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Depression During Pregnancy
Pregnancy is often touted as a time when a woman looks and feels her best. Until recently even doctors thought that it was natural for women to have an enhanced sense of well-being during pregnancy. Depression during pregnancy was considered a rare phenomenon. Recent studies have shown that an estimated 10 to 20% of women suffer with depression during this time. Of these, 25 to 50% will struggle with major depression.
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Triggers of Depression During Pregnancy
Any of the following can trigger an episode of depression during pregnancy:
Previous pregnancy loss
Stressful life events
Complications in the pregnancy
A personal or family history of depression.
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Who's at Risk?
As you might expect, women who have a prior history of depression or premenstrual dysphoric disorder, a severe type of PMS, are most at risk. A woman's age is a risk factor. The younger she is at time of pregnancy, the higher the risk. The number of children she already has is a factor, with the more children she has, the more likelihood of depression. Ambivalence about the pregnancy increases risk, as do living alone and not having adequate social support.
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If a woman experiences any of the following for two or more weeks, these are warning signs of possible depression:
Change in eating or sleeping habits
Loss of interest in activities once enjoyed
Feelings of worthlessness or guilt
Lack of energy
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Is Depression During Pregnancy Harmful?
If left untreated, depression during pregnancy can cause harm to the mother and the baby. Untreated depression can cause an expectant mother to not care for herself properly. She may drink, smoke, make poor nutritional choices, and even exhibit suicidal behavior. These habits can in turn cause the baby to be born prematurely, have low birth weight, and problems developing. Babies of depressed mothers may also be less active and attentive and more irritable than other babies. A mother may not be able to connect emotionally with the baby growing inside her and not look forward to its arrival. She is also at risk of developing a type of high blood pressure called preeclampsia, which occurs during pregnancy. Depression while pregnant also increases the risk of postpartum depression.
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The most common treatments for depression during pregnancy include support groups, individual psychotherapy, medication, and light therapy. Light therapy would be used for women suffering with seasonal affective disorder, which affects some people during the winter when there is less light.
Probably the most important treatment is for a woman to be able to talk about her feelings with someone--a partner, family member, friend, or health care provider. Most people are glad to help, but it's important to ask for assistance and let them know what's going on. An ongoing support group of others facing similar problems can help women not to feel so alone. Individual psychotherapy can also be helpful.
A woman's physician may want to prescribe an anti-depressant. Certainly if she's been taking an anti-depressant and has become pregnant, she should not discontinue using it without first talking with her physician. Some research indicates the use of SSRI's (selective serotonin reuptake inhibitors such as Prozac and Celexa) during pregnancy can cause miscarriage or birth defects, but other studies do not bear this out.
The FDA in 2004 warned against the use of SSRI's in the third trimester, based on studies showing "withdrawal" symptoms of jitteriness, difficulty feeding, and breathing problems in babies exposed to them through the placental barrier. The results of the studies are mixed, and are generally inconclusive. It comes down to an individual decision between a mother and her doctor, weighing the potential risks and benefits to both mother and baby.