How Common Is Depression In Pregnancy

If Youre Taking An Antidepressant When You Get Pregnant Dont Stop Taking It Without Talking To Your Provider First

What is depression?

Depression is a medical condition that causes feelings of sadness and a loss of interest in things you like to do. It can affect how you feel, think and act and can interfere with your daily life. It needs treatment to get better.

Perinatal depression is depression that happens during pregnancy or in the first year after having a baby. Its one of the most common medical complications of pregnancy. It affects up to 1 in 7 women . It includes postpartum depression , which is depression that happens after pregnancy.

Depression is not your fault. And treatment can help you feel better. Untreated perinatal depression can cause problems for you and your baby. If you think youre depressed, tell your health care provider right away.

What are the signs and symptoms of depression?

Major depression is more than just feeling down for a few days. You may have depression if you have signs or symptoms of depression that last for more than 2 weeks. Signs of a condition are things someone else can see or know about you, like you have a rash or youre coughing. Symptoms are things you feel yourself that others cant see, like having a sore throat or feeling dizzy.

Signs and symptoms of depression include:

Changes in your feelings

• Feeling sad, hopeless or overwhelmed
• Feeling restless or moody
• Thinking about death or suicide

Changes in your everyday life

Changes in your body

Can depression during pregnancy affect you and your baby?

What causes depression?

More information

Women With A History Of Depression And Receiving Maintenance Antidepressants

Evidence suggests that continued antidepressant use may prevent relapse of depression in pregnancy, although the greatest prophylactic effect is in women with severe or recurrent depression.5859 Switching antidepressants during pregnancy or lactation is not recommended as there is no clear evidence that the safety profile of one drug is superior to that of another, and switching from an effective drug could increase the risk of relapse.

Domestic Violence Or A History Of Abuse

It’s very common for domestic violence and emotional abuse to get worse when you’re pregnant. If this happens to you, it’s crucial that you speak to someone to make sure you and your baby stay safe. Talk to your provider about how to change your situation. You can also call the National Domestic Violence Hotline at 800-799-SAFE or text START to 88788.

Women who have a history of physical or sexual abuse are also more likely to experience depression during pregnancy. If you’ve struggled with abuse in the past, it’s important to seek help from a mental healthcare professional. If you aren’t already seeing a therapist, ask your primary care doctor or OB-GYN for a referral.

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Are Antidepressant Medications Safe During Pregnancy

Growing evidence suggests that many of the currently available antidepressant medicines are relatively safe for treating depression during pregnancy, at least in terms of short-term effects on the baby. Long-term effects have not been fully studied. You should discuss the possible risks and benefits with your doctor.

What Are The Symptoms Of Antenatal Depression

“Pregnancy is meant to be such a happy time but because we dont talk about mental health in pregnancy women dont know that it can be a very different story.”

Typical signs of depression include if you:

• feel generally down most of the time
• cant be bothered with things
• cant concentrate or make decisions
• dont enjoy life
• feel irritable and dont want to be with other people
• feel restless and agitated
• think about harming yourself or suicide.

You may not have all these symptoms and they may come on gradually or you may suddenly start to feel very low.

If you feel like you want to harm yourself or feel like you want to die, its important to tell someone. This could be a family member, friend, your GP or midwife. Help is available now if you need it. You can call the Samaritans on 116 123.

“I wasnt sleeping well and Id wake up with that horrible feeling of doom starting every day. Id cry at the drop of a hat about things that wouldnt normally make me cry.”

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The Following May Suggest Depression During Pregnancy:

• History of depression either before pregnancy or during a previous pregnancy
• Excessive anxiety such as being so concerned about the wellbeing of your baby that it negatively affects your daily activities
• Poor self-esteem such as excessive concern about the ability to be a good mother
• Despondency or hopelessness
• Using alcohol, illicit drugs, tobacco
• Poor weight gain due to decreased appetite and inadequate diet
• Suicidal ideation

Your doctor will look for these five specific symptoms of major depression:

Symptoms Of Depression In Pregnancy

Some symptoms of depression, such as fatigue or trouble sleeping, are normal during pregnancy. But you may have prenatal depression when you have a sense of sadness or hopelessness, lose interest or pleasure in things that you used to enjoy, or aren’t able to function in your daily life, and these symptoms last for weeks.

You may be depressed if you’ve experienced any of the following symptoms for at least two weeks:

• Losing interest in daily activities, or having a sense that nothing is enjoyable or fun anymore
• Feeling “blue,” sad, or “empty” for most of the day, every day
• Having low self-esteem, such as thinking that you won’t be a good parent
• Crying all the time
• Feeling extremely irritated or agitated
• Feeling anxious about your baby
• Finding it hard to concentrate or make decisions
• Having low energy or extreme fatigue that doesn’t improve with rest
• Experiencing changes in your patterns of eating or sleeping, such as wanting to eat or sleep all the time or not being able to eat or sleep at all
• Having overwhelming feelings of guilt, worthlessness, or hopelessness
• Feeling that life isn’t worth living

Research suggests these symptoms may be more likely to happen in the first and third trimesters.

It’s also common for women to develop the first signs of postpartum depression , or depression that develops in the year after giving birth, during pregnancy. In fact, an estimated half of women with PPD first notice symptoms of depression during pregnancy.

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Are You Or A Loved One Struggling With Depression During Pregnancy Learn How To Spot The Signs Understand The Risks And Find Help For This Debilitating Condition

Anyone that has been pregnant or has known someone pregnant can say that it is both a beautiful and terrifying experience. For women encountering their first pregnancy, there are many unknowns about the process and how it changes the female mind and body. Not everyone is aware that depression and pregnancy can be related. In fact, for many women, depression can happen during their pregnancy. As it stands, there is not very much information about why depression occurs during pregnancy in certain women, or if it can be prevented.

It is important to note that any woman can become depressed over the course of their pregnancy, even women that have never had depression and have no family history of depression. Pregnancy causes both physical and mental stress for most women due to fluctuating hormones and rapid lifestyle changes. Even women that have had normal pregnancies before can still develop depression during later pregnancies. Having an understanding of how to recognize depression during pregnancy, how this condition specifically affects both mother and baby and how it can be treated is critical.

How Is It Treated

Treatment for depression is based on the severity of the presenting illness, as recommended in the NICE pathway for common mental disorders in primary care.34Figure 1 provides an example of a stepped care framework. Box 3 outlines suggestions to determine the severity of the depression. A womans treatment may begin at any step in the pathway, depending on the severity of her illness. The NICE guidelines on antenatal and postnatal mental health recommend that all pregnant women with depression, regardless of severity, receive education from their treating provider about depression, including how to recognise symptoms and the short and long term effects on mothers, children, and families.23 Clinicians should explore the severity of depressive symptoms with the women, and review treatment preferences to make shared decisions about treatment. Invite partners and other members of the support system to join management discussions whenever possible.

Fig 1 Stepped care approach to management of depression in pregnancy

Box 3: Determining the severity of a depressive episode using ICD-10 criteria35

Assessment of severity relies on clinical judgment and the number, type, and severity of symptoms:

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Mood Swings Or Depression During Pregnancy

Anyones emotions can be up one day and down the next, pregnant or not. Its part of being human! But pregnancy can take those mood swings to a different level. And every woman, in every pregnancy, will experience those ups and downs in different ways and at different levels of intensity.

Its normal to feel emotional ups and downs while pregnant. You may feel delighted and anxious, excited and exhausted, serene and stressed all in the same hour. You might feel like your body doesnt seem like your own anymore while its changing size and shape. And you may have all kinds of unanswerable questions about your future and your babys future. On top of all that, your hormones fluctuate in different ways than when youre not pregnant, leading to changes in appetite, energy and sleep.

Its no wonder that mood swings are more common and pronounced during pregnancy!

However, for nearly 10% of pregnant women* in the U.S., that anxiety, exhaustion, and stress are more than just mood swings. When these symptoms interfere with daily life, they are reasons to seek help for depression.

Risk Factors For Anxiety And Depression During Pregnancy

Doctors once thought that all of those hormones rushing around a woman’s body during pregnancy would shield her from depression. We now know that for some moms-to-be, the opposite is true. But while experts agree that hormones play a role in depression, the exact mechanisms are unknown.

“It may be triggered by any number of physiologic or life stressors,” says Sheila Marcus, M.D., director of the Women’s Depression Program at the University of Michigan Depression Center in the department of psychiatry. “In women with a genetic predisposition to depression, the hormone changes may be one of these stressors,” Dr. Marcus says

Anyone can experience anxiety and depression during pregnancy, but women with these risk factors are especially susceptible:

• A personal or family history of a mood disorder, such as depression or anxiety
• A history of premenstrual dysphoric disorder
• Being a young mother
• Having poor social support

• Having a C-section

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Are There Other Therapies To Treat Symptoms Of Depression

There are other treatments your doctor may consider. Electroconvulsive therapy, or ECT, is a treatment option for people whose symptoms don’t get better with medicine or who have severe depression and need treatment right away.

Transcranial magnetic stimulation, or TMS, involves using a noninvasive device that is held above the head to induce the magnetic field. It targets a specific part of the brain that can trigger depression.

With vagus nerve stimulation, or VMS, a pacemaker-like device is surgically implanted under the collarbone to deliver regular impulses to the brain.

Getting Help And Support

If symptoms last for more than two weeks, its time to seek support.

Depression is a treatable illness being anxious or depressed doesnt mean youve failed as a parent-to-be, or as a person.

If youre worried:

• talk to your partner, someone in your whnau, or a trusted friend
• talk to your doctor or midwife. Your doctor will be able to talk to you about treatment options, which may include taking medicine. They should also know what support is available in your area.

If youve had depression or another mental illness before, you might like to think about the help or practical support that has worked for you in the past and put a plan in place for after your baby is born. You could ask other people to be ready to help you, or let people know what to look for when you start to feel low so that you can get help early.

Its also good for your partner and other support people to know what to do if theyre worried about you, and to get advice on the best way to support you.

Its really important for both you and your baby you get the help you need to be happy and healthy. If you dont get help the first time you ask, ask again, or find someone else who will listen.

• Talk to other people you may be surprised by who has experienced the same feelings as you.
• Ask for help. This is a sign of strength, you dont have to go through this alone.

You can find out more about depression and get support from:

• PADA Perinatal Anxiety and Depression Aotearoa

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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 the chemicals in your brain, which are directly related to depression and anxiety. These can be exacerbated by difficult life situations, which can result in depression during pregnancy.

If Im Depressed Will It Affect My Children

Depression is treatable. But if it is not treated, it will affect your children.

Moms who are depressed may have trouble caring for their children. They may be loving one minute and withdrawn the next. They may respond to their child in a negative way or not respond at all. Your feelings and your behaviour will affect your ability to care for your children.

Depression can also affect attachment, which is important for your childs development. Attachment is a deep emotional bond that a baby forms with the person who provides most of his care. A secure attachment develops quite naturally. A mother responds to her crying infant, offering whatever she feels her baby needsfeeding, a diaper change, cuddling. Secure attachment helps protect against stress and is an important part of a babys long-term emotional health. It makes a baby feel safe and secure, and helps him learn to trust others.

If youre depressed, you may have trouble being loving and caring with your baby all the time. This can lead to an insecure attachment, which can cause problems later in childhood.

How a mothers depression affects her child depends on the childs age.

Babies who dont develop a secure attachment may:

• have trouble interacting with their mother ,
• have problems sleeping,
• may be delayed in their development,
• have more colic,

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What Causes Perinatal Depression

Perinatal depression is a real medical illness and can affect any motherregardless of age, race, income, culture, or education. Women are not to blame or at fault for having perinatal depression: it is not brought on by anything a mother has or has not done. Perinatal depression does not have a single cause. Research suggests that perinatal depression is caused by a combination of genetic and environmental factors. Life stress , the physical and emotional demands of childbearing and caring for a new baby, and changes in hormones that occur during and after pregnancy can contribute to the development of perinatal depression. In addition, women are at greater risk for developing perinatal depression if they have a personal or family history of depression or bipolar disorder or if they have experienced perinatal depression with a previous pregnancy.

Postpartum Psychosis Postpartum psychosis is a severe mental illness that occurs after childbirth. PP is a medical emergency, and it is important to seek help immediately by calling 911 or going to the nearest emergency room. Women who have PP can have delusions , hallucinations , mania , paranoia, and confusion. Women who have PP also may be at risk for harming themselves or their child and should receive help as soon as possible. Recovery is possible with professional help.

Which Are The Most Popular Antidepressants Suggested To Pregnant Women

Selective serotonin reuptake inhibitors or SSRIs are the most common antidepressants prescribed to women during pregnancy. Other drugs include serotonin, norepinephrine reuptake inhibitors , bupropion , and tricyclic antidepressants.

Selective serotonin reuptake inhibitors or SSRIs are the most common antidepressants prescribed to women during pregnancy. Other drugs include serotonin, norepinephrine reuptake inhibitors , bupropion , and tricyclic antidepressants.

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Screening Is Key To Diagnosing Perinatal Depression

Perinatal depression is frequently missed because many of the signs, including acute and chronic stress, lack of sleep, and hormone swings, are present in all pregnant women. In addition, new mothers may not admit to having symptoms because they feel an overwhelming sense of shame and embarrassment about being less of a mother than they believe they should be. Furthermore, family members may not understand that their partners or relatives behavior constitutes a clinical depression that requires treatment.

Primary care clinicians can dramatically increase the rate of detection and diagnosis by screening pregnant and postpartum patients for mood and anxiety disorders. Trials in the United States have concluded that screening improves outcomes in the depressed mother., Therefore, screening is recommended for all women in the perinatal period by a number of organizations, including the US Preventive Services Task Force , the American College of Obstetricians and Gynecologists, the American Psychiatric Association, and the American Academy of Pediatrics.

One of the simplest and most reliable screening tools is the Edinburgh Postnatal Depression Scale . The EPDS is a cross-culturally validated 10-question form that a woman can complete in 2 to 3 minutes in a waiting room, online, or with a clinician. Sensitivity and specificity range from 70% to 88%, and studies have found that the EPDS is twice as effective as a clinicians interview in detecting depression.