Depression in Pregnancy

 

Depression during pregnancyPregnancy is supposed to be one of the happiest times of a woman’s life, but for many women this is a time of confusion, fear, sadness, stress, and even depression. According to The American Congress of Obstetricians and Gynecologists ( ACOG), between 14-23% of women will struggle with some symptoms of depression in pregnancy.

Depression is a mood disorder that affects 1 in 4 women at some point during their lifetime, so it should be no surprise that this illness would also touch women who are pregnant. But all too often, depression is not diagnosed properly during pregnancy because people think it is just another type of hormonal imbalance. This assumption can be dangerous for the mother and the unborn baby.

Depression in pregnancy is an illness that can be treated and managed, but the first step, seeking out help and support, is the most important.

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What is depression in pregnancy?

Depression during pregnancy, or antepartum depression, is a mood disorder just like clinical depression. Mood disorders are biological illnesses that involve changes in brain chemistry. During pregnancy, hormone changes can affect brain chemicals, which are directly related to depression and anxiety.  These can be exacerbated by difficult life situations, which can result in depression during pregnancy.

What are the signs of depression in pregnancy?

Women with depression usually experience some of the following symptoms for 2 weeks or more:

  • Persistent sadness
  • Difficulty concentrating
  • Sleeping too little or too much
  • Loss of interest in activities that you usually enjoy
  • Recurring thoughts of death, suicide, or hopelessness
  • Anxiety
  • Feelings of guilt or worthlessness
  • Change in eating habits

What are possible triggers of depression during pregnancy?

  • Relationship problems
  • Family or personal history of depression
  • Infertility treatments
  • Previous pregnancy loss
  • Stressful life events
  • Complications in pregnancy
  • History of abuse or trauma

Can depression during pregnancy cause harm to my baby?

Depression that is not treated can have potential dangerous risks to the mother and baby. Untreated depression can lead to poor nutrition, drinking, smoking, and suicidal behavior, which can then cause premature birth, low birth weight, and developmental problems. A woman who is depressed often does not have the strength or desire to adequately care for herself or her developing baby. Babies born to mothers who are depressed may also be less active, show less attention and are more irritable and agitated than babies born to moms who are not depressed. This is why getting the right help is so important for both mom and baby.

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What is the treatment for depression during pregnancy?

If you feel you may be struggling with depression, the most important thing is to seek help. Talk with your health care provider about your symptoms and struggles. Your health care provider wants the best for you and your baby and may discuss options with you for treatment. Treatment options for women who are pregnant can include:

  • Support groups
  • Private psychotherapy
  • Medication
  • Light therapy

 

Are there any safe medications to treat depression during pregnancy?

There is a lot of debate over the safety and long-term affects of antidepressant medications taken during pregnancy. Some research is now showing that certain medications used to treat depression may be linked to problems in newborns such as physical malformations, heart problems, pulmonary hypertension and low birth weight.

A woman with mild to moderate depression may be able to manage her symptoms with support groups, psychotherapy and light therapy. But if a pregnant woman is dealing with severe depression, a combination of psychotherapy and medication is usually recommended.

Women need to know that all medications will cross the placenta and reach their babies. There is not enough information about which drugs are entirely safe and which ones pose no risks. But when treating major depression, the risks and benefits need to be looked at closely. The medication that can offer the most help, with the smallest risk to baby should be considered carefully.

If medication seems like the best treatment for your depression, forming a collaborative treatment team can be the most helpful. This would include your prenatal care provider and your mental health provider. Ask questions of both about what will provide you with the best treatment but still protect your baby. Find out if you have options of medications and do research on both. What long term affects do they have? Is your baby likely to deal with withdrawal symptoms after birth? Is this medication linked to health problems in the newborn or developmental delays in the future? And always remember that you need to weigh out the possibilities of problems in the future versus the problems that can occur right now if your depression is not treated appropriately.

Are there any natural ways to treat depression during pregnancy?

With the controversy regarding the use of some antidepressants during pregnancy, many women are interested in other ways to help treat depression. As mentioned above, support groups, psychotherapy and light therapy are alternatives to using medication to treat mild to moderate depression. In addition to these, you may want to talk with your health care providers about some of the other natural ways to help relieve the symptoms of depression.

  • Exercise–Exercise naturally increases serotonin levels and decreases cortisol levels.
  • Get adequate rest–Lack of sleep greatly affects the body and mind’s ability to handle stress and day to day challenges. Work on establishing a routine sleep schedule that has you going to sleep and getting up at the same time.
  • Diet and Nutrition–Many foods have been linked to mood changes, the ability to handle stress and mental clarity. Diets high in caffeine, sugar, processed carbohydrates, artificial additives and low protein can all lead to issues regarding your mental and physical health.  Make a conscious decision to start fueling your body with the foods that can help you feel better.
  • Acupuncture-New studies report acupuncture to be a viable option in treating depression in pregnant women.
  • Omega-3 fatty acids–For years its been know that omega-3 can help with a number of health issues, but the newest studies are showing that taking a daily supplement of omega-3/ fish oils can decrease symptoms of depression. Pregnant women would want to make sure to take a mercury free version of fish oil and check with their care provider or nutritionist on a recommended amount.
  • Herbal remedies—There are a number of herbal and vitamin supplements known to affect moods and the hormone serotonin. Talk with your health care provider and nutritionist/ herbalist about the options of using St John’s Wort, SAM-e, 5-HTP, magnesium, vitamin B6 and flower remedies. Many of these can not be used in conjunction with antidepressants and should be evaluated on the dosage for pregnant women.

If you do not feel comfortable talking with your health care provider about your feelings of depression, find someone else to talk with. The most important thing is that someone knows what you are dealing with and can try to help you. Never try to face depression alone. Your baby needs you to seek help and get treatment.

Last Updated: 01/2014

Compiled using information from the following sources:

U.S. Department of Health and Human Services, http://www.4woman.gov

March of Dimes, http://www.marchofdimes.com

The American Congress of Obstetricians and Gynecologist (ACOG), http://www.acog.org

MGH Center for Women’s Mental Health, http://www.womensmentalhealth.org

Acupuncture for depression during pregnancy:a randomized control study. Obstet Gynecol, 2010 Mar;115(3):511-20.PMID:20177281[pubMed-indexed