Depression And Pregnancy: Signs To Look For And How To Get Help
By Nadia Khan
Updated July 10, 2019
Can You Experience Depression In Pregnancy?
Most people trying to get pregnant yearn to see two bright pink lines on a pregnancy test indicating a positive result. They whoop with joy when a digital sign reads "Pregnant". They can't wait to share the news with family and post an acute announcement on social media. Good wishes and congratulations pour in and everyone looks forward to the due date in anticipation of the bundle of joy.
Pregnancy is typically depicted as a joyful, ecstatic time for the new mom and dad to be. Socially there is an expectation and belief that the mom is glowing, happy and excited. And for the most part, these are all emotions a newly pregnant woman experiences or expects to experience. It's a well-known fact the surge of hormones and the hundreds of changes a woman's body goes through can trigger all sorts of emotional ups and downs and highs and lows. The happiness and joy is a given, but what happens when things are not as rosy as you expected them to be? What happens when the initial ecstatic joy you feel begins to be clouded with anxiety, fear, and sadness?
Through the haze of social media announcements, planning a nursery, shopping for baby clothes, the last thing you might expect to feel is a darker, less magical emotion - depression. As you struggle with the confusing mélange of emotions coursing through your brain, you may hesitate to talk about them because women have been taught pregnancy is a happy time and anything less than positive thoughts are unheard of and won't be tolerated.
But that is not always the case.
Depression during and post pregnancy is a fact and thankfully it is a topic which is starting to gain some traction and in most of the western world is starting to be recognized and addressed as an issue which needs to be treated as seriously as any other mental illness.
According to the American Congress of Obstetricians and Gynecologists (ACOG), between 12% and 23% of all pregnant women go through depression during pregnancy, while 5% to 25% of women go through postpartum depression. Nine months of being pregnant and growing a human being, while having to cope with the daily responsibilities and activities of your normal life come with its own set of discomforts and challenges, when you add depression on top of it, things become further complicated putting the health of the baby and the mom at risk.
Society places certain expectations on a mom, whether they are new or old. There is a pressure to be 'perfect' in every way, to not gain too much weight, to have the perfect belly bump, to always be happy because you were blessed with beautiful children, to breastfeed because it's better for the baby, regardless of the physical or mental toll it may place on the mother's health. There is even a certain level of judgment when a woman admits to having a difficult time post-baby.
Given all these pressures, it is only natural that a new mom would feel reluctant to talk about or admit to depression during pregnancy.
Pregnancy is full of unknowns and as such, some form of anxiety is common for most women, after all, you are going through a life changing event and it's affecting you physically as well as emotionally. All mothers to be at some point or other during the pregnancy lie awake at night filled with worries and anxieties about finances, all the things they need to do before the baby comes. They worry about labor and giving birth and whether they'll come out of it okay. They worry about the health of their unborn child and wonder what kind of parent they'll be, if and how a baby will change and shift the dynamics of their relationships and their current life.
Then once the baby is here, the immediate rush of relief and joy of holding your baby in your arms is replaced by the baby blues.
Baby blues is a common experience that women go through right after giving birth. It's classified as a short period of time which starts a day or two post labor where the new mom goes through mood swings, periods of sadness and crying for no known reason, feeling anxious and nervous, etc. These symptoms usually last for a couple of weeks postpartum and generally resolves on its own.
But this isn't always the case for every new mom, some women experience prolonged bouts of baby blues, which intensifies and becomes more severe. When this happens, it's called postpartum depression.
While the condition is entirely beyond a woman's control, some factors (like any other illness or disorder) may increase the risk of postpartum depression in some women such as:
- Suffering from a mental disorder pre-pregnancy i.e. bipolar disorder, mood disorder or depression;
- Family history of depression or mental illness;
- Having gone through postpartum depression in a previous pregnancy;
- Living through a stressful pregnancy or dealing with stressful things such as relationship problems with your partner, problems with finances, having a baby with special health needs, etc.
- If the baby was a surprise and not wanted
What Does Depression In Pregnancy Look Like?
Being a new parent, whether it's your first child or second, third or fourth, can be an overwhelming experience and in the chaos of sleepless nights, frantic crying, feedings and diapers it can be very easy to miss the signs depression or dismiss them. Therefore it can often fall on the husband, partner or other family members to take notice and point it out. Some things to look out for are:
- Going through intense mood swings, crying excessively;
- Lack of interest towards the baby or having a hard time bonding with the baby;
- Becoming socially withdrawn from friends and family;
- Can become angry and irritable very quickly for little things;
- Feeling hopeless and sad;
- Feeling like a bad mother;
- Lack of interest or joy in previously enjoyable activities;
- Experiencing problems with sleeping, either sleeping too much or not at all;
- Difficulty getting through the day;
- Experiencing intense fatigue and lack of energy;
- Experiencing panic or anxiety attacks;
- Thoughts of self-harm, suicide or death.
If you identify or relate to a few of the symptoms above it's very important to get help as soon as possible before your depression intensifies. Untreated depression may also pose risks for the unborn baby and lead to potential developmental problems, cause premature birth or result in low birth weight.
Postpartum depression does not always develop immediately post-partum. It can happen during pregnancy - known as prenatal or antenatal depression - or crop up sometime later, even up to a year after the new mom has given birth. Therefore, keeping an eye on yourself and your emotions are very crucial at every stage of your pregnancy and afterward. Just as the development of conditions such as gestational diabetes and preeclampsia are completely out of your control, so is the development of postpartum depression. What IS in your control, however, is recognizing the condition and choosing to get help and treatment for yourself and your family.
In some cases postpartum depression in it's most extreme form can lead to the development of postpartum psychosis, which means the person has become detached from reality. Some of the symptoms for postpartum psychosis include seeing and hearing things (hallucinations), being delusional and believing in things that are not real, rapid shifts in mood as well as feeling paranoid. If any of these symptoms creep up during and after pregnancy, it is imperative to get help, left untreated postpartum can take a dangerous turn and lead to deadly results.
Andrea Yates is a prime example of the dangers of postpartum depression. Mother of five young children, their ages ranging from seven years old to six months old, she developed depression after she had her fourth child. Her depression spiraled and she tried to commit suicide. Following treatment and hospitalization, she was stable enough to return to her normal life but attempted suicide twice more. She was diagnosed with postpartum psychosis and was advised to have no more children. A couple of months later she became pregnant with her fifth child. Six months after the birth of her daughter, one morning when left alone with all five of her children, she drowned them before calling her husband and asking him to come home.
Again, while this is a very extreme case of postpartum depression, unfortunately, it's not the only case of a mother killing or hurting her child. These cases serve to demonstrate the severity and seriousness of the illness and why it is so important to seek help as soon as you feel like something is wrong.
How Is Depression During Pregnancy Diagnosed?
Diagnosis for prenatal or postpartum begins with a visit to the doctor, therapist or your whoever you are seeing during your pregnancy i.e. a midwife or your OBGYN.
Your doctor will base their diagnosis on conversations with you. They will ask you questions about your family life, how you feel on a daily basis, your eating and sleeping patterns, how you feel towards the pregnancy and the baby, do you ever contemplate hurting yourself or the baby, etc.
It can be hard to remember everything on the spot so it may be a good idea to write down all the symptoms you are experiencing and keep a diary or jot notes of what kind of thoughts are going through your head and what you are feeling. No matter how dark or embarrassing you think your symptoms are, do not be ashamed to share them with your doctor.
Diagnosing depression during pregnancy can be challenging given the range of emotions women feel as a result of the hormonal imbalance. Therefore being honest and truthful will help you get an accurate diagnosis. Once you have received your diagnosis, you can look at treatment options with your doctor.
Like depression, prenatal and postpartum depression is treated using different forms of talk therapy and medication.
During your therapy sessions, you will meet with either a psychologist, a psychiatrist or a mental health therapist who will take the time to listen to understand your thoughts, emotions and what you are going through. They will provide you with the necessary tools to cope with these emotions and turn your negative feelings and thoughts into positive ones. Over time the symptoms of depression will decrease and fade and you will once again feel like your normal self. Therapy sessions can also involve family, couples and group therapy since the way you are feeling will likely have had an impact on close family members.
In conjunction with therapy, the doctor may also prescribe anti-depressants if they feel therapy alone will not yield the right results. There are also some natural ways of decreasing the symptoms of depression, staying active, eating well and getting plenty of rest are all things you can do to help yourself feel better.
If you were diagnosed with depression or an anxiety disorder prior to becoming pregnant, you should discuss it with your doctor at the start of your pregnancy and look at what steps you can take in order to prevent or prepare for prenatal or postpartum depression. Your doctor will likely monitor you a little more closely, recommend therapy sessions and depending on the situation may even give you pregnancy safe anti-depressants.
Once you have given birth, your doctor will again make an appointment with you and keep an eye on signs of postpartum so you can receive treatment as soon as possible.
Treatment for postpartum depression will be more effective and successful when the mom has a very strong support system and an understanding and involved partner. So if someone you know and love is going through this, try to keep an open mind and be there for them as much as you can. And if you're a mom going through depression and you're just not sure where to start looking for help, plenty of resources online like BetterHelpcan guide you and provide you with immediate support.
It's a common saying that it takes a village to raise a child, it can also take a village to ensure the health and well being of the person who gave life to the child. Often moms feel bad about asking for help and they feel they need to everything on their own. This is not the case. A baby changes things, especially in the first few months so if you are struggling do not be too shy or afraid to ask for help or feel guilty about taking some downtime for yourself.
Even though it can be hard to find the time or the prospect may seem daunting, try to get in some regular physical activity through the week and force yourself to take out time to engage in one enjoyable activity like reading or taking a bath or doing your nails. Something that forces you to focus just on you and give you a breather from all things baby. In addition, make sure to not isolate yourself, be social, go for a walk, talk to a neighbor or have a friend over for coffee. It can even be something as simple as sharing stories and experiences with other moms online.
If you have absolutely no support at all, no family, no partner, no friend to rely on and you desperately need help or you have concerns about what you might do to yourself or your baby, put the baby down in a safe place like a crib or a bassinet or even the floor and call 911. Go to the nearest hospital, clinic or police station or knock on a neighbor's door to get you some help.
Bringing a child into this world is a joyous occasion but it is also an overwhelming experience and physically and mentally taxing. In the early days, the only thing that matters is keeping your baby happy and healthy and the key to achieving that is a happy and healthy mommy which is why help and treatment for any kind of health concern and depression are imperative.