulness

➍ A combination of:
• Hormonal changes
• Fatigue and sleep deprivation
• Increased responsibility
• Establishing feeding

➎ Disruption to early bonding and breastfeeding

Question 2

Postnatal Depression:
When does it occur?

What are its symptoms?
→ How long do they have to be present for a diagnosis to be made?

How is it managed?

What are its complications?

Answer 2

➊ 3 months – 1 year after birth

➋ That of normal depression – Low mood and energy, Anhedonia
→ 2 wks – Important to find out the timescale of symptoms

➌ Additional support, SSRIs

➍ • Disruption to early bonding and breastfeeding
• Neglect of the baby
• Marital/relationship problems
• Child development and behavioural problems later on
• Maternal suicide or Infanticide in extreme cases

Question 3

Puerperal Psychosis:
When does it occur?

What are its symptoms?

What should be ruled out when investigating it?

How is it managed?

What are its complications?

Answer 3

➊ Few wks after birth

➋ Delusions, Hallucinations, Thought disorder, Depression, Mania, Confusion

➌ Infection

➍ • Admission to mother and baby unit
• Antipsychotics, Lithium (mood stabiliser), Antidepressants

➎ • Neglect of the baby
• Maternal suicide or Infanticide