The 8 psychological disorders that can arise during pregnancy

Normally, pregnancy is synonymous with happiness for many women: it means that they are going to bring the world to a new life, made by them.

However, there are many occasions in which women may suffer from a problem psychological, since pregnancy and motherhood are the focus 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 we are going to see and understand what they are below. psychological disorders that may arise during pregnancy.

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Common psychological disorders that can appear during pregnancy

Pregnancy is usually a time of joy and excitement for most women, anxiously awaiting the arrival of a new life in the world. They can imagine what name to give her, what clothes to buy her, what she will want to be when she grows up, if she will look like her father... there are many positive thoughts that can appear when knowing that they are pregnant and that in a few months they will give birth.

However, pregnancy is also an intimidating event, source of a lot of stress, worry and, sometimes, a real health problem. Emotional ups and downs, temperamental and physiological changes, and doubts about whether the most whether or not it is convenient to have a child are issues that can lead to a mental problem throughout rule.

In part, the mother's health is compromised, and this 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 suffers from, it surely does not surprise us. Mood disorders are the type of disorder most commonly associated with pregnancy. Many of the symptoms of depression can resemble 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 seen that about 14% would meet diagnostic criteria for depression at 32 weeks. This percentage rises to 17% when they are between weeks 35 and 36. It seems that the first and third semesters are those in which women report being the most down and depressed, coinciding with having received the news of her pregnancy and knowing that they will soon give birth.

Among the risk factors for a pregnant woman to suffer depression we have: history of depression, stopping taking antidepressants if she takes them, a history of postpartum depression and a family history of this disorder. Also there are psychosocial correlates that contribute to the appearance of this diagnosis, such as a negative attitude towards pregnancy, lack of social and family support and negative from the partner or family for a new baby to come.

The effects of depression in pregnant women affect both their health and that of the fetus. It can cause a woman to not take seriously her doctor's recommendations for prenatal care, nutrition, and self-care, in addition to leaving aside the medication prescribed by the professional or, on the other hand, taking drugs that do not should. Suicidal thoughts, self-injurious behavior and harm to the fetus or baby can also appear once she is born.

The treatment used for pregnant women diagnosed with depression is usually the same as for depressed people, although with the additional need to ensure the safety of the fetus. Education and family and professional support are essentialSince pregnancy is a unique experience for women, some may not know how the process will develop. In the event that pharmacological treatment is chosen, it will be necessary to assess whether the benefits outweigh the risks.

2. Anxiety Disorders in Pregnancy

Anxiety disorders are a group of mental disorders that are linked to anxiety and stress. All of them suppose states of hyperactivation of the nervous system and muscle groups, leading the person to be in a sustained state of alert.

Among the most common we have panic attacks, Obsessive-Compulsive Disorder, generalized anxiety disorder, and social phobia. Each of them can occur in pregnancy, some being more common than others.

2.1. Panic attacks

Panic attacks are sudden episodes of intense fear that cause severe physical reactions, despite there being no real danger or apparent cause. These attacks can be very scary and make the sufferer feel that they are losing control, have a heart attack or are even going to die.

Some women can experience panic attacks during pregnancy. The idea has been raised that they could be due to dysfunctions in the thyroid gland, but the possible psychosocial factors that can promote the appearance of attacks should not be ignored.

Another explanation also of biological origin for panic attacks during pregnancy are the increased resistance of blood flow in the uterine artery, in addition to the changes in cortisol levels in the plasma of the mother and fetus.

The main treatments for panic attacks during pregnancy include therapies pharmacological drugs, especially benzodiazepines, sedatives at night and antidepressants, although doctor's approval. They can also be treated with cognitive-behavioral, relaxation techniques, sleep hygiene, and dietary changes.

2.2. Obsessive-Compulsive Disorder

The TObsessive-Compulsive Rash (OCD) is characterized by two main symptoms. One is obsessions, which are intrusive and catastrophic thoughts, which cannot be eliminated from consciousness. The other, compulsions, are repetitive behaviors and rituals performed in response to obsessions.

Pregnant women are at higher risk of developing OCD early in pregnancy and shortly after giving birth. In fact, about 40% of pregnant patients with this disorder indicate having started to manifest it early in their pregnancy.

It is believed that the appearance of OCD during pregnancy is related to the fact that the woman has to worry about an extra reason: the pregnancy itself and how the birth will take place.

They care a lot about how healthy the baby will be, and they fervently want to be able to control all the variables of the gestation, but since they cannot, they begin to perform compulsions such as pulling their hair, cleaning themselves, eating, ordering things meticulously ...

The available treatments are the same as for non-pregnant people, cognitive behavioral therapy and drug therapy. There is also education, specifying to the pregnant woman that although she cannot control absolutely everything Concerning 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 minimally annoying stimulus. What's more, people with this disorder can easily experience panic episodes, startle excessively and suffer attacks of tremors, dizziness and senseless sweating.

About 10% of pregnant women meet diagnostic criteria for generalized anxiety disorder at some point in their pregnancy. Between risk factors for developing this disorder during pregnancy It is having previously presented it, in addition to lack of education about how pregnancy can develop, lack of social and family support and history of child abuse.

Some of the therapies that may be beneficial for pregnant women with this disorder are Mindfulness, acceptance of the situation, 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 great anguish, when faced with difficult situations. The person feels uncomfortable going out on the street, seeing other strangers or having to face situations in which she has to meet a new person.

There is not much data on social phobia during pregnancy. It has been observed that it can appear in some cases, as a result of the fear that people will see the physical changes of her, especially if there were not many people who knew that she was pregnant. Also it may be due to a drop in self-esteem, since the physical changes that pregnancy entails are not usually perceived as positive.

3. Eating Disorders in Pregnancy

The prevalence of Eating Disorders in pregnant women is close to 5%. Among the reasons that make a woman change her eating behavior pattern we have the obsession with not wanting to gain weight, worrying excessively about eating everything you think your baby needs or, simply, take cravings to extreme cases. There can even be cases of pica, causing the woman to eat things that in theory are not edible (p. e.g. rolling paper, sucking coins)

Having an eating disorder appears to increase the risk of having a cesarean delivery, as well as suffering from postpartum depression. Also, as it may be the case that the woman follows a diet that does not have all the necessary nutrients, she runs a greater risk. to suffer spontaneous abortions or that, if the baby is born, has a weight significantly lower than expected.

• You may be interested in: "Eating disorders: how are they approached from psychotherapy?"

4. Schizophrenia and pregnancy

Psychosis episodes during pregnancy are a really strange phenomenon, although they can occur. They are especially common in those women who already have a history of schizophrenia. Pregnancy is an experience that can cause a lot of alteration at the mental level, being catastrophic in those people who lack it completely.

Some women may have such delusional symptoms of schizophrenia that they can deny that they are pregnant, despite showing obvious signs of it. This could be understood as the opposite case of what is a psychological pregnancy. Postpartum these women can be especially sensitive to later psychotic episodes.

Has been found Relationships Between Schizophrenia Disorder and Premature Membrane Rupture, Gestational Age Less Than 37 Weeks, and Incubator Use and Resuscitation. Relationships have also been found between the mother suffering from schizophrenia and the delivery being premature, in addition to being associated with low birth weight.

Treatment is mainly focused on psychoeducation, which could reduce the risk of pregnancy complications. Brief, case-specific therapies may also be helpful for some patients. Regarding pharmacological treatment, clozapine has been tested with pregnant women and with schizophrenia, being seen to pose few risks in pregnancy, childbirth and in the health of both the mother and baby.

5. Bipolar disorder

Pregnancy is a period in which changes in mood are to be expected. However, if these changes occur very suddenly, are very frequent and intense, they are cause for concern, since it could be spoken of a case of bipolar disorder. The main risk factor for presenting it during pregnancy is having a history of this disorder and having stopped drug treatment.

It is common for women who followed a treatment with mood stabilizers, when they become pregnant, stop it since they consider it harmful to their baby. When leaving them, the sudden changes in mood return, thus manifesting the symptoms of the disorder.

While it is normal that you cannot take mood stabilizers, It will be the psychiatrist's decision that the woman can consume them while pregnantas long as the benefits have been considered to outweigh the possible risks. Among the factors that will be taken into account when deciding whether or not to prescribe these drugs will be the number and severity of manic and depressive episodes, level of insight, family support, and the mother's own wishes person.

What to do to prevent them?

Each woman is different and her pregnancy experience is unique. It is not possible to expect that all women, after receiving the same advice or the same treatments, will develop the same type of pregnancy and experience it the same. Likewise, it is possible to reduce the severity of possible 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 disturbances, especially if it is not managed properly. For this reason, there are not few psychologists and psychiatrists specialized in mental health of pregnant women, knowing what treatments, both preventive and to treat a disorder that has appeared, are best suited for this population. They are experts in the detection and intervention of psychological problems that pregnant women may manifest.

During pregnancy, it is not only necessary to take into account the physiological and temperamental changes that the woman may experience. What's more, it should be evaluated if she has good psychosocial supporther, to what extent is she excited about the new life that she is going to bring into the world, whether she really wants to have a baby and to what extent her environment is pressuring her to have it or not.

Bibliographic references:

• American Psychiatric Association (2013), Diagnostic and Statistical Manual of Mental Disorders. Arlington: American Psychiatric Publishing.
• The American Congress of Obstetricians and Gynecologist (2019). Depression and Postpartum Depression: Resource Overview.