There are different theories about why you might develop a mental health problem, and particularly why you might develop one during or after pregnancy, but no-one knows for sure.
Some mental health problems like postpartum psychosis or postnatal PTSD have clearer causes, but for many people it may be a combination of risk factors that mean you develop a mental health problem. These include:
Previous experience of mental health problems
If you have experienced a mental health problem in the past, being pregnant or having a baby can put you at risk of experiencing another episode of poor mental health. If you have a diagnosis, or know you struggle with your mental wellbeing, it's important to understand what might trigger an episode and what can help you look after yourself. See our pages on different mental health problems for more information.
If you experienced a perinatal mental health problem around the birth of one child, you are at increased risk of developing one around the birth of your next child. However, you may have coped well with your first child but struggled with your mental health after your second, or the other way around. Your experience of your mental health, and of becoming a parent, will be personal to you.
Some people think it is likely that there is a biological cause – changes in your body, for example, including hormonal changes. However, while some studies show that changes in the level of hormones during pregnancy and after birth can trigger changes in mood, only some women go on to develop a perinatal mental health problem – so hormones are unlikely to be the only cause.
Lack of support
Lack of support from a partner or other family members can put you at risk of developing a mental health problem in the perinatal period.
Having a baby is a major life event and can be stressful, exhausting and overwhelming. Lacking a support network, and people to help you, can increase your risk of developing a mental health problem.
Difficult childhood experiences
There is good evidence to show that going through difficult experiences in your childhood can make you vulnerable to mental health problems later in life. This could be:
- physical, sexual or emotional abuse
- loss of someone close to you
- traumatic events
- unstable family situation
These experiences can have a big impact on how you feel about becoming a parent. If you experienced abuse while growing up, for example, you may now find it hard to relate to others, including your baby.
If your own parents did not have good parenting skills, you may find it hard to adapt to your new role as a parent. For example, you may feel unsure how to interpret your baby's needs. You may even fear that you are going to harm your baby somehow, because you are unsure how to take care of them.
NAPAC supports anyone who's experienced abuse in childhood, including sexual, physical or emotional abuse, and neglect.
I have PTSD due to trauma experienced in childhood. It gave me the added fear that my daughter would experience the same challenges because of me. I worked so hard to fight my anxiety and accept my experiences and to realise that these were very different to the circumstances in which I would be bringing up my daughter.
Experience of abuse
Experiencing abuse and assault can trigger anxiety, depression and lower your self-esteem. This might be:
- domestic violence
- verbal abuse
- emotional abuse
- sexual assault and rape
- violent assault
- financial abuse – for example, if a partner tries to have power over you by stopping you having control over your own money
If you experienced abuse as a child (or later in life) you may also have post-traumatic stress disorder (PTSD), which can further add to your risk for postnatal depression.
If your self-esteem is low, you may doubt your ability to cope as a new mother. When your baby cries, for example, you may think it is because of something you have done wrong, or because of something you haven’t done. The way you think about yourself can put you at risk of developing common perinatal mental health problems like depression and anxiety. See our pages on your self-esteem for more information.
Stressful living conditions
It can be difficult for anyone to deal with stressful living conditions, but if you are also trying to cope with becoming a new parent it can make it even harder and put you at risk of developing a mental health problem. You might be struggling with:
- insecure or poor housing
- insecure employment
You may feel that you are unable to provide your baby with everything that he or she needs, and you may feel that you are failing your baby. Dealing with stressful living conditions can be particularly difficult if you are also living alone with little or no support from others.
I had a difficult labour with my first baby and many significant life changes, which I can now see all contributed to my depression.
Major life events
Major life events can include:
- an illness or death in the family
- the break-up of a relationship
- moving house
- losing your job
Each of these events can add serious stress to your life. If you experience any of these in addition to having a baby, this can increase your risk of developing a perinatal mental health problem.
Having a baby is a major life event in itself, as it is likely to involve many changes in your life. You may have had to give up your job and lose your financial independence. You may also have had to give up social activities and have limited or no opportunities to meet up with your friends.
Being responsible for a baby 24 hours a day means that your day is likely to revolve around your child’s needs rather than yours. All of this can have an impact on your vulnerability to developing a mental health problem.
This information was published in July 2016. We will revise it in 2019.