Here's the Truth About Depression During Pregnancy

According to The American College of Obstetricians and Gynecologists (ACOG) and The American Psychiatric Association (APA), somewhere between 14 and 23 percent of women experience symptoms of depression during pregnancy. But misconceptions about perinatal depression make it difficult for some women to cope.

What is depression during pregnancy?

There are many heartwarming stories of girl meets boy, falls in love, they get married, she becomes pregnant and she gives birth to their child. No one shares the underlying narrative of what happens to the woman if she begins to experience unexpected feelings of sadness or overwhelm, or the frequent low moods or bouts of crying while pregnant.

Prenatal depression, also known as antenatal depression or antepartum depression, is a form of clinical depression that can be a precursor to postpartum depression if not properly treated. Yes, depression can begin during pregnancy — not just after childbirth, which is known as postpartum depression and is much more well known.

Risk factors

Antenatal depression is often caused by the stress and worries that pregnancy can bring at a severe level. There are several risk factors:

• Unplanned pregnancy
• Difficulty becoming pregnant
• History of abuse
• Economic instability
• Stressful family situations

• A history of depression does put a mother at higher risk for antepartum depression, but it is not a prerequisite. A history of depression does not mean depression will occur during pregnancy.
• A clean history of mental health or depression does not mean you are not susceptible to pregnancy depression. 

Still, antenatal depression is not something women expect to experience, and many don’t recognize the symptoms, chalking up their emotions to typical side effects of pregnancy attributed to their hormones. The truth is that pregnancy hormones do make you feel different, but they will not make you feel like a completely different person.

Depression affects everyone differently, which is one of the primary reasons antenatal depression goes undiagnosed and is undertreated. There are, however, women as early as three months pregnant who are diagnosed with depression. 

Experts say that, if you’re feeling three or more of the following symptoms for more than two weeks, make an appointment with your healthcare provider for a depression screening and potential treatment options. 

Symptoms

• Intense feelings of sadness
• Consistent low moods
• Recurrent bouts of crying
• Paranoia
• Insomnia
• Sleep disturbances
• Being overwhelmed with a “I can’t do this” mindset
• Thinking the worst of situations
• Thinking something is wrong with your baby
• Feelings of inadequacy
• Frequent outbursts of anger
• Panic attacks
• Feelings of guilt with a "Why am I not happy I’m pregnant?" mindset

The U.S. Preventive Services Task Force recommends depression screening for women both during and after pregnancy so they can cope with their depression. Nancy Byatt, medical director at the Massachusetts Child Psychiatry Access Project for Moms (MCPAP for Moms) and an assistant professor of psychiatry and obstetrics and gynecology at UMass Medical School, says: “Depression care should become a routine part of obstetrical care as it is twice as common as diabetes in pregnancy. Obstetric providers always screen for diabetes and they have a clear treatment plan. The goal [here] is that women are screened for depression [during pregnancy and postpartum] and they are assessed and treated, and this becomes a routine part of care just like diabetes." 

What is your pre-emptive plan?

Factors such as a lack of social support, being on bed rest, having a high-risk pregnancy or high levels of stress can contribute to feeling depressed while pregnant. If you regularly find yourself in these types of situations, or if you are just not feeling yourself, ask to be screened for pregnancy depression. Depression screening is becoming the norm as part of an obstetric exam. The test places you on a probable scale of "at risk for pregnancy depression," this way you will know if you are a likely candidate and it is something you can be aware of and monitor.

Many doctors make the claim that the depression will likely disappear after giving birth, which is unfounded, as there is no proof that it will cure itself. However, most doctors do not want to scare or place further undue stress on their patients. It is their intention to provide hope that childbirth will be the cure that will allow a woman to “just snap out of it.” The truth is that antenatal depression can resolve itself after childbirth when pregnancy hormones restabilize, but it could also devolve into postpartum depression, anxiety, OCD, psychosis or other mental health and mood disorders.

How can you treat depression during pregnancy?

There is not a one-solution-fits-all treatment for depression during pregnancy. For mild to moderate depression, treatment ranges from the following:

• Talk therapy
• Group discussion
• Exercise
• Yoga
• Breathing
• Acupuncture
• Massage
• Changes in diet

For more severe symptoms, or if you haven’t been able to manage your symptoms with alternatives, there is the option of anti-depressants or anti-anxiety medications. This option should be discussed with your health provider to decide what is best for you and your baby.

Antenatal depression is temporary, but if it continues untreated or mismanaged, research has shown that it can affect your baby, too (read: preterm birth risks and poor fetal growth).

Carmine Pariante, who specializes in biological psychiatry at the well-known Kings College in the United Kingdom, says, “Children born from mothers who were depressed during pregnancy were two to three times more likely to become depressed themselves when they become adolescents.”

Depression during pregnancy must be treated in one way or another. No one should have to put on a happy face when they’re suffering.

-- 

Valerie Lynn is a traditional feminine healthcare expert specializing in postnatal recovery, as well as author of The Mommy Plan, Restoring Your Post-Pregnancy Body, Using Women’s Traditional Wisdom and the cookbook Healing Meals: Simple Recipes for New Moms (2018). Valerie has lived, worked and conducted research in Japan, the U.K., Australia, Indonesia and Malaysia. Her coaching practice in New York City supports expecting mothers and their families, guiding them through a new mother’s recovery based on the most holistic and effective after-birth recovery program in the world with success rates of 97 percent. Her seminar, Optimizing Maternity Leave: A Roadmap to Post-Pregnancy Recovery, is gaining recognition in the public and private sectors.