MIDWIFERY, WOMEN AND MENTAL ILLNESS. Lyn Gardner. The Impact of Pregnancy on Mental Health.
Psychiatric definitions or diagnosis of mental illness are made using the following classifications:
IDC-10 (International Classification of Diseases) research based concepts updated by international committees on behalf of WHO. Section on Mental and Behavioural Disorders and divided into 9 groups.
DSM-IV (Diagnostic and Statistical Manual) compiled by the American Psychiatric Assoc. Numerous revisions over short period of time – created debate and controversy
Thus, according to Casey & Long (2003)
‘psychiatric diagnoses are not objective, scientific renderings of truth, but constructions of life experiences inextricably linked to the social and political context’
‘…we should never forget how the bestowal of a psychiatric label can so usurp the person’s sense of identity that all subsequent distress (relapse) is reconstituted as a function of that diagnosis’
Barker et al (1999)
‘prior to developing schizophrenia, the workings of my mind had been unquestioned. Suddenly I was being told that I could not always trust my own thoughts and senses….Self had become a traitor and was working against my own good’
‘not having a label, I think that’s the real problem’ (Peters et al. 1998)
‘on a positive note, at least when I did learn of my diagnosis I was able to begin coming to terms with my illness…I discovered a common identity and a camaraderie’ (McIntosh, 1996)
Pregnant mentally ill women may also stop taking their psychiatric medication- ‘the moment that blue line appears they stop smoking, they stop drinking, they stop eating soft cheese and they stop taking their medicine. This is very dangerous for women with serious mental disorders’
(Dr Margaret Oates, 2002, RCP meeting to discuss findings of the fifth report of the Confidential Enquiry into Maternal Deaths in the UK 1997-1999).
For discussion of use of Lithium during pregnancy see Young, K. (2004) Manic Depression and Pregnancy, The Practising Midwife, 7, 7:15-18.
‘sharing our stories finally gave us the courage to believe that we are not mad: we are angry…our distress and anger is often a reasonable and comprehensible response to real life situations which have robbed us of our power and taught us helplessness’
‘I think the best professionals involved in my care have walked alongside me, opening themselves to the mystery that is schizophrenia’
Babiker, G. & Arnold, L. (1997) The Language of Injury: Comprehending Self-Mutilation. Leicester: BPS.
Barker, P. et al (1999) From the Ashes of Experience: Reflections on Madness, Survival and Growth. London: Whurr.
Busfield, J. (1996) Men, Women and Madness: Understanding Gender and Mental Disorder. Basingstoke: Macmillan.
Casey, B. & Long, A. (2003) Meanings of Madness, Journal of Psychiatric and Mental Health Nursing, 10:89-99.
Horsfall, J. (2001) Gender and Mental Illness, Issues in Mental Health Nursing, 22:421-438.
Nehls, N. (1998) Borderline Personality Disorder, Issues in Mental Health Nursing 19:97-112
Perkins, R. & Repper, J. (1998) Dilemmas in Community Mental Health Practice. Abingdon: Radcliffe Medical Press.
Price, S. (2004) Midwifery Care and Mental Health, The Practising Midwife, 7,7:12-14.
Showalter, E. (1987) The Female Malady: Women, Madness and English Culture. London: Virago.
Ussher, J. (1991) Women’s Madness: Misogyny or Mental Illness? London: Harvester Wheatsheaf.