Most women approach pregnancy with a certain expectation of how it will make them feel. Despite the discomfort brought on by the many changes their bodies will undergo—the aches and pains, the weight gain, the morning sickness, and the cramping—women are often led to believe that the experience will make them glow, and that hormones will stave off depression during pregnancy.
Unfortunately, this is not true. Doctors have recently come to understand that pregnancy hormones do not prevent depression during pregnancy, and prenatal depression is believed to affect 10–15 percent of pregnant women. In fact, a study published in The Scientific World Journal reports that 70 percent of pregnant women report feeling anxious or depressed, although most of these women are not necessarily suffering from clinical depression.
Depression during pregnancy can have serious consequences for mother and baby alike; it is not merely “feeling blue”; it is a medical condition that affects the brain.
Symptoms of Depression During pregnancy
The chief symptoms of depression are:
- Feelings of sadness, or of being overwhelmed
- Feelings of apathy/listlessness
- Fatigue
- Restlessness
- Rapid changes in mood
- Frequent crying
- Changes in appetite
- Changes in sleep habits
- Loss of interest in favorite activities
- Anxiety
- Difficulty concentrating on simple tasks
- Recurrent thoughts of death or suicide
If you experience some or all of these symptoms for two weeks or longer, you should probably seek medical attention for your depression. Most of these symptoms are common in depression sufferers, and depression during pregnancy is no different. Prenatal depression can also affect your body, causing stomachaches, headaches, and other physiological symptoms.
Causes of Depression During Pregnancy
The causes of depression are not completely understood, but it is known to have a biological basis. Heredity plays an important role, and a family history of depression is something you should keep in mind if you’re planning to become pregnant. Your overall health is important—obesity or excessive use of alcohol, tobacco, or narcotics can cause depression or exacerbate an existing case. Environmental factors and difficult life experiences also play a role in depression—for example, the loss of a loved one or a pet, the loss of a job, or the failure of an important project.
Risk Factors
As suggested by the preceding paragraph, drug and alcohol abuse are significant risk factors for depression during pregnancy. Other risk factors include:
- Personal history of depression or drug abuse
- Family history of depression
- Premenstrual dysphoric disorder (a severe form of PMS)
- Anxiety, particularly about money, your marriage, or the pregnancy itself
- Thyroid problems
- Teen pregnancy
Complications
Depression during pregnancy can potentially affect your baby, both directly and indirectly. Indirectly, the effect of prenatal depression may be seen in your own behavior—a depressed pregnant woman is less likely to take proper care of herself, less likely to eat right, and more likely to miss her scheduled appointments with her ob-gyn. Consistent neglect of prenatal care can have a cumulative effect on the baby.
Finally, babies born to mothers who suffer from depression while pregnant are more frequently born underweight, premature, or both. After they are born, these babies sometimes exhibit signs of depression themselves—they may be irritable, slow to learn, and unresponsive to attention. As they grow older, some may develop a tendency to be aggressive.
Others may suffer from anxiety—babies born to mothers who suffer depression during pregnancy have been observed to cry more, and many appear to be more susceptible to stress. This may be merely because women who are prone to anxiety to begin with are more likely to become “helicopter parents” whose aggressive parenting style causes anxiety in their children. However, some experts also think stress hormones can cross the placenta and affect the development of the baby’s brain. Some studies have indicated that newborns of depressed mothers may be born with elevated levels of the stress hormone cortisol.
Finally, depression during pregnancy is linked to an elevated risk of depression after pregnancy—i.e., post-partum depression. New mothers who suffer from post-partum depression often have difficulty bonding with their babies or caring for them. Approximately 25 percent of cases of post-partum depression start during pregnancy, and a study published in the British Medical Journal also found that this type of depression may peak during pregnancy.
Diagnosis
Prenatal depression can be difficult to diagnose because its symptoms can easily be mistaken for normal symptoms of pregnancy—fatigue, changes in appetite, insomnia, etc. Because the symptoms of depression are subjective (meaning that only you are in a position to observe them), it is important to talk honestly with your doctor about your symptoms so that he or she has the clearest possible picture of your mental state. Remember that your condition is nothing to be ashamed of.
Treatment
Fortunately, while the causes of prenatal depression are not as well understood as we might like, the condition is treatable. First, it is important to get a proper amount of rest. Although pregnancy symptoms can make sleeping difficult, you should try to sleep seven or eight hours a night, if possible.
It is also important to get plenty of regular exercise (a recent study conducted by the University of Michigan indicates that yoga can be extremely helpful) and to eat the right kinds of foods (omega-3 fatty acids, which can be found in fish oil supplements, have been shown to help with depression).
Antidepressants are an important tool for fighting depression, and recent data shows that many of them are quite safe to take while pregnant. Whatever risks may be associated with antidepressants are considered acceptable risks when weighed against the potential consequences of allowing your prenatal depression to go untreated. Tricyclic antidepressants such as amitriptyline and nortriptyline are considered safe; while there have been studies linking these drugs to limb malformation, more recent studies have not confirmed this link. Selective serotonin reuptake inhibitors (SSRIs) such as Prozac and Zoloft are also considered safe for pregnant women, as is Wellbutrin.
It is important to understand that prenatal depression does not indicate a character flaw. It is a medical condition with known causes and treatments. If you are suffering from depression during pregnancy, telling yourself to just “snap out of it” will only make matters worse. For your sake—and for the sake of your baby—it is important that you seek medical attention.