Depression And Pregnancy: Signs To Look For And How To Get Help

This article addresses serious content, including depression, self-harm, and suicide. If you think you may hurt yourself or attempt suicide, reach out to 911 or call a suicide hotline. In the U.S., you can dial 1-800-273-TALK (1-800-273-8255) to reach the National Suicide Prevention Lifeline. Or, use the webchat at suicidepreventionlifeline.org/chat.

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 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 parents 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 changes a woman's body goes through can trigger all sorts of emotional ups and downs. The happiness and joy are a given, but what happens when things are not as rosy as you had 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, and 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 generally been led to believe that pregnancy is a happy time, and anything less is out of the question.

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. In fact, much of the western world is starting to recognize and address postpartum depression as an issue that 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 mom and fetus at risk.

Society places certain expectations on a mom, whether this is her first pregnancy. There is pressure to be “perfect” in every way: not to gain too much weight, have the perfect belly bump, always be happy because you have a beautiful child(ren), and 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 mom, especially a new mom, would feel reluctant to talk about or admit to depression during pregnancy.

Postpartum Depression:

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 and 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 fetus and wonder what kind of parent they'll be and 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, and feeling anxious and nervous. These symptoms usually last for a couple of weeks postpartum and generally resolve on their own.

But this isn't always the case for every mom. Some women experience prolonged bouts of baby blues, which intensify and become 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 (e.g., bipolar disorder, mood disorder or depression);
• Having a family history of depression or mental illness;
• Experiencing postpartum depression in a previous pregnancy;
• Living through a stressful pregnancy or dealing with stressful events such as relationship and finance problems orhaving a baby with special health needs.
• If the pregnancy was inintended

What Does Prenatal and Postpartum Depression Look Like?

Being a new parent, whether it's your first child or second, third, or fourth, can be an overwhelming experience. In the chaos of sleepless nights, frantic crying, feedings, and diapers, it can be very easy to miss the signs of depression or, if recognized, dismiss them. Therefore, it can often fall on the spouse, partner, or other family members to take notice. Here are some signs of depression to look for:

• Experiencing intense mood swings and crying excessively
• Lacking interest in the baby or having a hard time bonding with the baby
• Becoming socially withdrawn from friends and family
• Becoming angry and irritable very quickly for little things
• Feeling hopeless and sad
• Feeling like a bad mother
• Lacking interest or joy in previously enjoyable activities
• Experiencing problems with sleeping, either sleeping too much or not at all
• Having trouble getting through the day
• Experiencing intense fatigue and lack of energy
• Experiencing panic or anxiety attacks
• Having thoughts of self-harm, suicide, or death

If you think you may hurt yourself or attempt suicide, reach out to 911 or call a suicide hotline. In the U.S., you can dial 1-800-273-TALK (1-800-273-8255) to reach the National Suicide Prevention Lifeline. Or, use the webchat at suicidepreventionlifeline.org/chat.

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 when pregnant may also pose risks for the fetus and lead to potential developmental problems, premature birth, or low birth weight.

Postpartum depression can also crop up sometime later, even up to a year after a 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 its 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 (i.e. hallucinations), being delusional, experiencing rapid shifts in mood, and feeling paranoid. If any of these symptoms creep up during and/or after pregnancy, it is imperative to get help. Left untreated, postpartum psychosis can take a dangerous turn.

Andrea Yates is a prime example of the dangers of postpartum psychosis. Mother of five young children, their ages ranging from six months to seven years old, Yates 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 Yates 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.

While this is a very extreme case of postpartum psychosis, it’s unfortunately 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 and After Pregnancy Diagnosed?

Diagnosis for prenatal or postpartum depression begins with a visit to a doctor, therapist, or whoever you are seeing during your pregnancy (e.g.,midwife).

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 toward the pregnancy or if already given birth, the baby; and if you’ve had any thoughts of hurting yourself or the fetus or baby.

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 because 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.

Therapy for Prenatal and Postpartum Depression

Like other forms of 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 and 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. 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. Online therapy has been proven to be especially effective for mothers because of its convenience and cost effectiveness.

In conjunction with therapy, a 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 by staying active, eating well, and getting plenty of rest.

If you were diagnosed with depression or an anxiety disorder prior to becoming pregnant, it’s important to discuss this with your doctor at the start of your pregnancy and look at what steps you can take to prevent or prepare for prenatal or postpartum depression. Your doctor will likely monitor you a little more closely and recommend therapy sessions and depending on the situation, you may even be given 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 depression, so you can receive treatment as soon as possible.

How BetterHelp Can Support You

Treatment for prenatal and postpartum depression generally proves more effective and successful when the mom has a very strong support system and an understanding and involved partner. 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 experiencing depression, and you're just not sure where to start looking for help, plenty of resources online like BetterHelp can guide you and provide you with immediate support in the comfort of your home and on your schedule. Below are some reviews from clients who have worked with BetterHelp online therapists.

Counselor Reviews

“Tammy listens and understands my struggles. She works with me to help me understand how to be in better control of my anxiety. She’s been a godsend as I got through a very difficult pregnancy after a loss.”

“I’ve had a few sessions with Wafa. She is kind, attentive, good sense of humor, and is firm in her approach which I was hoping for. I’m pregnant and she has been great help in conquering issues related to pregnancy, relationships, and the identity change that comes it. She asks great questions that lead me to consider the root of my problems and gives good practical suggestions to move forward in healing/changing limiting behaviors/thoughts. She checks in on me in between sessions as well. Moreover, Wafa ends sessions naturally, not abruptly and gives me something to think about and work on for the week. So far, because of her insight and attention to detail, I feel I can move forward in a positive direction in my life and relationships.”

Conclusion

It's a common saying that it takes a village to raise a child, but 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 do everything on their own. This is not the case. A baby changes things, especially in the first few months. So, if you are struggling, ask for help and take 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 encourage yourself to engage in one enjoyable activity. Choose something that forces you to focus just on you and give you a breather from all things babies. In addition, make sure not to isolate yourself: be social, go for a walk, talk to a neighbor, or invite a friend over. 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 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 mom, which is why help and treatment for any kind of health concern and depression are imperative.