Symptoms of distress

In collaboration with Dr Camilla Rosan

If you are trying to conceive, and are experiencing difficulties, this understandably increases your risk of experiencing emotional distress. It’s most common to experience anxiety or depression. But often people don’t fall into a neat diagnosis of depression or anxiety, often they co-exist. This has been found to  be even more the case during the preconception period.

If you identify with any of these symptoms, it’s important to know there is help and support available, and that many people fully recover with evidenced based treatments. It’s also important to know that you are not alone –  up to 25% of women will experience depression and/or anxiety during the preconception period. And this percentage significantly rises if difficulties endure.

Here we explain the different mental health problems and the common signs and symptoms. However, lots women will not quite have the right selection of symptoms to meet an official ‘diagnosis’, but their difficulties still cause them significant distress, and they need support too. You might only identify with one of the symptoms listed below – perhaps you aren’t sleeping as well, or you are feeling restless at work or you’ve lost your appetite. While these might feel like small things, there are things you can do to make sure your emotional health stays on track.

Depression  – Depression is a low mood that lasts for a long time, and affects your everyday life. In its mildest form, depression can mean just being in low spirits. It doesn’t stop you leading your normal life but makes everything harder to do and seem less worthwhile. At its most severe, depression can be life-threatening because it can make you feel suicidal or simply give up the will to live. Some of the common symptoms include:

  • low motivation,
  • avoiding social events and activities you usually enjoy,
  • losing interest in sex,
  • difficulty in remembering or concentrating on things,
  • no appetite and losing weight,
  • or eating too much and gaining weight,
  • difficulty sleeping, or sleeping too much

Anxiety  – Anxiety is what we feel when we are worried, tense or afraid – particularly about things that are about to happen, or which we think could happen in the future. Anxiety is a natural human response when we perceive that we are under threat. Anxiety can become a mental health problem if it impacts on your ability to live your life as fully as you want to.  Some of the common symptoms include:

  • anxiety can impact both our body and mind, and it’s common for it to manifest in physical symptoms, such as a churning feeling in your stomach, feeling restless or unable to sit still, headaches, backache or other aches and pains, problems sleeping,
  • panic attacks,
  • having a sense of dread, or fearing the worst,
  • wanting lots of reassurance from other people,
  • worrying that people are angry or upset with you,
  • rumination – thinking a lot about bad experiences, or thinking over a situation again and again,
  • worrying about anxiety itself, for example worrying about when panic attacks might happen.

Post Traumatic Stress Disorder (PTSD) – Post-traumatic stress disorder (PTSD) is a type of anxiety disorder which you may develop after being involved in, or witnessing, traumatic events. Research finds that 4 in 10 women experience PTSD symptoms after miscarriage.

There are lots of misconceptions about PTSD. For example, people may wrongly assume it means you are ‘dwelling’ on past events. They might even suggest that you should ‘get over it’ or ‘move on’. But having PTSD isn’t a choice or a sign of weakness, and it’s important to remember that you are not alone. Some of the common symptoms include:

  • reliving aspects of what happened:
    • vivid flashbacks,
    • intrusive thoughts or images,
    • nightmares
  • alertness or feeling on edge:
    • panicking when reminded of the trauma,
    • being easily upset or angry, extreme alertness,
    • disturbed sleep or a lack of sleep,
    • irritability or aggressive behaviour,
    • finding it hard to concentrate,
  • avoiding feelings or memories:
    • feeling like you have to keep busy,
    • avoiding anything that reminds you of the trauma,
    • being unable to remember details of what happened,
    • feeling emotionally numb or cut off from your feelings
  • Difficult beliefs or feelings
    • 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).

Obsessive Compulsive Disorder – is a type of anxiety disorder characterised by obsessions and compulsions. Obsessions are unwelcome thoughts, images, urges, worries or doubts that repeatedly appear in your mind. They can make you feel very anxious. Compulsions are repetitive activities that you do to reduce the anxiety caused by the obsession.

It is a commonly misunderstood condition with some people thinking it just means you wash your hands a lot or you like things to be tidy. Recent studies suggest that OCD is more common during the perinatal period than other times in life.

Obsessions can include:

  • fear of causing or failing to prevent harm,
  • intrusive thoughts, images and impulses (unwanted thoughts, for example violent images or actions),
  • fear of contamination
  • fears and worries related to order or symmetry (for example if things are not clean, in order or symmetrical).  

Compulsions can include:

  • something like repeatedly checking a door is locked,
  • repeating a specific phrase in your head or checking how your body feels.
  • you might have to continue doing the compulsion until the anxiety goes away and things feel right again.
  • you might know that it doesn’t make sense to carry out a compulsion – but it can still feel too scary not to.

Bipolar disorder is a mental health problem that mainly affects your mood. If you have bipolar disorder, you are likely to have times where you experience: manic or hypomanic episodes and depressive episodes, and sometimes psychotic episodes.
Symptoms of a manic episode include:

  • feeling high,
  • being more active than usual,
  • talking a lot,
  • being very friendly,
  • spending money excessively or in a way that is unusual for you

Depressive episodes:

  • down, upset or tearful
  • tired or sluggish
  • not being interested in or finding enjoyment in things you used to
  • low self-esteem and lacking in confidence
  • guilty, worthless or hopeless

Psychosis (also called a psychotic experience or psychotic episode) is when you perceive or interpret reality in a very different way from people around you. You might be said to ‘lose touch’ with reality.  It’s not a mental health problem in itself, but is a symptom of some mental health problems. Some of the common symptoms include: