19ĭepression is never trivial in mothers. For a depressed young person, sexual activity and the associated risks may be seen as a diversion, a relief of tension or a salve of affection seeking-a self medication with sex. Risk taking may represent an indirect expression of anger or a mechanism for exerting control over one’s life. With regard to sexual initiation, other questions arise, such as the role of sexual abuse-also a major precursor to mental health disorder. 18 Even clinical depression was associated with increased rates of “risky sex”, sexually transmitted diseases, and early sexual experience. Ramrakha et al identified an increased probability of “risky sex” across a range of mental health diagnoses. Furthermore, depressed women are more likely to improve after childbirth. Their data suggest that childbirth is less likely than the events of pregnancy to be followed by depression in women who are not depressed. 16 They suggest that postnatal depression is not a distinct syndrome. Evans et al suggest that the proportion of women rating themselves as severely depressed was similar before and after childbirth. 13 More recent studies, such as those by Menzies 14 and Knauer, 15 have reinforced the extent and severity of prenatal depression. He called this “puerperal insanity” and included recurrent prenatal depression. There is good research, dating back to that of Esquirol in 1818, describing all pregnancy related mental illness. Psychopathological symptoms during pregnancy have physiological consequences for the fetus and this may explain some of these effects. 11 Depressed mood during pregnancy has also been associated with poor attendance at antenatal clinic, substance misuse, low birth weight, and preterm delivery.

Watson et al found that in 23% of those with postnatal depression, this had started during pregnancy. Studies of antenatal psychopathology have mostly examined antenatal mood as a predictor of postnatal depression. Indeed, pregnancy has been thought to protect against depression. In contrast, depression during pregnancy has been relatively neglected. Research also suggests that the babies may develop emotional or behavioural problems or cognitive delays in childhood.

4– 7 Postnatal depression has become a focus of concern and the consequences to the child, mother, and family may include neglect of the child, family breakdown, self harm, and suicide. 3ĭEPRESSION RELATED TO PREGNANCY AND CHILDBIRTHĪlthough depressive illness is often perceived as a disorder of postnatal mothers it is, in fact, as common in pregnant women. 2 Some level of anxiety may be protective and a portrait of the primiparous woman most likely to have a positive birth experience was proposed as anxious and realistically fearful, yet competent in her knowledge of labour and delivery.

1 Paradoxically, some women with a pregravid anxiety disorder have a decrease of symptoms in the first trimester. First medically described by Marcé in the 18th century, the disorders of anxiety during pregnancy, especially those in the first trimester have profound features of turmoil. There are disorders in which anxiety is the primary symptom of a pathological mental state. Anxiety and fear of pregnancy and childbirth are documented features of eating disorders, mood disorders, and pathological dread and avoidance of childbirth or tokophobia. It is not the purpose of this paper to comment on psychiatric and psychological descriptions of the “normal” pregnant woman but concentrate on some pathological psychiatric conditions that may effect pregnant women. Lthough the state of pregnancy is both normal for, and often desired by, women in early adulthood, it is not uncommon to experience anxiety at the physical and emotional consequences of the gravid state.

Normal fear vs pathological fear