Pregnancy or the first year after birth

What do you need help with?

If they have not spoken about what is happening

Choose a quiet time and describe what you have noticed: sleep, mood, fear, withdrawal, confusion, energy or difficulty managing daily life. Do not use this page to decide which condition they have. Ask what feels hardest and offer one practical next step.

When the change is sudden or very unusual

Postpartum psychosis is a medical emergency and can become worse quickly. Signs can include hallucinations, unusual beliefs, confusion, agitation, extreme energy, feeling unusually high, rapid speech, major changes in mood and needing very little sleep. The person may not recognise that they are unwell.

1. Use emergency contacts in an existing care plan if there is one.
2. Otherwise request an urgent same-day assessment from the GP, midwife or health visitor if you can contact them. If you do not know the GP, cannot reach one or are unsure what to do next, use the urgent route for their UK nation. In England, call 111. A friend or family member can call.
3. Keep the surroundings quiet, reduce visitors and stimulation, and arrange for a trusted person to help with the baby.
4. Call 999 if there is imminent danger or you cannot keep anyone safe.

Do not argue about unusual beliefs. Acknowledge the fear without agreeing that the belief is true.

If they disclose unwanted thoughts about harm

Unwanted intrusive thoughts can occur with perinatal anxiety or OCD. The person may be horrified by the thought and afraid to tell anyone. Stay calm, thank them for telling you and help them speak to their GP, midwife or health visitor. Do not shame them, demand reassurance or decide for yourself that there is no risk.

Get urgent same-day help if they feel they may act, seem to have lost touch with reality, have unusual beliefs about the baby, are severely confused, or you are unsure whether anyone is safe. Call 999 for immediate danger.

When they seem low, anxious or unable to cope

The short-lived “baby blues” are common after birth. Ask for professional help when low mood, anxiety, hopelessness, withdrawal or difficulty coping persists, becomes worse or disrupts daily life. Fathers and partners can also develop depression after a baby is born.

• Offer specific help such as food, washing, school runs or sitting with the baby while they rest.
• Protect sleep in agreed shifts where possible.
• Do not force them to talk about a traumatic birth or tell them they should feel grateful.
• Support their informed feeding choices without adding pressure or guilt.
• Ask directly about suicide if they say the family would be better off without them, and use urgent help if needed.

Find the right professional help

A GP, midwife, health visitor, obstetric team or existing mental-health team can help with assessment and referral. For urgent symptoms, you do not need to identify their GP first: use an existing care plan, call 111 if you cannot reach a known professional, and call 999 only for immediate danger. In England, specialist community perinatal mental-health teams support people with moderate, severe or complex needs. Routes differ across the UK, so ask the local maternity or mental-health service what applies where they live.

For severe illness, admission may be to a Mother and Baby Unit, where specialist care is provided while the mother and baby stay together. A referral can be discussed with a GP, psychiatrist, midwife or health visitor.

Questions about psychiatric medicines in pregnancy or breastfeeding belong with the prescriber or specialist perinatal team. Encourage the person to seek advice before making changes.

Support recovery and the whole family

• Agree practical help rather than taking over without asking.
• Keep rest, meals, appointments and ordinary connection manageable.
• Ask what helped, what made things harder and who should be contacted if symptoms return.
• Use a shared care or crisis plan when the person is well enough to make one.
• Recognise that partners and relatives may also be frightened, exhausted or low and need their own support.