Pregnancy and childbirth are both universally celebrated milestones in many cultures. Yet, for certain individuals, these experiences may not be as joyful and may end up creating an ambience of sadness or agony, that may go unnoticed.

Post-partum psychiatric illnesses are generally classified into the post-partum blues, the post-partum depression and the post-partum psychosis. It may be easier to conceptualise each of these enlisted disorders as occurring along a continuum, with the post-partum blues being the mildest and the post-partum psychosis being the most severe form.

Many new mothers may experience post-partum blues after childbirth, which commonly include feelings of being overwhelmed, sadness, anxiety, irritability and mood swings, reduced concentration as well as changes in the appetite or sleeping patterns.

Post-partum blues typically begin within the first two to three days after delivery and may last for up to two weeks, while the family is still getting accustomed to their parental roles and to their new way of living.

Post-partum depression is not a sign of weakness but a complication that is associated with the process of giving birth. This kind of depression may easily be mistaken for post-partum blues at its initial stages. However, when the symptoms start intensifying to a point of interfering with one’s ability to take care of themselves, their newborn or handling other daily chores, it would then be the time to speak to a healthcare professional. This condition may affect both mothers and fathers.

Post-partum depression is not a sign of weakness but a complication that is associated with the process of giving birth

The signs and symptoms of post-partum depression usually develop within the first few weeks after giving birth and may even last up to a year. The key eye-openers may include: severe mood swings, intense irritability or restlessness, prolonged depressive episodes, difficulties in bonding with the newborn, social withdrawal, changes in appetite, insomnia or excessive sleeping, fatigue, feelings of hopelessness and fearing that one is not a good parent, a diminished ability to think clearly, concentrate or make decisions, panic attacks as well as recurrent thoughts of harming oneself or the newborn.

The 10th international classification of mental and behavioural disorders regards post-partum psychosis as a form of personality disintegration and a loss of contact with reality. Its clinical picture may take the form of manic or depressive episodes, as well as psychosis. The onset of the condition is rapid, with signs appearing as early as two to three days after delivery.  The signs and symptoms of post-partum psychosis may include: confusion and disorientation, obsessive thoughts on the newborn, hallucinations and delusions, sleep disturbance, excessive energy and agitation, paranoia or suicidal ideation.

While previous studies have suggested that a number of demographic and clinical variables such as primiparity and child-delivery complications may be associated with post-partum psychosis, the most significant risk factors of post-partum psychosis are: a family history of post-partum depression or psychosis, a history of bipolar disorder or a previous episode of post-partum depression or psychosis. Post-partum psychosis may lead to life-threatening behaviours and requires immediate medical attention and psychiatric treatment.

It is vital for anyone to speak up if they are not feeling well and seek early professional post-natal healthcare services to address their needs during critical times.

It is okay not to be okay... help will always be given to those who ask for it.

Georgiana Farrugia Bonnici is a diagnostic radiographer and medical doctor. For regular updates on mental health, lifestyle modifications and holistic well-being, like and follow her blog on Facebook, via

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