It can be easy to slip into idealistic vision that pregnancy should be a time of joy and wonder for all women.
While this is the case for some, pregnancy can come with its fair share of physical and emotional issues or even hardships.
For at least one in ten expectant mothers, antenatal depression is a challenging reality that calls for understanding, compassion, care and early support.
Pregnancy is a time and experience of radical physical and hormonal change.
For some women, antenatal depression is simply the result of hormone balances and changes.
Others become depressed as a result of concerns over physical changes, feel deeply anxious and out of control about their changing lives, or are just struggling to cope with a difficult pregnancy.
Some women may assume the depression they are experiencing is a ‘normal’ pregnancy symptom. While some changes in mood are normal, true feelings of depression should be addressed. Depression during pregnancy may seem difficult to see, understand and make sense of with everything else going on, but it’s vital that it’s picked up as quickly as possible.
Early support can make a real difference to the rest of the pregnancy, birth and early parenting experiences, helping mama and baby to get off to the best possible start together.
Symptoms of Depression During Pregnancy
Here are 6 symptoms of antenatal depression:
#1: Chronic Anxiety
It can be normal to worry about lifestyle changes when expecting a baby. Concerns about what type of mother you will be, finances and relationship concerns are also normal. However, if you are constantly occupied by these worries, so much so that it impacts your daily activities, it can be a sign of antenatal depression.
#2: Appetite Changes
Changes in your appetite while pregnant can occur frequently. Changes that occur that are not due to nausea/vomiting, or due to a normal increase in caloric needs might be a sign of antenatal depression. Not wanting to eat, or eating drastically less, despite a lack of nausea/vomiting can be concerning. Wanting to eat constantly, especially when feeling down, might also be a red flag for depression.
#3: Severe Fatigue and Insomnia
While fatigue and insomnia can occur in pregnancy, if you're depressed these symptoms can be severe. If fatigue is so overwhelming that most days you're unable to go about your typical activities you might be experiencing depression related fatigue. There are other causes of fatigue in pregnancy, but if it is severe it is good to go over symptoms with your provider.
Many pregnant mamas experience insomnia. However, if you are really unable to rest due to anxious thoughts or unable to rest regardless of fatigue this might be a sign of depression related insomnia.
#4: Frequent Crying/Weeping
It is not unusual to be more emotional during pregnancy. Crying occasionally usually isn't a cause for concern. If you find yourself crying often, experiencing an overwhelming sense of sadness or hopelessness, the tears might be more than typical pregnancy emotions.
#5: Changes in Social Interactions
Many expectant mamas feel some fatigue and may limit their social interactions during pregnancy. Not wanting to go out as much as you normally would can be normal. If you find that you are not wanting to go out because the idea of interacting with others brings anxiety that might be a sign of depression. Intentional isolation is a symptom of depression, and unfortunately can make depression even worse.
The exception to this can be towards the end of pregnancy when you are beginning to nest and prepare for birth.
Due to hormonal changes it isn't uncommon to feel a little short with yourself, your partner and others.
However, if you find that you are irritated more often than not, and frequently over little things, it might be related to depression.
What Can Cause Depression During Pregnancy?
There are many physical, emotional and lifestyle changes that occur with pregnancy that can lead to depression during pregnancy.
Previous History of Depression or Other Mood Disorders
If you have a previous history of depression, or other mood disorders, you might be more likely to experience antenatal depression. The hormonal changes that occur during pregnancy can trigger depression.
Even without a history of depression, the hormonal changes of pregnancy can trigger depression.
Weight fluctuations, breast changes, skin changes and more can be drastic for some women. These changes, though normal, can be upsetting to some women. Women with a history of eating disorders are particularly vulnerable to depression related to physical changes in pregnancy.
Previous Pregnancy or Child Loss
Grieving parents can find themselves experiencing a mix of emotions. They are still saddened by the loss of a pregnancy or child and trying to reconcile those feelings with the joy of new life. There may be fear and concern about another loss, or guilt for moving on.
Having a high risk pregnancy, dealing with bed rest, or dealing with severe nausea and vomiting (Hyperemsis Gravidarum) can lead to depression. This can be due to the physical effects as well as the emotional.
Being active, staying hydrated and adequate nutrition intake are important for physical and mental health. When a mother is on bed rest she isn't likely to get much physical activity and she is likely to miss out of natural vitamin D. A mother experiencing severe nausea and vomiting might be missing key nutrients, health omega fats and she isn't likely to remain physically active.
For mothers experiencing a high risk pregnancy they might experience emotional stress worrying about complications. Mothers on bed rest or with HG are likely to feel isolation and worry for themselves and their babies.
Relationship concerns and troubles, family situations, work and maternity leave concerns can all cause a lot of stress during pregnancy. An unexpected pregnancy or lack of support can also cause stress. Difficult social situations, added to typical pregnancy stresses, can lead to depression during pregnancy.
How Do You Deal With Depression During Pregnancy?
Anytime you have concerns it is important to reach out to your care provider. If you have any general concerns or if you feel you have any symptoms of depression during pregnancy, reach out to your provider.
While it's designed for the postnatal period, some providers recommend the Edinburgh Postnatal Depression Scale to help evaluate risk for antenatal depression. This is a self-assessment tool, the results are then discussed with your healthcare provider.
You should seek help immediately if you have any thoughts about self-harm.
How Is Depression During Pregnancy Treated?
While antenatal depression is sometimes the result of pregnancy, simply waiting for the pregnancy to end is rarely recommended. Untreated antenatal depression is linked to postnatal depression.
The first step in treatment is reaching out to a trusted healthcare provider. There are a number of treatment options and things that can help alleviate antenatal depression symptoms:
- Counseling or therapy (try and find a therapist who specialises in prenatal or perinatal issues)
- Nutrition is important for emotional health. Ensure an adequate intake of B vitamins, vitamin D and omega 3s. A recent study has also identified a strong link between processed grains and depression. Sugar and processed grains keep proving time and time again that they are bad for both body and mind.
- Treating iron deficient anemia if present (ask your doctor for a full blood test to check for any deficiencies)
- Physical activity when safe, including walking and mindfulness yoga
- In-person and online support groups
- Byron Katie's The Work can be helpful if you'd like help with turning any unhelpful, negative thoughts around
- Learn about mindfulness — see the short video below from world famous mindfulness guru, Jon Kabat Zinn
- Support from your partner, family and friends
- Meditation, prayer, or journaling
- Medication when necessary (discuss side effects with your care provider and research this option)
If you come across a care providers who is dismissive or insensitive, understand that it's just their attitude and nothing about you. Please ask your friends for recommendations to find someone who will truly support you like you need.
Most importantly, remember that no one chooses to be depressed. Your depression and symptoms are not a reflection of the type of parent you will be or your ability to love your child. Being proactive with treatment can also reduce the risk of postnatal depression. With treatment, many women find relief from depression during pregnancy.