When Motherhood and Mental Illness Collide

Motherhood is often described as one of life's most joyful experiences. But for some parents, the reality of becoming a mother can also bring overwhelming anxiety, depression, frightening thoughts or, in rare cases, a serious mental health crisis.

Recent coverage of the trial of Lindsay Clancy in the United States has once again brought postpartum mental illness and postpartum psychosis into the public conversation. Clancy's case is complex and remains a matter for the legal process, and it would be inappropriate to speculate about an individual's diagnosis, experiences or responsibility. However, the wider discussion highlights something important: postnatal mental health deserves to be talked about openly, without shame or stigma.

Because behind the headlines are thousands of parents experiencing mental health difficulties who may be frightened to tell anyone how they really feel.

Postnatal mental health is more than the 'baby blues'

Having a baby is a huge physical, emotional and practical adjustment. Sleep deprivation, hormonal changes, a new sense of responsibility and the pressure to care for another person can all contribute to emotional difficulties.

The 'baby blues' are very common and usually settle within around two weeks. But when difficult feelings continue, become more intense or begin to affect everyday life, it may be a sign that additional support is needed.

Postnatal depression can involve:

• persistent low mood

• feeling hopeless, worthless or unable to cope

• anxiety or constant worrying

• irritability or restlessness

• difficulty sleeping, even when the opportunity to rest is there

• difficulty concentrating or making decisions

• difficulty bonding with your baby

• frightening thoughts about yourself or your baby.

Postnatal depression can begin during pregnancy, shortly after birth or at any point during the first year after having a baby. It can affect partners and fathers too. Most importantly, experiencing postnatal depression does not mean that you are a bad parent.

What about intrusive thoughts?

One of the most frightening experiences for a new parent can be having an unwanted, upsetting thought about something happening to their baby. Intrusive thoughts are unwanted thoughts, images or impulses that can feel completely at odds with who you are and what you want. A parent might suddenly imagine their baby falling, becoming injured or being harmed. The fact that a thought is frightening or unwanted does not mean that someone wants it to happen.

However, intrusive thoughts can cause enormous distress, particularly when someone interprets having the thought as meaning something terrible about themselves. They may become afraid to tell anyone because they worry they will be judged, misunderstood or seen as an unsafe parent.

That fear can create a painful cycle: frightening thought → anxiety → shame → keeping it secret → more anxiety.

Talking to an appropriate healthcare or mental health professional can help someone understand what they are experiencing and decide what support is appropriate.

Postnatal anxiety can be overwhelming

Not every postnatal mental health difficulty looks like depression. Some new parents experience intense anxiety, constant checking, racing thoughts, panic or an overwhelming sense that something terrible is going to happen.

You might find yourself repeatedly checking whether your baby is breathing, worrying about illnesses or accidents, struggling to leave the house or feeling unable to switch off even when everything is okay. A certain amount of worry is understandable when you're responsible for a tiny person. But when anxiety becomes persistent, overwhelming or starts to interfere with your ability to live your life, it is worth talking to someone. You don't have to wait until you reach breaking point before asking for help.

Postpartum psychosis is different

Postpartum psychosis is rare, affecting around 1 in 1,000 people after giving birth, but it is a serious mental health emergency. It usually develops suddenly, often within the first two weeks following birth.

Symptoms can include:

• hallucinations

• delusions or unusual beliefs

• confusion

• rapidly changing moods

• mania or feeling unusually energetic

• racing thoughts or very rapid speech

• severe difficulty sleeping

• paranoia or suspiciousness

• significant changes in behaviour.

Someone experiencing postpartum psychosis may not recognise that they are unwell, which means family members, friends or professionals may sometimes notice changes before they do. This is very different from the baby blues or ordinary postnatal emotional changes. If you think you or someone you know may be experiencing postpartum psychosis, urgent medical help is needed. The NHS advises contacting a GP immediately, calling NHS 111 if you cannot access a GP, or calling 999 or going to A&E if there is an imminent risk of harm.

Why can asking for help feel so difficult?

There is enormous pressure on mothers to appear as though they are coping. There can be an expectation that motherhood should feel natural, that you should instantly bond with your baby and that you should be grateful for the experience. So what happens when your reality doesn't match that picture?

You might think:

'Everyone else seems to be managing.'

'I should be happier than this.'

'What kind of mother has thoughts like these?'

'What if people think I'm a bad mum?'

'What if I tell someone and they take my baby away?'

These fears can become barriers to asking for help. The NHS specifically acknowledges that some parents worry their baby will be taken away if they disclose how they are feeling. It states that this is very rare and that healthcare teams are there to provide support. Asking for help is not a failure. In many cases, it is an important step towards getting well.

Motherhood doesn't make you immune to mental illness

There can sometimes be an uncomfortable contradiction in the way we talk about motherhood. We recognise that pregnancy and birth involve enormous physical changes, and we understand that new babies can disrupt sleep, routines, relationships and everyday life. Yet we can still expect mothers to simply cope emotionally. Mental health is health.

Depression, anxiety, OCD and other mental health conditions can occur during pregnancy and after birth. NICE's guidance on antenatal and postnatal mental health recognises a range of mental health conditions during this period and emphasises the importance of recognising problems, assessing needs and providing appropriate care. There is no shame in needing support.

How can we support a new mother who is struggling?

Sometimes the most helpful thing you can do is create a space where someone doesn't have to pretend. Instead of simply asking, 'Are you enjoying being a mum?', try:

'How are you really doing?'

'How are you coping with everything?'

'Do you feel like you can tell me if you're struggling?'

And if they do tell you something difficult, try to listen without immediately judging, reassuring or trying to solve everything. Practical support can matter too. A meal, an hour of childcare, helping with household tasks or simply sitting with someone while they talk can make a difference. If you are concerned about someone's immediate safety or think they may be experiencing postpartum psychosis, professional help should be sought urgently rather than trying to manage the situation alone.

You don't have to struggle in silence

There is no single way that motherhood is supposed to feel. You can love your baby and still struggle. You can be grateful and still feel overwhelmed. You can be a devoted parent and still experience depression or anxiety. And having an unwanted thought does not automatically make you a dangerous or bad person. The important thing is not to suffer in silence because you are afraid of what someone might think.

If you're struggling with your mental health during pregnancy or after having a baby, speak to your GP, midwife, health visitor or a mental health professional. NHS talking therapies can also support people experiencing conditions including depression and anxiety, including postnatal depression.

At The Wellbeing Therapy Hut, we understand that asking for support can be difficult. You don't need to wait until things feel unbearable, and you don't need to have everything figured out before reaching out.

If you're struggling with your mental health, book an assessment with The Wellbeing Therapy Hut. An assessment gives us an opportunity to understand what you're experiencing and help identify the most suitable counsellor and approach for you.

You don't have to navigate motherhood – or your mental health – alone.