Depression during pregnancy

Depression during pregnancy

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What is depression?

Depression is a type of mood disorder that causes feelings of sadness and hopelessness. It's normal to feel down from time to time, but when you're depressed, these feelings can last for weeks or even months. Depression can affect every aspect of your life, from how you think and act to how you eat and sleep.

Even when a woman has depression that's under control, the hormonal shifts her body goes through during pregnancy could lead to a relapse. It's common for women to develop the first signs of postpartum depression (PPD) during pregnancy.

Feeling this way is hard any time, but it can be especially difficult to cope when you're pregnant. There's an expectation that pregnancy is supposed to be a joyful time, so it can be hard to admit it if that's not the way you're feeling.

But depression is an illness, not a choice. It's also surprisingly common: About 1 in 10 women have depression during pregnancy, and the actual number could be even higher because so many people affected by depression are reluctant to admit it.

Clinical depression is unlikely to go away without treatment, but there are many effective options. Many people feel better after only a few months, and almost all feel back to normal within a year.

So don't hesitate to ask for help. Your emotional health is just as important as your physical health.

What are the symptoms of depression?

Some symptoms of depression, such as fatigue or trouble sleeping, are normal during pregnancy. But when you also have a sense of sadness or hopelessness, lose interest or pleasure in things that you used to enjoy, or aren't able to function in your daily life, you may have depression.

You may be depressed if you have experienced five or more of the following symptoms for most of the day, nearly every day, for at least two weeks:

  • Losing interest in daily activities, or having a sense that nothing is enjoyable or fun anymore
  • Feeling "blue," sad, or "empty" for most of the day, every day
  • Crying all the time
  • Feeling extremely irritated or agitated
  • Feeling anxious
  • Finding it hard to concentrate
  • Having low energy or extreme fatigue that doesn't improve with rest
  • Experiencing changes in your patterns of eating or sleeping, such as wanting to eat or sleep all the time or not being able to eat or sleep at all
  • Having overwhelming feelings of guilt, worthlessness, or hopelessness
  • Feeling that life isn't worth living

If you think you might be depressed, talk to your provider. Only your provider or a mental health professional can diagnose depression.

But you can also take our Pregnancy Depression Quiz to get some insight into your state of mind.

Am I at high risk for depression?

Anyone can have depression, though it affects up to three times as many women as men. Depression often develops for the first time during women's 20s – right around the same time many women have their first baby.

It's likely that depression is caused by a combination of factors, including:

Family history

If depression runs in your family, you have a higher risk of the condition, and you're more likely to get it at a younger age. The risk of suicide also goes up if there's a family history of depression.

Personal history of depression or anxiety

If you've struggled with depression or anxiety in the past – like during an earlier pregnancy or after the birth of a previous child – you're more likely to become depressed now that you're pregnant. Also, women who've struggled with depression before are at a higher risk of developing postpartum psychosis, a rare but very serious condition that involves hallucinations.

Life stress

Coping with stressful events, such as financial problems, the end of a relationship, the death of a close friend or family member, or a job loss, can trigger depression.

Lack of support

If you're having your baby on your own, or if you feel isolated from friends or family, you have a higher risk of depression. Having relationship problems or an unsupportive partner can also increase your risk of depression.

Unplanned pregnancy

Finding out you're pregnant when you weren't planning to be can be extremely stressful and increases your risk of depression.

Domestic violence

It's very common for domestic violence and emotional abuse to get worse when you're pregnant. If this happens to you, it's crucial that you speak to someone to make sure you and your baby stay safe. Talk to your provider about how to change your situation.

What can I do if I have depression during pregnancy?

Talk to your provider. Depression is one of the most common pregnancy complications. At your prenatal visits, it's likely your provider will ask you about your mood and how you're feeling. If she doesn't, feel free to bring it up.

Talking about mental health issues can be hard, and it's easy to think you're the only one who feels this way. But your provider probably sees many other women going through a similar experience.

Remind yourself that she's there to help, not judge. You can begin to recover just by speaking up.

What's the treatment for depression during pregnancy?

There are different treatment options available to help you manage the condition. These may include psychotherapy, medication, or both.

It's natural to feel concerned about taking medication while you're pregnant. Your provider will weigh the benefits and risks of medication for you and your baby and explain them so you can make an informed decision about your treatment.

If you were taking medication for depression or any other mental health condition before you became pregnant, don't stop taking it without talking to your provider first. Stopping suddenly could be risky for you and your baby.

The main concern when stopping treatment is that your depression will get worse. Untreated depression has been linked to not gaining enough weight during pregnancy and problems bonding with a baby after birth.

If you're feeling very low, you could also find that it's hard to get to your prenatal appointments, and that means you won't get the care you and your baby need. This can be the start of a downward spiral. That's why it's so important to reach out for help, as difficult as that may be.

How does depression affect a baby?

There isn't a lot of good research about how depression affects babies because it's difficult to separate the effects of depression from the side effects of the antidepressants women take during pregnancy.

Untreated depression during pregnancy is linked to a higher likelihood of a baby being born early or having a low birth weight. Research also suggests that babies born to women with depression are more likely to be irritable and may cry more than babies born to moms who aren't depressed.

The risks involved with taking an antidepressant are small and vary depending on the medication, the dose, and how long you take it.

Potentially harmful side effects of antidepressants include:

  • Preterm birth
  • High blood pressure in a baby's lungs (pulmonary hypertension)

If you take antidepressants in your third trimester, your baby may experience withdrawal at birth. This will likely be mild and short-lived but can include breathing problems, jitteriness and irritability, low blood sugar (hypoglycemia), or trouble feeding.

What can I do to have a healthy pregnancy?

Coping with the physical, hormonal, and emotional changes of pregnancy is hard when you have depression. The best approach is to talk to your provider and find a treatment plan that works well for you, and remember to take care of yourself.

Resist the urge to tackle too many chores before the baby comes. You may think you need to clean the house or do a lot of extra work before you go on maternity leave, but you don't.

Put self-care at the top of your to-do list instead. Taking care of yourself is an essential part of taking care of your baby. You won't be able to take as much time for yourself once you have your baby, so until then make time to read a book, have breakfast in bed, or go for long walks around the neighborhood. Also be sure to nurture your relationship with your partner.

Don't try to handle the challenges of depression and pregnancy alone. Following an individualized treatment plan – whether it's talk therapy, medication, or some combination of both – is the best way to stay healthy during your pregnancy and beyond.

What is postpartum depression (PPD)?

If you develop depression in the first year after giving birth, you could have PPD. (Half of women with PPD first notice symptoms during pregnancy.) Except for the timing, the symptoms and treatment are the same as depression before or during pregnancy.

Don't confuse postpartum depression with the baby blues, which go away after a week or two. Like depression before or during pregnancy, PPD is probably the result of a combination of hormonal, environmental, and genetic factors. Having depression or anxiety during pregnancy is the strongest predictor of PPD.

When should I call my healthcare provider?

If you're unable to handle your daily responsibilities, or if you have thoughts of harming yourself, call your provider immediately for help and a referral to a mental health specialist.

Also, it's not unusual for a woman with severe depression at the end of pregnancy or after giving birth to develop anxiety or have panic attacks. If you feel extreme worry or fear, or have obsessive thoughts of wanting to hurt yourself or your baby, it's critical to seek help from a specialist.

Seeing a therapist or psychiatrist, or taking medication doesn't mean you're weak. It shows that you're willing to do what's necessary to keep you and your baby safe and healthy.

Visit the Society for Maternal-Fetal Medicine's website for more information and to find an MFM specialist near you.

Watch the video: Stressed during pregnancy? Your baby might feel long term effects (June 2022).