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When Depression Blights Your Pregnancy: Spotlight on Prenatal Depression

written by: Emma Lloyd • edited by: Paul Arnold • updated: 6/26/2011

Most people have heard of postnatal depression these days, but prenatal depression isn’t quite as well known, even though a significant percentage of women become depressed during pregnancy.

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    What causes Depression during Pregnancy?

    Women have an increased risk of depression during certain life stages, including during the child-bearing years. The risk is unfortunately increased during and after pregnancy, for example. This type of depression, known as perinatal depression, includes prenatal and postnatal depression, which occur during and after pregnancy, respectively. Up to 30 percent of women may experience mild depression during pregnancy, but sometimes the depression is more severe. (Bennett et. al.).

    Depression is triggered during pregnancy for several reasons. The main factor is that the levels of many hormones, including estradiol, progesterone, and cortisol, alter dramatically during pregnancy. Increased hormone levels can contribute to increased stress and feelings of anxiety. Another factor is that pregnancy can be a time of increased stress due to the changes that a new baby brings. Some women, for example, feel apprehensive about becoming a mother, or having another child, and begin to feel guilty about having negative pregnancy-related thoughts.

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    When to seek Treatment

    One problem faced by many people who develop depression is that it becomes hard to see that there is a problem. Depression can start to feel "normal", and it becomes difficult to remember a time when the depression wasn't there. It's important, therefore, to be able to understand and recognize the symptoms of depression, especially if close family members have been affected by this illness.

    Signs and symptoms of prenatal depression can include the following:

    • Loss of interest or pleasure in normal activities
    • Feelings of guilt, worthlessness, or hopelessness, particularly in relation to the pregnancy
    • Difficulty concentrating
    • Changes in sleeping habits, including insomnia or sleeping more than usual
    • Unexplained fatigue
    • Changes in weight (apart from those normal to pregnancy)
    • Feelings of disconnection from the pregnancy

    Some women are reluctant to seek treatment due to fears about the effects that depression medication might have on their unborn children. These fears can be exacerbated by the depression itself, in particular because depression often causes feelings of guilt.

    Often, however, medication isn’t required, and when it is, there are many antidepressant medications that are known to be safe to use during pregnancy. If your doctor suggests medication to treat depression during pregnancy, remember to think about your own health as well as that of your baby. Whether medication is included or not, treating pregnancy-related depression is particularly important. Some studies suggest that depression during pregnancy can affect the health of the baby both during and after birth, with indications that blood flow to the placenta is negatively impacted, and that depression can trigger abnormal hormone surges (University of Washington).

    Whether or not treatment includes medication, psychotherapy can be very helpful, especially when it focuses on helping an expectant mother cope with pregnancy and the mental health issues that can arise during this time.

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    Avoiding Pregnancy-Related Depression

    Many women expect to feel happy, content, joyous, and excited during pregnancy, and there is a certain amount of pressure on women to enjoy pregnancy because it is viewed as one of the happiest times in a woman’s life. The reality is, however, that there are no rules on how you should feel during pregnancy. You might have all those good feelings at times, but you might also feel anxious and nervous about pregnancy, birth, or other issues—and that is absolutely natural. To help prevent depression during pregnancy, it’s important to recognize that it’s OK to have negative feelings sometimes, and that there’s no need to feel guilty for being apprehensive.

    Having a great support network is important for preventing depression both during pregnancy and after birth. Talking over your fears with family and friends, and getting help and support when you need it is crucial. Getting plenty of good rest, as well as regular exercise and good nutrition is also important, both for your health and for the health of the baby.

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    References

    Agency for Healthcare Research. Perinatal Depression: Prevalence, Screening Accuracy, and Screening Outcomes. From <http://www.ahrq.gov/clinic/epcsums/peridepsum.htm>. Accessed 12 June 2011.

    Heather A. Bennett; Adrienne Einarson; Anna Taddio; Gideon Koren; Thomas R. Einarson. Depression During Pregnancy. In Clinical Drug Investigation. 2004; 24 (3).

    University of Washington Family Child and Health Bulletin. Preventing Perinatal Depression. From <http://depts.washington.edu/nwbfch/PDFs/NWBv21n2.pdf>. Accessed 12 June 2011.