Causes And Treatments For Depression During Pregnancy
Updated December 13, 2018
Reviewer Lauren Guilbeault
It's supposed to be the happiest time of your life. So why are you feeling so down?
This may seem paradoxical, but the truth is, you're not alone. The American Congress of Obstetricians and Gynecologists has found that 14-23% of women report symptoms of depression during pregnancy.
You may wonder why this is true. But the combination of changing hormones in your body and the prospect of a dramatic life change can wreak havoc on anyone's mental state.
As unpleasant as depression is, you feel apprehensive about treating it. Medication is often the easiest solution, but is it safe? Is it worth the risk of allowing your unborn fetus to come into contact with these medicines?
We're going to take a look at some of the causes of depression during pregnancy, as well as a strategy for treating it safely.
Causes Of Pregnancy Depression
It's difficult to isolate one specific cause of depression during pregnancy (sometimes known as antepartum depression).
It is believed that the hormonal changes occurring during pregnancy play a large role in triggering a depressive episode. That's because these changes have a direct impact on the chemicals in your brain that regulate mood (serotonin, dopamine, etc.) Also, you may be dealing with difficult life situations that make it tough to handle the stress of your pregnancy effectively. The birth of a child on the horizon can make other problems with things like finances or relationships seem more overwhelming. You are also dealing with changes to your body which can be distressing.
While it's tricky to isolate one specific cause for depression in pregnancy, we do know that there are some common triggers, listed below.
- A family history of depression
- A recent traumatic life event, such as the death of a loved one
- Relationship problems
- A lack of support from friends or family
- Domestic violence
- Money problems
All of the above factors can lead to depression even in people who are not pregnant. However, pregnancy exacerbates each of these risk factors, making it a recipe for poor mental health.
For example, if you recently lost someone close to you, you may be overwhelmed with sadness at the thought that this person will not be a part of your child's life. If you are living with domestic violence, you may despair at the thought of bringing a child into this scary and sad dynamic.
But how do you know when it has crossed the line from sadness into true depression?
Look for the following signs that you are suffering from antepartum depression.
- Excessive worry and anxiety
- Feelings of worthlessness
- Loss of interest in activities that you once enjoyed
- Appetite problems
You may be tempted just to ignore these signs of depression. But this is a bad idea. Some of the risks of untreated depression may surprise you.
Left untreated, antepartum depression poses some significant risks to you and your baby.
When you are depressed, you are less likely to take care of yourself. Pregnant women who suffer from depression make poor nutritional choices, either not eating enough or choosing foods that are unhealthy. They are also more likely to smoke or to consume alcohol. In the worst case scenario, a depressed mom-to-be may even engage in suicidal thoughts or behaviors…an obvious risk to her fetus as well as herself.
For all these reasons, depression during pregnancy has a proven link to all kinds of problems, most notably premature birth, and low birth weight. Pregnant women who suffer from depression have an increased risk of developing pregnancy-induced hypertension or pre-eclampsia, a condition which is dangerous to both mother and child.
The newborn children of depressed moms-to-be suffer many adverse outcomes. If they were born prematurely, they are likely to have developmental problems or congenital disabilities. Maternal depression prevents moms from bonding with their babies. And infants born to women with antepartum depression are shown to be less active and more sensitive to stress.
There is evidence that the effects of depression during pregnancy can last for a child's entire lifespan. A study from the Journal of the American Medical Association found a direct link between pregnancy during the depression and children developing mood disorders later in life. Children born to depressed mothers were 1.5 times as likely to suffer from depression at the age of 18.
Of course, this may be partly because of the proven genetic component of depression. But it has also been found that the effects depression has on the brain can be passed along through the placenta, directly impacting the unborn child's brain development.
If you are a pregnant mom suffering from depression, this information probably doesn't make you feel any better. In fact, now you may find that you are depressed about being depressed.
But when you think about taking medication for depression, your sense of helplessness increases. Ingesting a substance which can cross the placenta and harm your baby doesn't seem like a good idea at all.
But don't despair! There are some highly effective strategies to combat depression which don't require any medication at all.
Treating Depression Without Medication
The following natural methods can help you get a handle on your pregnancy depression.
Different kinds of therapy can be successful in treating antepartum depression. Relationship therapy can help you reduce stress caused by a difficult relationship. Cognitive behavioral therapy can help you alter negative thought processes that are causing you to feel depressed.
The therapists at BetterHelp are experienced at the kind of therapy that can ease depression. Don't hesitate to reach out to one of them if needed.
There are plenty of support groups for depression, both in person and online, so you can easily find one that meets your needs. Talking about your feelings in a non-judgmental group setting can give you some perspective, as well as improve your self-esteem. You will also feel better knowing that others have some of the same concerns and issues as you do.
It might sound simplistic, but exercise really can help overcome depression. When you exercise, your brain releases feel-good endorphins that immediately elevate your mood. To establish a routine of hitting the gym or going for a brisk walk, and you'll be amazed at what a difference it makes.
In 2010, the Stanford School of Medicine found that acupuncture was a highly effective way to treat depression during pregnancy. It releases endorphins which function as natural painkillers and calm the stress response.
Any of these methods, or some combination of them, can help you overcome mild to moderate depression.
But if your depression is severe, you may find that you need to resort to antidepressant medication for relief.
If so, there is no reason to panic. Your mental health is essential to give birth to a healthy baby. The benefits far outweigh the risks, as we'll point out.
The Benefits And Risks Of Antidepressants During Pregnancy
- First, the bad news.
Any medication that you take during pregnancy will cross the placenta to reach your unborn baby. Also, we still don't know for sure that antidepressants are safe to take during pregnancy.
However, as we already discussed, the risks of untreated depression during pregnancy are too great to be ignored. And the good news is that antidepressants during pregnancy do not increase your baby's risk for congenital disabilities, as we used to think they did.
Most doctors will want to try as many alternative methods as possible before prescribing an antidepressant during pregnancy. But if none of these are working, medication is the route that represents the least amount of risk to you and your unborn child.
If you do need antidepressant medication, your doctor will try to prescribe the lowest possible effective dose. It can take some time to figure out what dosage will be effective in treating your depression while minimizing the risk to the baby.
In general, it's important to understand that any slight risk associated with antidepressant medication is minimal compared to the real and proven danger posed by untreated depression.
If You Become Pregnant While Taking Antidepressants
If you are already taking medication for depression when you become pregnant, you may be tempted to reduce your dosage, or even quit cold turkey. But don't decide this without first talking to your doctor.
This decision is complex, and there are many factors which need to be considered. How long have you been symptom-free? How severe is your depression? While stopping your medication may seem like the obvious choice, remember that depression has a real effect on your unborn baby. It's possible that the benefits of continuing to take your medication may outweigh any potential risks.
Pregnancy is the first of many occasions in which mothers must put their children's well-being ahead of their own. But in fact, taking good care of yourself is always the best choice for raising happy, healthy children. During your pregnancy and throughout your life as a parent, remember that your physical and mental health is of paramount importance. Because if you don't take care of yourself…you certainly can't take care of anyone else.