The first week in May is World Maternal Mental Health Awareness Week. Did you know Antenatal (or Prenatal) Depression is depression during pregnancy? Not only is it common, it may also continue or newly manifest as Perinatal Mood And Anxiety Disorder (PMAD) which encompasses a wide range of mood disorders after delivery and up to year after your baby is born. You may have signs of depression but not even be aware that you are depressed. It’s estimated that approximately 13 percent of pregnant women and new mothers experience depression. Every woman may have a few days where she feels sad, blue or down in the dumps. However with depression, the sad, anxious or empty feelings do not go away and your day-to-day routine and lifestyle changes because of these emotions. Your depression may present simply as feelings of unhappiness and gloom, or possibly spiral to feelings of overwhelming guilt, uncontainable hysteria or thoughts of inflicting harm on yourself or your baby.
Depression is a mental illness that does tend to run in families. If you or your family has a history of depression or other mental illness, you may be more likely to experience depression during or after pregnancy. There is no single cause for depression. Your depression may be triggered by a combination of factors including the stressful events of everyday life. Maybe you are young, single and pregnant, experiencing a lack of support from your family and friends, a victim of physical abuse, or facing marriage or money difficulties. Perhaps there is substance abuse or a problematic pregnancy and birth in your past. Do you have anxious or negative feelings about your present condition? Are you caring for an aging family member or have you just lost a loved one? Unfortunately, any of these variables may become a trigger for your depression during or following pregnancy.
Women are at a greater risk of depression at certain times in their lives than men, and with some women hormonal factors may contribute to their depression. Research tells us that hormonal changes occurring within the brain chemistry that controls our emotions and mood may play a large role in depression.
Growing up you may have experienced depressive symptoms right before menstruation. Some women experience depression during and following pregnancy because when pregnant, levels of the female hormones estrogen and progesterone surge. Then, in the first 24 hours after childbirth, hormone levels quickly return to normal levels leading researchers to believe that these extreme changes in hormone levels may lead to depression. Women may also experience hormonal and mood fluctuations during perimenopause.
It is normal to feel symptoms of mild depression-like feelings during and after pregnancy, but if your baby blues don’t go away after two weeks or you have any of the following symptoms for more than two weeks, you should speak to your health care team. Sadly, some women don’t tell anyone about their symptoms, worrying that they will be viewed as unfit parents. They feel embarrassed, ashamed, or guilty about feeling depressed when they are supposed to feel overjoyed at this time in their lives.
Symptoms of Prenatal and Postnatal Depression
You may experience:
– Feelings of restlessness, moodiness, sadness, hopelessness or being overwhelmed that may intensify.
– Crying a lot.
– Having no energy or motivation.
– Eating too little or too much.
– Sleeping too little or too much.
– Having trouble focusing, remembering, making decisions or performing tasks at work or home.
– Feeling worthless and guilty.
– Losing interest or pleasure in activities you used to enjoy.
– Withdrawing from friends and family.
– Having headaches, aches and pains, or stomach problems that don’t go away.
– Having trouble caring for yourself or your baby.
– Having thoughts of harming yourself or your baby.
Your symptoms will provide the basis for an accurate diagnosis from your health care team. Your doctor will ask the necessary questions to test for depression and may also refer you to a mental health professional that specializes in treating depression. Please know that depression does improve with treatment.
If you are already on medication for depression, stopping your medicine when you become pregnant or are breastfeeding could cause your depression to come back. You must be open and honest with your health care team regarding your depression and pregnancy. Do not stop any prescribed medicine without first talking to your doctor as not taking it could be harmful to you or your baby.
Untreated depression during pregnancy can hurt you and your developing baby, as you will have a difficult time caring for yourself. Depression may cause you to eat poorly, not gain adequate weight and suffer from insomnia. You may miss vital prenatal visits, become incapable of following medical instruction and even begin using harmful substance such as tobacco, alcohol or illegal drugs. Your baby may be small for his or her gestational age (SGA) and be born prematurely. Receiving professional treatment is important for both you and your baby.
In a recent study in the May issue of Obstetrics & Gynecology, researchers found that women with the symptoms of depression were associated with a 27 percent increased risk of delivering their babies before 37 weeks gestation, an 82 percent increased risk of delivering their babies before 32 weeks gestation, and a 28 percent increased risk of having a SGA baby. But they also discovered that approximately one fifth of the expectant women that were treated with antidepressants for depression had no association with the increased risks for any of these problems with their babies.
Dr. Kartik K. Venkatesh M.D., Ph.D., the study’s lead author and Clinical Fellow in Obstetrics, Gynecology and Reproductive Biology at Harvard states, “By screening early in pregnancy, you could identify those at higher risk and counsel them about the importance of treatment. Treating these women for depression may have real benefits.” Screening mothers early for depression is the key to not only their health but also that of their expected babies.
Following a diagnosis of depression, your may be treated with Talk Therapy that involves visiting a therapist, psychologist, or social worker to learn to change how depression makes you think, feel, and act. Or an Antidepressant Medication may be prescribed to relieve the symptoms of your depression. These treatment methods can be used alone or together. Talk with your doctor about the benefits and risks of taking medication while you are pregnant or breastfeeding. Other therapies such as exercise, acupuncture and support groups may be helpful.
“What mental health needs is more sunlight, more candor, more unashamed conversation about illnesses that affect not only individuals, but their families as well.” ― Glenn Close