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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 is PTSD and birth trauma? 

Postnatal post-traumatic stress disorder (PTSD) is a type of anxiety disorder. It is also known as birth trauma. 

You may develop postnatal PTSD if you experience traumatic events during labour or childbirth. 

This page covers: 

  • Causes of postnatal PTSD 
  • Signs and symptoms of postnatal PTSD 
  • Treatments for postnatal PTSD 
  • Self-care for postnatal PTSD 

Causes of postnatal PTSD 

Examples of traumatic events that may cause postnatal PTSD include: 

  • a difficult labour with a long and painful delivery 
  • an unplanned caesarean section 
  • emergency treatment 
  • other shocking, unexpected and traumatic experiences during birth. 

Some people feel that having a new baby makes up for any traumatic experiences. Or they may think that enjoying being a new parent means they will soon forget about trauma. 

But these traumatic experiences can have a negative effect on your relationship with your baby and the people around you. 

You may feel disappointed that childbirth was not the experience you were hoping for. Or you might feel angry with the medical staff if you felt that the delivery wasn’t handled well. 

Your experiences may also make you feel anxious about having another baby in future, in case you have to go through a similar experience during birth. 

“I had a traumatic birth. I was so petrified that my son would die that in my head it was easier not to love him just in case.” 

Signs and symptoms of postnatal PTSD 

Some of the common signs and symptoms of postnatal PTSD include: 

Re-living aspects of the trauma 

This may include: 

  • vivid flashbacks (feeling that the trauma is happening right now) 
  • intrusive thoughts and images 
  • nightmares 
  • intense distress at real or symbolic reminders of the trauma 
  • physical sensations such as pain, sweating, nausea or trembling. 

Alertness or feeling on edge 

This may include: 

  • panicking when reminded of the trauma 
  • being easily upset or angry 
  • extreme alertness, sometimes known as ‘hypervigilance’ 
  • finding it hard to sleep, even when you have the chance 
  • irritability or aggressive behaviour 
  • finding it hard to concentrate, including on simple or everyday tasks 
  • being jumpy or easily startled 
  • self-destructive or reckless behaviour 
  • other symptoms of anxiety. 

Avoiding feelings or memories 

This may include: 

  • feeling like you have to keep busy 
  • avoiding situations that remind you of the trauma 
  • being unable to remember details of what happened 
  • feeling emotionally numb or cut off from your feelings 
  • feeling physically numb or detached from your body 
  • being unable to express affection 
  • using alcohol or recreational drugs to avoid memories. 

Difficult beliefs and feelings 

This may include: 

  • feeling like you can’t trust anyone 
  • feeling like nowhere is safe 
  • feeling like nobody understands 
  • blaming yourself for what happened 
  • overwhelming feelings of anger, sadness, guilt or shame. 

Treatments for postnatal PTSD 

There are various treatments that you may be offered for postnatal PTSD. Your doctor should discuss these options with you, so you can make a decision together about the best treatment for you: 

Talking therapy 

The main treatments for PTSD are specific types of talking therapy: 

  • Trauma-focused cognitive behavioural therapy (CBT), which is specifically designed to treat PTSD. See our pages on CBT for more information. 
  • Eye movement desensitisation and reprocessing (EMDR). In this treatment a therapist guides you to make rhythmic eye movements while recalling the traumatic event. The eye movements are designed to stimulate the information-processing system in the brain. The aim of the treatment is to help you process the traumatic events, and speed up re- adjustment and recovery. 

Medication 

Medication is not normally offered to treat PTSD itself. But there are a few related reasons why your doctor may offer you medication: 

  • It is common to also experience anxiety and depression alongside PTSD. Your doctor might offer you medication to treat those symptoms. 
  • Your doctor might offer you medication to help you feel more stable and able to care for your baby. 
  • Sometimes there are long waiting lists for talking therapies in your area. Your doctor may offer you medication to help you while you wait for therapy.  
  • Some medications are used to treat recurrent nightmares in PTSD.

See our page on treatments for PTSD for more information. 

Self-care for postnatal PTSD 

Living with the effects of a traumatic birth can feel very challenging, but there are some things you can do to help yourself: 

Get to know your triggers 

You might find that certain experiences, situations or people seem to trigger flashbacks or other symptoms. These might include specific reminders of past trauma, such as smells, sounds, words, places, or particular types of book or film. 

Some people find things especially difficult on significant dates. For example, this could be the anniversary of a traumatic experience, such as a child’s birthday. 

Confide in someone 

If you experience postnatal PTSD, you may find it hard to open up to others. This may be because you feel unable to talk about what has happened to you. But you don’t need to be able to describe the trauma to tell someone how you are currently feeling. 

It could help to talk to a friend or family member. Or you might want to speak to a professional such as your family doctor or a trained listener at a helpline.

Give yourself time 

Everyone has their own response to trauma and it’s important to take things at your own pace. For example, it may not be helpful to talk about your experiences before you feel ready. 

Try to be patient with yourself. Don’t judge yourself for needing time and support to recover from postnatal PTSD. 

Try peer support 

Peer support brings together people who have similar experiences, to share and listen to each other’s experiences. This includes meeting in person at a local peer support group, or joining an online community.

See our pages on peer support to find out more. 

Look after your physical health 

Coping with postnatal PTSD can be exhausting. You might feel like you can’t find the energy to take care of yourself. But where possible, looking after your physical health can make a difference to how you feel emotionally. For example, it can help to spend time outside, look after your diet, and try to do some physical activity. 

For more ideas, see our page on ways to look after your mental health when becoming a parent.

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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 is PTSD and birth trauma?

What is PTSD and birth trauma? 

Postnatal post-traumatic stress disorder (PTSD) is a type of anxiety disorder. It is also known as birth trauma. 

You may develop postnatal PTSD if you experience traumatic events during labour or childbirth. 

This page covers: 

  • Causes of postnatal PTSD 
  • Signs and symptoms of postnatal PTSD 
  • Treatments for postnatal PTSD 
  • Self-care for postnatal PTSD 

Causes of postnatal PTSD 

Examples of traumatic events that may cause postnatal PTSD include: 

  • a difficult labour with a long and painful delivery 
  • an unplanned caesarean section 
  • emergency treatment 
  • other shocking, unexpected and traumatic experiences during birth. 

Some people feel that having a new baby makes up for any traumatic experiences. Or they may think that enjoying being a new parent means they will soon forget about trauma. 

But these traumatic experiences can have a negative effect on your relationship with your baby and the people around you. 

You may feel disappointed that childbirth was not the experience you were hoping for. Or you might feel angry with the medical staff if you felt that the delivery wasn't handled well. 

Your experiences may also make you feel anxious about having another baby in future, in case you have to go through a similar experience during birth. 

"I had a traumatic birth. I was so petrified that my son would die that in my head it was easier not to love him just in case." 

Signs and symptoms of postnatal PTSD 

Some of the common signs and symptoms of postnatal PTSD include: 

Re-living aspects of the trauma 

This may include: 

  • vivid flashbacks (feeling that the trauma is happening right now) 
  • intrusive thoughts and images 
  • nightmares 
  • intense distress at real or symbolic reminders of the trauma 
  • physical sensations such as pain, sweating, nausea or trembling. 

Alertness or feeling on edge 

This may include: 

  • panicking when reminded of the trauma 
  • being easily upset or angry 
  • extreme alertness, sometimes known as 'hypervigilance' 
  • finding it hard to sleep, even when you have the chance 
  • irritability or aggressive behaviour 
  • finding it hard to concentrate, including on simple or everyday tasks 
  • being jumpy or easily startled 
  • self-destructive or reckless behaviour 
  • other symptoms of anxiety. 

Avoiding feelings or memories 

This may include: 

  • feeling like you have to keep busy 
  • avoiding situations that remind you of the trauma 
  • being unable to remember details of what happened 
  • feeling emotionally numb or cut off from your feelings 
  • feeling physically numb or detached from your body 
  • being unable to express affection 
  • using alcohol or recreational drugs to avoid memories. 

Difficult beliefs and feelings 

This may include: 

  • feeling like you can't trust anyone 
  • feeling like nowhere is safe 
  • feeling like nobody understands 
  • blaming yourself for what happened 
  • overwhelming feelings of anger, sadness, guilt or shame. 

Treatments for postnatal PTSD 

There are various treatments that you may be offered for postnatal PTSD. Your doctor should discuss these options with you, so you can make a decision together about the best treatment for you: 

Talking therapy 

The main treatments for PTSD are specific types of talking therapy: 

  • Trauma-focused cognitive behavioural therapy (CBT), which is specifically designed to treat PTSD. See our pages on CBT for more information. 
  • Eye movement desensitisation and reprocessing (EMDR). In this treatment a therapist guides you to make rhythmic eye movements while recalling the traumatic event. The eye movements are designed to stimulate the information-processing system in the brain. The aim of the treatment is to help you process the traumatic events, and speed up re- adjustment and recovery. 

Medication 

Medication is not normally offered to treat PTSD itself. But there are a few related reasons why your doctor may offer you medication: 

  • It is common to also experience anxiety and depression alongside PTSD. Your doctor might offer you medication to treat those symptoms. 
  • Your doctor might offer you medication to help you feel more stable and able to care for your baby. 
  • Sometimes there are long waiting lists for talking therapies in your area. Your doctor may offer you medication to help you while you wait for therapy.  
  • Some medications are used to treat recurrent nightmares in PTSD.

See our page on treatments for PTSD for more information. 

Self-care for postnatal PTSD 

Living with the effects of a traumatic birth can feel very challenging, but there are some things you can do to help yourself: 

Get to know your triggers 

You might find that certain experiences, situations or people seem to trigger flashbacks or other symptoms. These might include specific reminders of past trauma, such as smells, sounds, words, places, or particular types of book or film. 

Some people find things especially difficult on significant dates. For example, this could be the anniversary of a traumatic experience, such as a child's birthday. 

Confide in someone 

If you experience postnatal PTSD, you may find it hard to open up to others. This may be because you feel unable to talk about what has happened to you. But you don't need to be able to describe the trauma to tell someone how you are currently feeling. 

It could help to talk to a friend or family member. Or you might want to speak to a professional such as your family doctor or a trained listener at a helpline.

Give yourself time 

Everyone has their own response to trauma and it's important to take things at your own pace. For example, it may not be helpful to talk about your experiences before you feel ready. 

Try to be patient with yourself. Don't judge yourself for needing time and support to recover from postnatal PTSD. 

Try peer support 

Peer support brings together people who have similar experiences, to share and listen to each other's experiences. This includes meeting in person at a local peer support group, or joining an online community.

See our pages on peer support to find out more. 

Look after your physical health 

Coping with postnatal PTSD can be exhausting. You might feel like you can't find the energy to take care of yourself. But where possible, looking after your physical health can make a difference to how you feel emotionally. For example, it can help to spend time outside, look after your diet, and try to do some physical activity. 

For more ideas, see our page on ways to look after your mental health when becoming a parent.