What you are offered will depend partly on what problems you are experiencing, partly on how mild or severe the problems are, and partly on what’s available locally.
‘Talking treatments’ (psychological therapies)
Talking treatments are also known as physchological therapies. It’s a broad term that essentially covers treatment other than medication. During and after pregnancy, they may be offered with or without medication.
These may be offered in a group or on your own. You could be offered any of the following:
- ‘Listening visits’ from a trained health visitor, giving support without telling you what to do.
- Cognitive Behavioural Therapy (CBT) – counselling that focuses on changing negative patterns of thinking.
- Counselling – the counsellor helps with setting goals and problem-solving.
“At first I thought the CBT would be a load of rubbish, but I’d definitely recommend it. It helped me get rid of bad thoughts and instead concentrate on reality.” Kate, mum of one
These bring together people with a specific mental health problem to support each other. They may be based around activities or mainly talking.
In some places you can be matched up with a volunteer who has had the same mental health problem, to support you.
Cognitive Behavioural Therapy (CBT)
The aim of CBT is to change your thinking patterns, so that instead of feeling hopeless and depressed, you cope better with the situations you face. It is based on the idea that your thoughts, feelings, sensations and actions are interconnected and that negative thoughts and feelings can trap you in a vicious cycle. It helps you deal with your problems in a more positive way.
CBT can be carried out in several different forms, including:
- individual therapy – one-to-one sessions with a therapist
- group therapy – with others who wish to tackle a similar problem
- a self-help book – where you carry out exercises from the book
- a computer program – known as computerised CBT (CCBT)
- set goals with your therapist
- carry out tasks between sessions.
A course typically involves around six to 15 sessions, which last about an hour each. CBT deals with current situations more than events in your past or childhood.
CBT has been shown to be an effective treatment for a variety of mental health problems. In particular, CBT is recommended in pregnancy and after for:
- panic attacks
- obsessive compulsive disorder (OCD)
- post-traumatic stress disorder.
CBT is available on the NHS for people with depression or any other mental health problem that it has been shown to help. There are also self-help books and computer courses which use the concepts of CBT to help you.
Guided self-help is a Cognitive Behavioural Therapy (CBT) based approach for supporting people with mild to moderate anxiety, depression or stress. It is an evidence-based, problem-focused method of changing the way people think, feel and behave. Guided self-help sessions are held with a specially trained therapist face-to-face or over the phone, in a number of sessions that are generally spread across a number of weeks.
The therapist will
- listen and talk with you about your concerns
- support you to understand the issues you have and how they affect
- give you a range of self-help materials and guide you in how to use these
- help you to make positive and practical changes
Many women take medication for their mental health while they’re pregnant or breastfeeding. The type of medication you are offered will depend on a number of different things, including what type of problem you have, what the risk of relapse is, what effect any previous medication has had, and whether you are pregnant or breastfeeding. Some types of medication are known to be a risk to babies, and other types may be safe but there is not enough evidence to be completely sure. It can be a very difficult decision for women to make.
In pregnancy your doctor should talk to you about:
- the benefits and risks of taking medication
- the benefits and risks of a different treatment option, such as guided self-help or a ‘talking treatment’ psychological therapy
- what might happen if you don’t have any treatment.
Medication and breastfeeding
“The doctor prescribed antidepressants, which have worked. I feel a lot less stressed and everything feels a lot less intense. I feel like I can deal with things a bit more head on. I feel fine now.” Amy, mum of one
Medication can pass through your breastmilk to your baby, and some types of medication may have risks for your baby. However, most medications are passed into breastmilk in very small amounts (far smaller than the amount taht passes through in pregnancy). Your doctor should talk to you about:
- the benefits of breastfeeding
- the risks posed by your type of medication passing through to the baby
- the risks of stopping medication in order to breastfeed
- what your other treatment options are (for example, ‘talking treatments’ (psychological therapies)).
Sometimes your doctor may recommend that the best treatment for your mental health is a medication which is known to have risks for your baby if you breastfeed.
You should not be made feel guilty about not breastfeeding if there’s a risk of you becoming seriously unwell. If you think you might be faced with this decision, it’s a good idea to prepare for it before birth.
- NHS Choices [accessed 8/5/2015] Talking therapies explainedhttp://www.nhs.uk/Conditions/stress-anxiety-depression/Pages/Types-of-therapy.aspx#CBT
- National Institute for Health and Care Excellence. Antenatal and postnatal mental health: clinical and service management guidance, clinical guideline 192. London: NICE, 2014. Available at: http://www.nice.org.uk/guidance/cg192
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Pregnancy and having a baby can be an exciting and demanding time for women. If you have an existing or past mental health condition it brings extra challenges and you are at higher risk of relapse during this time than at others.
Myths and facts about mental health
Midwives and others in your care team are there to support you with your emotional health as well as physical health
ℹLast reviewed on February 1st, 2015. Next review date February 1st, 2018.