Prenatal Depression: How To Know The Signs
If you are pregnant and feeling depressed, it’s important to know that you are not alone. Psychologist Alison Bough
explains how to get the help and support you need during this time
Pregnancy is a time of enormous change. During this phase of life there are physical, emotional, relationship and role changes in particular. So, it is important to consider this when we think about the things that contribute to the risk of any mood problem, but particularly when we look at depression around pregnancy. We hear a lot about postnatal depression these days, but it’s also very important to talk about prenatal depression (depression during pregnancy), which actually occurs at the same rate as postnatal (depression after the baby is born).
Research studies have indicated that up to 23% of women experience depression during pregnancy. Psychology research has looked at the prevalence of depression by trimester, and rates of 7.4%, 12.8% and 12.0% in the first, second, and third trimesters respectively, have been found. Depression can negatively impact the baby as well as the mum, which makes diagnosis and treatment twice as important.
The symptoms of depression during pregnancy are very similar to the symptoms that are seen in a depressive disorder at any other time of life (and in any gender), so it can be difficult to tease out what the symptoms of depression are from the normal physical, mental and emotional changes that can occur during pregnancy.
Symptoms to watch out for include:
- Changes in sleep patterns, appetite, energy, mood, capacity to cope with stress, speed of thinking.
Changes in a sense of connection to people or roles, and daily thoughts that are more negative, fearful or guilty.
Often, those around the pregnant woman may notice that she is not her usual self and observe other changes in how she is thinking, feeling, or behaving. “But couldn’t pregnancy hormones be causing these changes?” I hear you ask. Yes and no; depression is a more likely possibility than the normal changes that can be brought on by pregnancy. If the symptoms persist and are getting worse – for example, if the emotions and thinking are becoming increasingly negative, the experience is not typical for the woman and if she can’t see any value or pleasure in her everyday life, the possibility of prenatal depression should be considered.
Depression is a very common condition with a broad set of symptoms and a multitude of different causes. Research indicates that pregnancy hormones may cause depression, but we also know that there are other factors, which increase the likelihood of experiencing prenatal depression.
This ‘higher risk’ category includes women who have a family history of depression or anxiety, have personally experienced depression or depressive episodes in the past, those with increased sensitivity to mood change with hormonal change (for example PMS), women who have high-levels of life stress, women with a lack of support and those who experience physical pain and complications during their pregnancies. Other risk factors for prenatal depression include being a younger mum, having an unplanned pregnancy and encountering relationship difficulties (or other stressful events) during pregnancy.
Not all women who experience prenatal depression will go on to have postnatal depression. In fact, a small percentage of cases seem to improve with delivery itself – indicating that the increased hormonal load of pregnancy seems to have been the depression ‘trigger’ for those particular women.
For most depressed mums-to-be, safe and successful treatment during pregnancy limits the potential for future depressive illness. Treatment during pregnancy also enhances the mum’s ability to bond with her baby after birth, so the best thing a mum can do for her health and her baby’s health is get the help and support she needs.
That help and support can include an array of treatment pathways including both medication (antidepressants) and non-medication treatment options (such as talk therapy).
Recommendations for a happy pregnancy:
Cognitive behavioural therapy can be a highly effective stand-alone treatment for mild to moderate symptoms of prenatal depression. Medications can be used for more severe symptoms with relative safety under the monitoring and the guidance of a psychiatrist. Family and friends are also important supports and shouldn’t be underestimated – both in terms of practical care for the mum-to-be and also in terms of reducing the stigma of depression occurring at a time that most assume is a happy one.
- Reduce stress where possible and discuss any concerns with your GP, midwife or obstetrician.
- Balance your exercise, nutrition and rest.
- Have practical and emotional supports in place.
- Consider counselling where possible.
- Discuss the benefits and risks of any medications with your GP or midwife.
Self-Care Is Important
Self-care is often a low priority for women who are depressed and pregnant, they may lose their appetite meaning their nutritional balance is not ideal. They may not be sleeping, and unfortunately many depressed mums-to-be try to self-treat with over-the-counter medications and herbal treatments, which can be dangerous for both mum and baby.
Scientific research has linked maternal life events, anxiety, and depression with complications for both mother and infant. Pregnant women who experience increased anxiety levels and prenatal depression are at higher risk for excessive vomiting and nausea during pregnancy (Hyperemesis Gravidarum), delivery complications, postnatal depression and other postnatal psychiatric illnesses. Depression during pregnancy also increases the risk for pre-term labour and low-birth weight.
For more advice and information on pregnancy health and wellbeing, please click here.