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According to The American Congress of Obstetricians and Gynecologists (ACOG), around 14 to 23% of women experience depression during pregnancy (1). It is normal for pregnant women to go through emotional highs and lows due to hormonal changes. However, if the lows persist for longer and start inferring in the daily activities, it can be a sign of depression.
Depression is a mental health issue and should not be ignored. However, it can be treated with the right support and treatment if sought at the right time.
Read on as we help you understand depression during pregnancy, including its causes, symptoms, and treatments.
What Is Depression In Pregnancy?
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Depression during pregnancy or antepartumiReferring to the period before childbirth depression is a mental illness characterized by mood disorders. You may have mood swings and feel anxious, sad, or hollow, which can ultimately take a toll on your day-to-day life. Depression can arise from chemical changes in the brain triggered by hormonal fluctuations and often heightened by the different life situations associated with pregnancy (1) (2).
Why Does Depression During Pregnancy Often Go Unrecognized?
Depression is often dismissed during pregnancy since depression symptoms, such as emotional instability, changes in energy levels, sleep, libido, and appetite, also occur in pregnancy (1) (3). Therefore, it is usual that you and your doctor may attribute these symptoms to pregnancy over depression. Also, a mother’s physical health is emphasized more than emotional health during pregnancy. However, depression can have a greater impact on the maternal mental health and the health of the baby, and hence it is important to be aware of the signs.
What Are The Risk Factors For Depression During Pregnancy?
Besides hormonal changes and chemical imbalance, the prevalence of depression can be triggered by other factors. They are:
- Family history of depression: You may experience depression symptoms during pregnancy if depression or anxiety runs in your family. Genetic predisposition can cause your development of the illness if you have a gene related to it (4) (5).
- Personal history of depression: You may be prone to depression during pregnancy if you are already suffering from it or have a previous history of depression (5).
- Lack of social support: You will strive for your family and loved ones’ support and care during pregnancy. However, if there is a sense of abandonment from your family or your partner, you may feel isolated and develop depression. In addition, marital or relationship issues can also lead to a lack of support (6).
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- Previous pregnancy issues: Extreme protectiveness towards the baby due to a previous failed or complicated pregnancy may give rise to anxiety and thus depression. History of stillbirth or miscarriage may also be one of the risk factors for depression (2) (6).
- Unplanned pregnancy: If you are pregnant by accident or without planning, you might develop depression due to the overwhelming situation. An unplanned pregnancy can be more intense for a single parent or teenager (5).
- Infertility treatments: The fertility treatments for inducing pregnancy can cause mixed emotions and psychological distress from the hormonal shifts (7).
- Stressful life events: Situations, including economic instability, problems or disputes in relationships, death of a loved one, and abusive relationships can create stress during pregnancy and trigger depression. You should seek a healthcare provider’s help immediately (2).
Research findsWhat Are The Signs And Symptoms Of Depression During Pregnancy?
Signs and symptoms
of normal pregnancy and depression are similar. The symptoms may be moderate or severe but we only talk of depression if they last for more than two weeks. These include (5):
Changes in feelings
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- An overwhelming feeling of sadness, hopelessness, and guilt
- Crying and feeling worthless
- Negative thoughts about life
- Continuous restlessness or moodiness
Changes in body
- Frequent pains, such as headaches and stomachaches
- Losing energy and feeling tired most of the time
Changes in daily activities
- Losing interest in favorite activities
- Increased or decreased appetite
- Troubled or excessive sleep
- Having problems with decision making or concentrating
- Withdrawing from family and friends
Gloria Lucas, a mom of three, opens up about her struggle with prenatal depression during her third pregnancy, “I felt isolated and alone, crazy even. I tried my best not to bother anyone. Many times, I would reach out to my phone, text a paragraph to my best friend, and hit delete.
“On the scariest day, I was home, alone with the kids, and sitting in my room. I felt a heaviness so immense I could barely breathe. I wanted the world to swallow me whole. I wanted everything to end. I wasn’t suicidal. I had no plan. I didn’t want to die. I just wanted to not be. I wanted to crawl into the darkest hole and not emerge until the nightmare ended (i).”
What Are The Recommendations For Screening Of Prenatal Depression?
ACOG recommends screening of perinataliThe time when you become pregnant and up to a year after giving birth depression at least once during pregnancy. The healthcare provider will carry out the screening using standardized tools. The Edinburgh Postnatal Depression Scale (EPDS) is the most used scale that consists of a set of questions about mood and anxiety to assess your mental state. It gives a score according to the scale based on your answers to determine if you have depression or not.
Additionally, the healthcare provider may ask if you have any previous history of depression, difficulty sleeping, or unwanted thoughts lately. Then, follow-up treatment is carried out to detect depression or anxiety symptoms (8).
Research findsHow Is Depression Treated During Pregnancy?
Your doctor may recommend different antidepressant treatments for your prenatal depression. These are:
- Talk therapy: Counseling sessions or talk therapies, such as cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT), can help you deal with negative thoughts, focus on the positive sides, and manage the symptoms effectively (5) (9).
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- Support groups: These groups of people can meet online or together to discuss and share their problems. It can help you get the understanding and care you need as you share each other’s experiences (5).
- Medications: Antidepressants in pregnancy are recommended depending on the severity of your symptoms. They include serotoniniA neurotransmitter and hormone that acts as a mood stabilizer reuptake inhibitors (SSRIs) and serotonin and norepinephrineiA neurotransmitter and hormone, released in response to stress and low blood pressure reuptake inhibitors (SNRIs). However, they are given only if their benefits outweigh the side effects they may have on your pregnancy and the baby.
Did you know?What Are The Natural Remedies For Depression?
You may also incorporate the below changes or alternative therapies in addition to the treatments by checking with your healthcare provider (1).
- Diet: Food can affect our mental state by controlling stress and mood. Certain foods high in carbohydrates, sugar, caffeine, or low in protein can impact your mental and physical well-being. Pick food that can fuel your body and brighten your mood.
- Omega-3 fatty acids: Daily intake of omega-3 supplements has shown significant improvement in alleviating depression symptoms. You can take omega-3 fish oil during pregnancy after consulting your doctor about the required amount.
- Exercise and rest: Get plenty of rest and sleep to have a balanced body and mind, and practice self-care. Regular exercise can also reduce depression by elevating serotonin levels and decreasing cortisoliA hormone that helps the body respond to stress and in regulating other processes levels.
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- Herbal medicine: Talk with your healthcare provider about taking herbal medicines for depression. These medicines are believed to affect the mood and serotonin in the body.
- Acupuncture: Studies have shown that acupuncture could help treat depression during pregnancy. A cohort study showed that women with acupuncture treatment had alleviated symptoms compared to those who did not receive the treatment (10).
- Help and support from your husband and relatives for ordinary stuff . This help is mandatory when the baby is here, to make you feel that you are not alone with the newborn
What Are The Complications Of Untreated Depression During Pregnancy?
Some of the obstetric complications that may arise from untreated antenatal depression are (5):
- Unhealthy coping mechanisms such as smoking, drinking, eating unhealthily, or skipping meals.
- Risk for premature birth, low birth weight, and developmental and mental health issues after birth.
- Postpartum depressioniFeelings of sadness and despair one to three weeks or up to a year after childbirth (PPD) makes it difficult for you to take care of yourself and your baby.
Can You Prevent Depression During Pregnancy?
According to the US Preventive Services Task Force, counseling sessions, such as CBT and IPT, can help prevent depression during pregnancy. These talk therapies aim at providing helpful suggestions to cope with mental issues that can trigger depression. Alternatively, pregnant women with risk factors should seek support or talk with a counselor to prevent depression (9).
Frequently Asked Questions
1. Does pregnancy worsen mental health?
Pregnancy causes the body to experience numerous changes. These changes can be challenging for women with existing mental health problems since they may experience worsening symptoms (11).
2. Do prenatal vitamins help with depression?
Research suggests folate supplementation may help improve symptoms of depressive disorders. You may consider having these supplements after consulting your ob-gyn (12).
3. What resources are available for someone with depression during pregnancy?
Several online platforms, websites, helpline numbers, and support groups provide information and continuous support to expecting mothers diagnosed with depression. Mental health professionals, including psychologists and licensed counselors, specializing in treating depression can also provide therapeutic support during pregnancy (16).
4. How can family and friends support a pregnant woman with depression?
Create a safe, non-judgmental environment to help the mother express her feelings and concerns. Actively listen to her empathetically and give her the reassurance she needs to stay strong. Offer assistance in household chores to reduce stress and allow the mother to focus on self-care. Help her practice how to be happy during pregnancy by pampering her and encouraging her to do activities that uplift her. Assisting her with childcare responsibilities, engaging together in mental health activities, and motivating her to seek professional help are additional ways family and friends can help an expecting woman effectively combat depression.
Pregnancy is a rollercoaster of emotions, and most pregnant women go through them. It is okay to feel overwhelmed by emotions and newfound responsibilities. You only need to be mindful of the changes and share your feelings with your family, friends, or a counselor for a smooth pregnancy journey.
Infographic: How To Manage Depression During Pregnancy?
Along with all the physiological, emotional, and hormonal changes, pregnant women are at increased risk of feeling depressed. Since medicine should usually be avoided, natural remedies can help to manage these pregnancy blues. Check out the infographic below to learn about some natural methods to manage depression during pregnancy
Illustration: Momjunction Design Team
Key Pointers
- Prenatal depression is a mental illness accompanied by troubled sleeping, eating, and energy levels.
- Risk factors include a prior history of depression, family history, unplanned pregnancy, etc.
- Talk therapies, support groups, and antidepressant medications are a few ways of treating depression.
- If you are depressed, talk to your healthcare provider to avoid complications for you and your baby.
Illustration: Depression During Pregnancy: Symptoms Risks And Treatment
Image: Stable Diffusion/MomJunction Design Team
Feeling overwhelmed and down during pregnancy? Learn how to cope with depression and find support.
Personal Experience: Source
MomJunction articles include first-hand experiences to provide you with better insights through real-life narratives. Here are the sources of personal accounts referenced in this article.
i. We don’t talk about prenatal depression and it almost killed me.https://medium.com/the-shadow/we-dont-talk-about-prenatal-depression-and-it-almost-killed-me-985860886231
References
- Depression during pregnancy.
https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/depression-during-pregnancy-2/ - Depression during and after pregnancy.
https://www.womenshealth.gov/a-z-topics/depression-during-and-after-pregnancy - Depression during pregnancy and after.
https://www.health.harvard.edu/womens-health/depression-during-pregnancy-and-after - Multigenerational depression and anxiety influence maternal measures of stress during pregnancy.
https://scholar.colorado.edu/concern/undergraduate_honors_theses/ng451j120 - Depression during pregnancy.
https://www.marchofdimes.org/find-support/topics/pregnancy/depression-during-pregnancy - Shaunak Ajinkya et al (2013). Depression during pregnancy: Prevalence and obstetric risk factors among pregnant women attending a tertiary care hospital in Navi Mumbai.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3895310/ - Fertility and mental health.
https://womensmentalhealth.org/specialty-clinics-2/infertility-and-mental-health/ - Screening for perinatal depression.
https://www.acog.org/clinical/withdrawn-document?utm_source=redirect757&utm_medium=web&utm_campaign=int - Preventing depression in pregnancy.
https://www.health.harvard.edu/blog/preventing-depression-in-pregnancy-new-guidelines-2019032616263 - Rachel Manber et al. Acupuncture for depression during pregnancy: a randomized controlled trial.
https://pubmed.ncbi.nlm.nih.gov/20177281/ - Planning a pregnancy with a mental health condition.
https://www.tommys.org/pregnancy-information/planning-a-pregnancy/planning-a-pregnancy-and-mental-illness/planning-pregnancy-mental-health-condition - New Research from the CWMH: Prenatal Supplement Containing Folate May Reduce Depressive Symptoms During Pregnancy.
https://womensmentalhealth.org/posts/research-from-the-cwmh-prenatal-supplement-containing-folate-may-reduce-depressive-symptoms-during-pregnancy/# - Monica Maria de Jesus Silva et al., (2016); Depression in pregnancy. Prevalence and associated factors.
https://pubmed.ncbi.nlm.nih.gov/28569938/ - Catherine Lebel et al., (2020); Elevated depression and anxiety symptoms among pregnant individuals during the COVID-19 pandemic.
https://pubmed.ncbi.nlm.nih.gov/32777604/ - Identifying Maternal Depression.
https://archive.cdc.gov/www_cdc_gov/reproductivehealth/vital-signs/identifying-maternal-depression/index.html - Depression During and After Pregnancy
https://mchb.hrsa.gov/sites/default/files/mchb/programs-impact/depression-during-after-pregnancy-en.pdf
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