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Postnatal depression and perinatal mental health

Disclaimer:

This publication is based on a Mind UK publication and the original version may be found here: https://www.mind.org.uk/information-support/a-z-mental-health/

Thank you to Mind UK for sharing their valuable content with us. Content included in Mental Health A-Z is made available free of charge and does not form part of any commercial activity. The adaptation has been done independently by Mind HK and is intended for general information purposes only.

What causes perinatal mental health problems? 

There are many reasons that you might develop a mental health problem. Nobody knows exactly why they happen. This includes mental health problems you develop while pregnant or after giving birth, known as ‘perinatal’ mental health problems. 

Some perinatal mental health problems have clearer causes. For example, difficult experiences while giving birth can cause postnatal PTSD. 

But for many people, it can be a combination of factors that cause a perinatal mental health problem. 

These factors might include: 

  • previous experience of mental health problems 
  • biological causes 
  • lack of support 
  • difficult childhood experiences 
  • experience of abuse 
  • low self-esteem 
  • stressful living conditions 
  • major life events 
  • Obstetric trauma or complications 

Previous experience of mental health problems 

Your experience of mental health will be personal to you, as will your experience of being pregnant and having a child. 

But if you’ve had mental health problems in the past, being pregnant or having a baby can increase the risk of those problems happening again. This includes any previous perinatal mental health problems. 

It is important to understand what might trigger another episode of any previous problems, as well as what support you may need during this time. You can speak to your doctor about this. 

See our page on types of mental health problems for more information about any specific problems you have experienced. 

Biological causes 

Some people think it is likely that perinatal mental health problems have a biological cause. This includes changes in your body during and after pregnancy, such as changes to your hormones. 

Some studies show that changes to your hormones during pregnancy and after giving birth can cause differences in your mood. But not everyone who gets pregnant and experiences these changes goes on to develop a perinatal mental health problem. So changes in hormones are unlikely to be the only cause if you do develop a problem. 

Lack of support 

Having a baby is a major life event and can be stressful, exhausting and overwhelming. If you don’t have people around who can help, like a partner or family members, this can affect how well you cope. It may mean that you are more likely to develop a mental health problem during this time. 

HK Family Welfare Society (HKFWS) provides advice and practical support for single parent families. And our page of useful contacts has details of other organisations who can help you find support. 

Difficult childhood experiences 

Some of us have difficult experiences in our childhood, such as: 

  • physical, sexual or emotional abuse 
  • neglect 
  • the loss of someone close to you 
  • traumatic events 
  • an unstable family situation. 

Some research shows that these experiences could make you more vulnerable to mental health problems later in life. 

These experiences can have a big effect on how you feel about becoming a parent. For example, if you experienced abuse while growing up, you may now struggle to relate to other people. This may include finding it difficult to relate to 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 of how to interpret your baby’s needs. You may even fear that you are going to harm your baby somehow, because you aren’t sure how to take care of them. 

HK FamilyLink Mental Health Advocacy Association and Talk Hong Kong offer support services for individuals who have experienced abuse in childhood, including sexual, physical or emotional abuse, and neglect. 

“I have PTSD due to trauma experienced in childhood… 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 can sometimes cause: 

  • anxiety 
  • depression 
  • low self-esteem 
  • post-traumatic stress disorder (PTSD). 

So if you have experience of abuse, you may be more likely to develop perinatal mental health problems. 

Different types of abuse include: 

  • 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. 

Low self-esteem 

If your self-esteem is low, you may doubt your ability to cope as a parent. For example, when your baby cries you may think it is because of something you’ve done wrong, or because of something important you haven’t done. 

The way you think about yourself can put you at risk of developing perinatal mental health problems like depression and anxiety. 

See our pages on self-esteem for more information, including ways to improve your self- esteem. Some of these tips might feel difficult while you are pregnant or have a new baby, but even small changes can make a big difference to how you feel. 

“I was angry, sad, irrational, indifferent towards my husband… I lied and said things were better than the reality out of fear of being laughed at and being judged as a bad mother.” 

Stressful living conditions 

It can be difficult for anyone to deal with stressful living conditions. If you are pregnant or recently had a baby, this may feel even harder. These conditions can make you more likely to develop a perinatal mental health problem. 

For example, you may be struggling with: 

  • money problems 
  • insecure or poor housing 
  • insecure employment. 

These problems can be even more difficult if you live alone, with little or no support from other people. 

Living with these conditions might make you worry that you are unable to provide your baby with everything that they need. Or you might feel like you are failing your baby. 

We have information on money and mental health which you may find helpful. 

“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 be difficult to deal with, and may increase the level of stress in your life. 

Examples of major life events include: 

  • an illness or death in the family 
  • the break-up of a relationship 
  • moving house 
  • losing your job. 

If you experience any of these events while you are pregnant or after having a baby, you may be more likely to develop a perinatal mental health problem. 

Having a baby is also a major life event in itself, and is likely to involve many changes in your life. It may cause you to leave your job and lose your financial independence. 

Or you may need to give up social activities, and find it difficult to spend time with friends. Being responsible for a baby means that your day is likely to revolve around your child’s needs rather than yours. 

These changes to your life might mean you are more likely to develop a mental health problem. 

Infant loss and mental health 

Experiencing infant loss can be extremely traumatic and can have a big effect on your mental health. This includes losing your baby through miscarriage, still birth or sudden infant death syndrome (SIDS). 

It’s important to remember that you don’t have to cope alone, and there is support out there. You can talk about your mental health or fertility concerns with your family doctor or Obsetrician. You can also find more information about infant loss from our webpage on women’s mental health or from links below: : 

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What is iACT Service?

Improving Access to Community Therapies (iACT®) is one of the services from Mind HK. Trained Wellbeing Practitioners will offer initial assessment and early intervention for people dealing with mild to moderate symptoms of depression, anxiety, or other emotional difficulties.

 

The service includes 6-8 sessions of low-intensity psychological support, the flexibility of the service allows individuals to receive free and timely support when needed.

If you’re aged between 18 – 65 and are facing some emotional challenges, we would like to invite you to take an online assessment for us to gain a better understanding of your current emotional struggle.

 

If you’re eligible, we’ll get you connected with a Wellbeing Practitioner within two weeks to sort out the next steps.

The service runs for about 3 months and includes 6-8 support sessions, tailored to your needs.

 

We encourage you to attend all sessions and actively practice the tips and exercises provided by your Wellbeing Practitioner.

We take your privacy seriously. Your chats with the Wellbeing Practitioner are confidential.

 

We won’t share any of your info unless you’ve provided consent or if there are risks detected.

This programme isn’t suitable for people facing emergencies, major setbacks, or those diagnosed with serious or complex mental health conditions.

 

If you’re having thoughts of suicide or self-harm, this programme might not meet your needs, so please seek help right away. You can check out Mind HK’s “Find Help Now” page for immediate information and services.

Most of our Wellbeing Practitioners have backgrounds in psychology or counselling and are passionate about mental health. They’ve gone through about 140 hours of intensive training and completed at least 120 hours of supervised clinical practice over 9 months to ensure the quality of service.

 

They’re trained by accredited local experts in the mental health field, including clinical psychologists, counselling psychologists, counsellors, and psychiatrists. Plus, we regularly check how effective our services are. All service outputs and performances are subject to consistent monitoring.

Who is suitable for participating in this programme?

This programme welcomes anyone between the ages of 18 and 65 who may be feeling lost or facing emotional difficulties. Please note that this programme is not suitable for individuals diagnosed with severe or complex mental health conditions.

This programme is not suitable for individuals diagnosed with severe or complex mental health conditions, but suitable for those who experience mild to severe moderate anxiety, mild to moderate depression, or other emotional challenges. If you are currently experiencing a major setback or even having thoughts of suicide or self-harm, please visit the “Find Help Now” page on our Mind HK’s website for immediate information and services.

After signing up, our Wellbeing Practitioner will contact you within two weeks to schedule a convenient time for a 45-minute conversation, either via video or phone call, according to your preference. During the conversation, the Wellbeing Practitioner will understand your current situation and help you gain a better understanding of your emotional state based on the questionnaire you filled out during application. Additionally, they will provide recommendations for appropriate community resources based on your needs, helping you take an important first step in taking care of your mental health.

Although the intervention procedure is mostly standardised, Wellbeing Practitioners will work flexibly with clients to address individual presenting problems and unique characteristics.

Our Wellbeing Practitioners are trained to support people who experience mild to moderate mental health difficulties primarily. This programme is not suitable for the situations mentioned above. If you are currently experiencing a major setback or even having thoughts of suicide or self-harm, please visit the “Find Help Now” page on our Mind HK’s website for immediate information and services.

Your conversations with the Wellbeing Practitioner are absolutely confidential. Any information about you will not be shared with anyone without your consent unless you or others are at immediate risk or the Wellbeing Practitioner has reason to believe that you may be in imminent danger.
Supervisors will monitor trainees’ development throughout the placement to ensure that they are meeting the required level of competency to pass the training course at the end of the placement.

Yes, it is necessary to book an appointment in advance by filling out the form. Additionally, you can select one of the five stores yourself. We will allocate clients to different Wellbeing Practitioners based on their chosen location.

Before having the conversation, we will ask you to fill out a basic questionnaire for preliminary screening assessment. This screening process aims to ensure that the training received by the Wellbeing Practitioners is sufficient to meet the needs of the individuals receiving the service. If it is determined after the screening assessment that the service is not suitable for you, Mind HK will provide alternative recommendations to ensure your safety and support.

For adults who are suitable for this service, all Wellbeing Practitioners have received training on how to identify and respond to safety and risk issues. If you have any concerns about the support process, the Wellbeing Practitioners have appropriate measures in place and will develop response plans based on the urgency of the situation. They can also access support from clinical practitioners from Mind HK or participating organisations.

What private training does Mind HK provide?

Mind HK provides 4 themes of mental health training, including: Supporting Self, Supporting Others, Family Wellbeing and DEI (Diversity, Equity and Inclusion).

 

Check out the brochure here for more information.

Mind HK provides a wide range of standardised mental health training, which can be tailored to different circumstances. Chat with our team to explore more! 

Our trainers come from a diverse, accredited pool of clinically experienced professionals. Check out our trainers’ biographies here.

Yes, the Mental Health First Aid class of Mind HK is internationally accredited by the MHFA International. The content and certification is delivered by trainers certified from the Mental Health Association of Hong Kong. You can find out our trainers accreditation here.

We are here to support your mental health education journey! Reach out to us and chat with our team.

What causes perinatal mental health problems?

What causes perinatal mental health problems? 

There are many reasons that you might develop a mental health problem. Nobody knows exactly why they happen. This includes mental health problems you develop while pregnant or after giving birth, known as 'perinatal' mental health problems. 

Some perinatal mental health problems have clearer causes. For example, difficult experiences while giving birth can cause postnatal PTSD. 

But for many people, it can be a combination of factors that cause a perinatal mental health problem. 

These factors might include: 

  • previous experience of mental health problems 
  • biological causes 
  • lack of support 
  • difficult childhood experiences 
  • experience of abuse 
  • low self-esteem 
  • stressful living conditions 
  • major life events 
  • Obstetric trauma or complications 

Previous experience of mental health problems 

Your experience of mental health will be personal to you, as will your experience of being pregnant and having a child. 

But if you've had mental health problems in the past, being pregnant or having a baby can increase the risk of those problems happening again. This includes any previous perinatal mental health problems. 

It is important to understand what might trigger another episode of any previous problems, as well as what support you may need during this time. You can speak to your doctor about this. 

See our page on types of mental health problems for more information about any specific problems you have experienced. 

Biological causes 

Some people think it is likely that perinatal mental health problems have a biological cause. This includes changes in your body during and after pregnancy, such as changes to your hormones. 

Some studies show that changes to your hormones during pregnancy and after giving birth can cause differences in your mood. But not everyone who gets pregnant and experiences these changes goes on to develop a perinatal mental health problem. So changes in hormones are unlikely to be the only cause if you do develop a problem. 

Lack of support 

Having a baby is a major life event and can be stressful, exhausting and overwhelming. If you don't have people around who can help, like a partner or family members, this can affect how well you cope. It may mean that you are more likely to develop a mental health problem during this time. 

HK Family Welfare Society (HKFWS) provides advice and practical support for single parent families. And our page of useful contacts has details of other organisations who can help you find support. 

Difficult childhood experiences 

Some of us have difficult experiences in our childhood, such as: 

  • physical, sexual or emotional abuse 
  • neglect 
  • the loss of someone close to you 
  • traumatic events 
  • an unstable family situation. 

Some research shows that these experiences could make you more vulnerable to mental health problems later in life. 

These experiences can have a big effect on how you feel about becoming a parent. For example, if you experienced abuse while growing up, you may now struggle to relate to other people. This may include finding it difficult to relate to 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 of how to interpret your baby's needs. You may even fear that you are going to harm your baby somehow, because you aren't sure how to take care of them. 

HK FamilyLink Mental Health Advocacy Association and Talk Hong Kong offer support services for individuals who have experienced abuse in childhood, including sexual, physical or emotional abuse, and neglect. 

"I have PTSD due to trauma experienced in childhood... 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 can sometimes cause: 

  • anxiety 
  • depression 
  • low self-esteem 
  • post-traumatic stress disorder (PTSD). 

So if you have experience of abuse, you may be more likely to develop perinatal mental health problems. 

Different types of abuse include: 

  • 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. 

Low self-esteem 

If your self-esteem is low, you may doubt your ability to cope as a parent. For example, when your baby cries you may think it is because of something you've done wrong, or because of something important you haven't done. 

The way you think about yourself can put you at risk of developing perinatal mental health problems like depression and anxiety. 

See our pages on self-esteem for more information, including ways to improve your self- esteem. Some of these tips might feel difficult while you are pregnant or have a new baby, but even small changes can make a big difference to how you feel. 

"I was angry, sad, irrational, indifferent towards my husband... I lied and said things were better than the reality out of fear of being laughed at and being judged as a bad mother." 

Stressful living conditions 

It can be difficult for anyone to deal with stressful living conditions. If you are pregnant or recently had a baby, this may feel even harder. These conditions can make you more likely to develop a perinatal mental health problem. 

For example, you may be struggling with: 

  • money problems 
  • insecure or poor housing 
  • insecure employment. 

These problems can be even more difficult if you live alone, with little or no support from other people. 

Living with these conditions might make you worry that you are unable to provide your baby with everything that they need. Or you might feel like you are failing your baby. 

We have information on money and mental health which you may find helpful. 

"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 be difficult to deal with, and may increase the level of stress in your life. 

Examples of major life events include: 

  • an illness or death in the family 
  • the break-up of a relationship 
  • moving house 
  • losing your job. 

If you experience any of these events while you are pregnant or after having a baby, you may be more likely to develop a perinatal mental health problem. 

Having a baby is also a major life event in itself, and is likely to involve many changes in your life. It may cause you to leave your job and lose your financial independence. 

Or you may need to give up social activities, and find it difficult to spend time with friends. Being responsible for a baby means that your day is likely to revolve around your child's needs rather than yours. 

These changes to your life might mean you are more likely to develop a mental health problem. 

Infant loss and mental health 

Experiencing infant loss can be extremely traumatic and can have a big effect on your mental health. This includes losing your baby through miscarriage, still birth or sudden infant death syndrome (SIDS). 

It's important to remember that you don't have to cope alone, and there is support out there. You can talk about your mental health or fertility concerns with your family doctor or Obsetrician. You can also find more information about infant loss from our webpage on women’s mental health or from links below: :