At DadPad, we talk a lot about the potential mental ill-health difficulties that a dad can face during the perinatal period – that is, from the start of pregnancy through until you baby is at least a year old. This is important to us as it’s a topic that’s historically not been discussed much in the past and can lead to really significant problems for the family unit if the appropriate support is not in place.

However, we’re equally keen to educate dads about the mental health conditions that can arise in their baby’s mum during this particularly challenging period of your lives.  This is because, as her partner, you’re most likely to be the (adult) person that spends the most time with her during pregnancy and early parenthood, you’re likely to know her pretty well, and therefore you’re the one most easily able to spot any significant changes in her behaviour that might benefit from support from the healthcare professionals surrounding your family.

In this article, then, we’re going to aim to provide you with a quick overview of some of the most common maternal mental health conditions which can arise during the perinatal period, what to do if you have concerns, and where you can find out more information.

“Baby Blues”

You will probably have heard mention of mums suffering from ‘baby blues’ and might wonder what this is.

Over 70% of new mums experience ‘baby blues’, and it’s important to know that this is not the same as post-natal depression.

The Perinatal Mental Health Team at Worcestershire emphasise that it is “important for dads to be aware of baby blues and that it is normal. Women can be very tearful, emotional or upset during this time, and may struggle to explain why.  It will resolve itself after a couple of days.  If it doesn’t, then it’s worth speaking to your Midwife or Health Visitor.”

You can learn more about the ‘baby blues’ via these websites:

• NHS: Feeling depressed after childbirth – The baby blues
• National Childbirth Trust (NCT): The baby blues: what to expect
• Tommys: Feeling low after childbirth (what are the baby blues?)

Post-Natal Depression

Post-natal depression (or PND) is a very common mental health condition, experienced by many parents after having a baby; it’s reckoned that around 10% of all new mums will get PND within a year of giving birth.

Just as is the case with the condition in dads, it’s useful to remember that PND is not only the result of the hormonal changes that mum experiences at this time, but also the situational changes.  Dr Andy Mayers, an academic psychologist at Bournemouth University, explains:

…hormones play a very small part in the risk of maternal PND. Environmental factors (such as income, housing, partner support, the mother not having her own mother close by, education, etc) and psychological ones (previous mental health, coping skills, etc) play a much larger part…

Although a lot of people still equate ‘depression’ with ‘sadness’, it’s actually a lot more complex than that.  Dr Andy told us:

While low mood [in both PND and depression] is common, another crucial symptom is losing the motivation to do those things we would normally do. It’s also about the duration, frequency and timing of those symptoms.

There are, then, a range of behaviours that you might need to be looking out for, as an indicator that your partner might be experiencing PND.  We spoke to some of our good friends and contacts with expertise in this area for an overview of the sort of things that dads might need to be alert to, and these are some of their suggestions.

First up is Kelly Arnold, Service Manager – Harm Reduction and Helplines Services at the Betsi Cadwaladr University Health Board:

Your partner may become withdrawn, more tearful or feeling that she is not good enough as a mum. Sometimes [she] may find it is difficult to bond with baby, but this is not always the case. Sometimes mum can feel over-protective of baby and have anxious thoughts around harm coming to baby.

Kieran Anders, Dad Matters Operations Manager at Home-Start HOST, added:

Mum might still be able to do all the practical stuff – changing nappies, feeding, etc – but it’s all about whether [she’s] responding to baby’s cues, nuanced little cues like returning a smile, responding when they [the baby] lifts their hands to play.

The team at Perinatal Mental Health Team at the Herefordshire & Worcestershire Health and Care NHS Trust also commented that it is “worth dads being aware that irritability is often a symptom of PND, along with low mood.”

Kerry Thomas from PANDAS (the Pre and Post Natal Depression Advice and Support charity) suggested that:

…consistent low mood and heightened anxiety, persistent sadness, frightening thoughts that won’t ‘go away’, feelings of worthlessness and struggling to bond with your baby.

By way of useful summary, Dr Andy has provided us with a list of symptoms that could be experienced by a mum experiencing PND, including:

• Low mood
• Poor motivation
• Changes in appetite
• Poor sleep (over and above what normally happens with a new baby)
• Poor concentration
• Feelings of guilt and/or worthlessness
• Thoughts of death or dying (including suicidal thoughts)

There are lots of useful sources of further information on PND available on the internet, including:

• NHS: Postnatal depression
• NCT: Spotting signs of postnatal depression in your partner
• Tommys: Postnatal depression (PND)

The PANDAS (PND Awareness and Support) charity’s website is a brilliant place to gain more detailed information on PND and other perinatal mental health conditions.  They also offer a FREE helpline, plus a whole support arm specifically for dads and carers.

Postpartum Psychosis

Also known as puerperal psychosis, this is a serious mental health condition that can develop quickly after birth (both ‘postpartum’ and ‘puerperal’ refer to the time immediately following childbirth) and which is often an overwhelming and frightening experience for the affected mum.

The indicators for this condition are quite different to those for PND and other perinatal mental ill-health.  You should be particularly alert for things like:

• rapid mood changes – mum goes from being elated to severely depressed, and vice versa;
• significant confusion;
• restlessness;
• insomnia (unable to sleep);
• being very excitable, ‘manic’ or overactive – such as talking or thinking too much or too quickly, or losing her inhibitions; and/or
• psychotic symptoms, such as having hallucinations (seeing, hearing, smelling or feeling things which aren’t there) or delusions (having suspicions, fears, or beliefs that are not likely to be true).

If you are concerned that your partner might be experiencing any of these symptoms/that she might have postpartum psychosis, you are encouraged to seek medical help immediately as it is considered to be a medical emergency. Speak to your Health Visitor or Midwife ASAP, or contact your GP and ask for a same-day urgent assessment.  If you can’t get hold of any of these, you should phone 111 or – if you think that baby’s mum or any of you could be in danger of suffering imminent harm – you should of course ring 999.

For more information on postpartum psychosis, you should look at these websites:

• NHS: Postpartum psychosis
• Mind: What is postpartum psychosis?
• NCT: Postnatal psychosis: what is it?
• PANDAS: Postpartum psychosis
• Tommys: Postpartum psychosis

In addition to these, the Action on Postpartum Psychosis (APP) website has lots and lots of useful information on postpartum psychosis, including their ‘Insider Guides‘ and their ‘Support for dads and co parents‘ section, which includes advice on ‘Supporting someone with postpartum psychosis‘.

Other perinatal mental health conditions

Whilst PND and, to some extent, postpartum psychosis might be the more well-known perinatal mental health conditions which can arise in a new or expectant mum, it’s worth being aware that there are other conditions which can arise, too.  These include:

Antenatal Depression: just as depression can arise following birth, as with most of the other common perinatal mental health conditions, it can also originate during pregnancy.  The signs and symptoms will be similar to those already discussed above relating to PND – e.g. feeling sad or tearful, feeling irritable or angry, losing interest in the world around you, negative thoughts, and/or having difficulty concentrating.  There’s more information on antenatal depression via the NHS website and the Tommys website.

Perinatal Anxiety: signs of anxiety include feeling tense, nervous, unable to relax and/or overthinking.  You can find out more about perinatal anxiety via the PANDAS website and the Anxiety UK website.

Perinatal OCD: OCD – or Obsessive Compulsive Disorder – is a condition in which a person has obsessive (repeated unwanted and unpleasant) thoughts and compulsive behaviours (repetitive behaviours or actions that you feel you need to do).  Perinatal OCD can sometimes develop during pregnancy or after baby is born, and her obsessions/compulsions might relate to worrying about harming her baby, making sure baby is still breathing, and so on.  You can find out more about perinatal OCD via the Mind website, the PANDAS website, and the NHS website.

Birth Trauma and/or PTSD: especially if mum’s birth experience was notably difficult, exhausting, painful or different to what had been planned or expected, she might experience a physical and/or psychological reaction that will need support to overcome.  In more extreme cases, this can result in Post-Traumatic Stress Disorder (PTSD).  For more information on birth trauma and related PTSD, the PANDAS website is a good place to start, and the Make Birth Better website has a whole ‘Support for Parents‘ section.  There’s also useful info on the NCT website.

Additional sources of help and information

As you’ve hopefully gleaned from having read this far, we strongly recommend that you raise any concerns that either you or your partner (or anyone else around your family) might have regarding your partner’s mental health during the perinatal period with the healthcare professionals supporting your family.  This might be a Community Midwife, a Health Visitor, or your GP. Whilst the professionals supporting your partner during her pregnancy and after she’s given birth will be keeping a close eye on, and checking in with her regularly about, her mental health, it’s important that you share anything with them that is concerning you.  In particular, it’s important to remember that – especially with conditions such as postpartum psychosis – mum might not realise that she’s unwell and/or she might feel nervous speaking about any worries that she has; it’s essential that you help and support her to either share her concerns and/or get her access to additional care, if needed.

Remember that these professionals will be experts on perinatal mental health conditions experienced by expectant and new mums. They won’t dismiss your concerns and will be pleased that you have brought your worries to their attention.  They’ll be able to properly assess the situation and provide advice on any next steps that might be needed.

As well as the specific webpages and support organisations listed within this article, some other useful sources of information include:

• Maternal Mental Health Alliance: especially their ‘What to do if you or someone you know is unwell‘ webpage;
• Association for Post Natal Illness (APNI): especially their ‘Advice for carers‘ webpage; and
• The Institute of Health Visitors (iHV): visit their ‘Top Tips for Parents‘ page and scroll down to the ‘Mental Health’ section.

There’s also (we hope!) lots of helpful guidance on some of our other mental health-focused blog posts, including:

• Ask DadPad: How do I start a conversation about mental health?
• Ask DadPad: Where do I go to access support for my mental health?
• Ask DadPad: How can I best support my own and my partner’s perinatal mental health?

And, of course, information on mum’s mental health is included within the DadPad, the Co-ParentPad and our DadPad apps.

Above all, remember that there is no shame in experiencing mental ill health at any time in your life, but especially during the very challenging perinatal period.  Both you and your baby’s mum are the most important people in your baby’s life, and will be for many, many years to come, so it’s crucial that you reach out to those around you in order to let them know how either of you are feeling, and to access any help that you might need.  The quicker that this support is sought and provided, the quicker (and often easier) it will be to recover.