The spectrum of disorder

THE SPECTRUM OF DISORDER
Mental illness occurring in the perinatal period includes a spectrum of mild to
severe problems from the ‘baby blues’ through to florid psychotic illnesses. In
between lies what is often called ‘post-natal depression’ (PND), that is, all the depressive disorders that do not fall within the category of the ‘blues’ or psychosis.

Thus, the clinical picture includes a wide array of presentations, ranging from
adjustment disorders and dysthymia to severe depression and psychosis. Anxiety
and/or obsessive-compulsive symptoms are common and may be a prominent
component of PND, but anxiety disorders (Generalised Anxiety Disorder;
Agoraphobia, Panic Disorder; Obsessive Compulsive Disorder, Post-Traumatic
Stress Disorder) may also diagnosed in their own right at this time. Depressive
symptoms are often ‘atypical’. Sleep disturbance, a common symptom of
depression, is hard to assess in new parents who often have a degree of sleep deprivation. Inability to sleep even when the baby sleeps is an important sign of distress. Inability to enjoy the baby or fear of the baby may also be present.

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