DEPRESSION DURING PREGNANCY
You’ve taken the pregnancy test and shared the good news with those closest to you. Everyone congratulates you and says how happy you must be. But although you’re buoyed up by the atmosphere, inside you may be feeling far from ecstatic. In fact, you may sometimes be downright unhappy.
To make matters worse, you probably feel guilty about being unhappy. But if you think you’re the only one to have these feelings, be reassured that you’re not.
How can I tell if I’m depressed?
Pregnancy can be a positive time, but not always, and not for every woman. About one woman in 10 suffers from bouts ofdepression during pregnancy.
You may think you should gloss over your feelings if you’ve been led to believe that pregnancy is a time of joy. Perhaps you assume that your sadness is just a form of moodiness that’s part and parcel of pregnancy. But depression is more than feeling sad or miserable and can become a serious problem if you don’t get the help you need.
There isn’t a simple set of symptoms which add up to depression, as it varies from person to person. Some people have a low mood all the time, others feel irritable and tearful, or feel useless and want to withdraw from life.
Depression can affect you emotionally and physically and it can alter your behaviour. You may find it very hard to talk about how you feel with others, including your doctor.
If you are suffering from depression, it’s likely that you:
- have trouble concentrating
- feel anxious a lot of the time
- are short-tempered and restless
- have problems with sleeping
- feel constant, extreme fatigue
- are preoccupied with constant, negative thoughts
- want to eat all the time, or not at all
- feel that nothing feels enjoyable or fun any more
- are low-spirited for most of the day
- feel weepy and helpless
What has caused my depression?
It used to be thought that pregnancy hormones provided a protective effect from depression. That’s because many women have a feeling of emotional wellbeing during pregnancy. But it’s now thought that hormone changes in pregnancy may actually contribute to the development of depression.
The stresses and strains of pregnancy, especially if you’re already caring for young children, can leave you particularly vulnerable to depression.
If things aren’t going well, when you’re perhaps experiencing relationship difficulties or money worries, then you may become even more prone to depression.
Other, more specific causes of depression are:
Stressful life events
Major life changes such as moving home, or events such as divorce or job loss can cause depression.
Unemployment and lack of qualifications both play their part but low income itself has a strong link with antenatal depression. If you’re struggling on a low income and looking after children already, then being pregnant again may add to your worries.
Problems with your pregnancy
A troubled pregnancy, such as one that’s marred by severe morning sickness, can take its emotional toll. If you didn’t plan to become pregnant at this particular point in your life then this could also contribute to your feelings.
Complications in a previous pregnancy or birth
Your experience of pregnancy and childbirth in the past can affect how you feel about this pregnancy. Previous pregnancy complications or a difficult or traumatic birth can cause depression and anxiety.
Infertility or miscarriage
If you experienced problems while trying to get pregnant, or have had a miscarriage in the past, it’s only natural to worry about the safety of this pregnancy.
Physical or emotional abuse
Unfortunately, pregnancy can be a trigger for domestic violence to start or get worse. If you’re a victim of domestic abuse you’re also more likely to experience depression during and after your pregnancy.
Talk to your midwife or doctor if you are suffering from, or have suffered from, abuse. It can be hard to bring up the subject, but once you ask for help, you can start to get the support you need.
Personal history of depression
If you’ve experienced depression, anxiety or other mental health problems in the past, you may be more likely to becomedepressed during pregnancy. You may also be more likely to have depression in the year after your baby is born.
During your antenatal appointments, your midwife or doctor should ask you how you’re feeling now and about whether you’ve experienced depression in the past. This is to make sure that help is there for you if and when you need it. Try to be open and honest, even though it may not be easy.
How should I deal with depression?
You don’t have to cope with your depression alone.
- Talk to your midwife or doctor during your booking appointment about your low mood. Explain how you’ve been feeling during the past month. And if you become depressed later in pregnancy, go back and explain that you’re feeling more than just a bit low.
- Take it easy by resisting the urge to pack in as many chores as you can before your baby comes. Make yourself top priority. Read a book, have breakfast in bed, or meet up with a friend. Taking care of yourself is an essential part of taking care of your baby.
- Try to get some exercise, even if you don’t feel like it. It’s unwise to start a full-on fitness regime when you’re pregnant, but exercise can help to lift your mood. Swimming, walking, pregnancy yoga and aquanatal classes are all safe in pregnancy.
- Talk about how you feel to your partner, family and friends, even if you’re more inclined to withdraw from them. Their support is important and unless they know how you feel, they won’t be able to help. Working through your fears and worries about the future can help to unburden you.
- If you’ve tried everything to bring yourself out of a low spell for two weeks but nothing has helped, consider a support group. This group therapy may offer you strategies for coping with your depression or breaking the cycle of negative thinking.
- Sharing your feelings and experiences with other people who are going through the same thing can make you feel less isolated. It can also help you to learn how other people use coping strategies
- If joining a support group doesn’t help, a therapist or a counsellor might. Your doctor or midwife may be able to refer you for whichever therapy is suited to you, such as cognitive behavioural therapy (CBT), problem-solving therapy or counselling. Unfortunately, in some areas of the UK, waiting lists are long, so you may need to pay for treatment. If yourdepression is severe your GP should be able to fast-track you so you can get the help you need as soon as possible.
Seeing a therapist or psychiatrist is not a sign of weakness. It means that you’re a good mum who is willing to take the stepsnecessary to keep your baby and yourself safe and healthy.
Will I need medication for my depression?
It depends on the depth of your depression. If you’re feeling suicidal, can’t cope with day-to-day life, or if you’re having panic attacks, talk to your doctor as soon as you can.
Your doctor may recommend an older type of antidepressant called a tricyclic antidepressant (TCA). This is thought to be the safest type of antidepressant during pregnancy. Amitriptyline, nortriptyline and imipramine are examples of TCAs.
Or your doctor may offer Prozac (fluoxetine). Prozac is a type of selective serotonin reuptake inhibitor (SSRI). SSRIs work well to treat severe depression. The downside of SSRIs is that they may carry slight health risks.
There’s a small chance that Prozac may slightly increase the risk of defects in your growing baby. Continuing to take SSRIs may slightly increase your risk of high blood pressure and pre-eclampsia too.
Another SSRI, Seroxat (paroxetine) carries slightly higher risks of these problems. This and another, related, type of antidepressant, called Efexor (venlafaxine), may also increase your risk of miscarriage. That’s why some SSRIs are not usually recommended in pregnancy.
The risks, however low, associated with antidepressants are why your doctor will talk you through the pros and cons. Your doctor may recommend an SSRI only if you’re through the first trimester. She’ll help you make the best decision. After all, if you’re struggling to take care of yourself because of depression, that’s not good for you and your baby, either.
Try not to feel guilty if you have to take medication to help you. You’re not alone. It’s thought that up to three per cent of pregnant women take SSRIs.
What about when my baby is born?
It’s thought there is a link between depression in pregnancy and postnatal depression. But this doesn’t mean that if you are depressed in pregnancy you will automatically be depressed after your baby is born.
Building a support network of your partner, friends, family, doctor and therapist means help will already be in place when your baby’s born.
DEPRESSION DURING PREGNANCY