Depression in Pregnancy

Depression occurs almost as commonly in pregnant women as it does in non-pregnant women. While the increase in hormones is often blamed for many of the mood swings and other emotional and psychological occurrences in pregnancy, they are only one part of the puzzle when it comes to pregnancy and depression. For some women the stress of pregnancy brings on depressive symptoms, even when the pregnancy is planned. These feeling might intensify if the pregnancy is complicated or unplanned, or if life itself is stressful.

What factors increase my risk of being depressed in pregnancy?
• Having a history of depression or PMDD
• Age at time of pregnancy — the younger you are, the higher the risk
• Living alone
• Limited social support
• Marital conflict
• Ambivalence about the pregnancy

What is the impact of depression on pregnancy?
Depression can interfere with a woman’s ability to care for herself during her pregnancy. You may be less able to follow health recommendations, and sleep and eat properly; jeopardizing proper nutrition, sleep habits, exercise and following prenatal care instructions from your healthcare provider. Depression can put you at risk for increased use of substances that have a negative impact on pregnancy (tobacco, alcohol, illegal drugs).

Depression may interfere with your ability to bond with your growing baby. A baby in the womb is able to recognize the mother’s voice and sense emotion by pitch, rhythm and stress. Pregnant women with depression may find it difficult to develop this bond and feel emotionally isolated and detached from their unborn child.

Many of the signs of depression can mimic pregnancy symptoms. It can be hard to determine what is normal fatigue in pregnancy and what is depression. This can lead to an underreporting of the problem to their healthcare provider. There is also a tendency of people to ignore depression in pregnancy simply because this is supposed to be “a happy time in their life,” and this includes the pregnant woman herself.

Signs of Depression
• Problems concentrating
• Problems with sleeping
• Fatigue
• Changes in eating habits
• Feeling anxious
• Irritability
• Feeling blue

How does pregnancy impact depression?
• The stresses of pregnancy can cause depression or a recurrence or worsening of depression symptoms.
• Depression during pregnancy can place you at risk for having an episode of depression after birth (postpartum depression).

Are there any other things I should know about?
Treatment during pregnancy involves several avenues. Developing your support network is extremely valuable. Having yourself surrounded by supportive individuals that you know can be beneficial, particularly if they have experienced the same feelings. Talking to a professional or psychotherapist can be very helpful, particularly since there are major physical, mental and emotional changes occurring during pregnancy. Medications can also be used during pregnancy under the care of a practitioner who has experience with using antidepressants and other medications during the course of pregnancy and breastfeeding.

So what are my options if I’m depressed during my pregnancy?
• Preparing for a new baby is lots of hard work, but your health should come first. Resist the urge to get everything done — cut down on your chores and do those things that will help you to relax. And remember, taking care of yourself is an essential part of taking care of your unborn child.
• Talking about the things that concern you is very important. Talk to your friends, your partner, and your family. If you ask for support, you’ll find that you often get it. If you are not finding relief from anxiety and depression by making these changes, seek your doctor’s advice or a referral to a mental health professional.

The key to preventing problems that stem from depression in pregnancy, which may also increase the likelihood of postpartum depression, is getting the support and help you need as soon as you realize that you are experiencing a problem. With more than two out of three pregnant women having depressive symptoms it’s important to recognize that you are not alone and that help is available. Talk to your healthcare provider if you are in need of help. Be open and honest with your concerns and realize there is help.

Angel J. Miller, MSN, CNM