As many parents can attest, with pregnancy comes an overwhelming sense of happiness and accomplishment. There is the excitement, baby showers, and the wonder of a new life yet to come. In contrast to all this joy, pregnancy can be clouded by depression, a condition that puts not only the suffering mother at risk, but also the unborn child.
In the case of more than 10 percent of pregnant women, the coming birth of a child is interlaced by feelings of sadness, hopelessness, and anxiety, as well as a decreased appetite and problems sleeping, but there is hope. Expectant mothers do not need to suffer from this condition.
Depression is almost always treatable during pregnancy with psychotherapy and antidepressant medication. During pregnancy, doctors try to keep women from taking antidepressants unless they have an extremely severe case of depression or if they have a history of repeating recurrences when taken off antidepressants in the past. Other interventions, like psychotherapy, are used to help reduce the need for an antidepressant.
If depression is so severe that a pregnant woman is not eating or gaining weight, for instance, it needs to be treated as aggressively and quickly as possible. Women at risk for depression during pregnancy are those who have battled major depression in the past or who have experienced depression during a previous pregnancy. On a more optimistic note, the risk associated with the use of antidepressants during pregnancy is small. There are many variables, which should be considered when deciding whether or not to take an antidepressant, or if it might be better to try other therapies first. One key factor to treat pregnancy-related depression is to put an expectant mother at ease.
15 How Does Pregnancy Affect Depression?
Depression during pregnancy, or antepartum depression, is a mood disorder just like clinical depression. Like any mood disorder, it cannot be avoided like any biological illness that involves changes in the brain chemistry.
It's not easy for a woman coping with depression, especially when everyone around says she should feel rosy. The reality is, pregnancy depression is common, affecting between 14-23 percent of expecting mothers. It's not surprising that women are especially vulnerable to depression when they’re expecting. The massive influx of hormones paired with stress, anxiety, and societal pressure to show a pleasant face to the world could traumatize any woman, doubly so during pregnancy. Some factors can put a woman at greater risk for depression, however, it’s an illness that strikes women of all ages, at all stages of their lives, and there’s no shame in asking for help.
Pregnancy depression can be severe and most definitely should not be underestimated. It leaves some women feeling so sad and hopeless that they have trouble taking care of themselves and their new babies. Not all is lost, however, symptoms of depression can be effectively treated with the right care. Drug-free approaches like talk therapy can have a massive impact. Tricyclic antidepressants have recently been shown in new research to be more effective and safer during pregnancy than was previously believed. Deciding what treatment is right for her is a highly personal decision. A woman’s doctor can walk her through the details and options specific to her. During pregnancy, hormone changes can affect the chemicals in a woman's brain, which are directly related to depression and anxiety. These can be exacerbated by difficult life situations, which can result in depression during pregnancy.
14 Depression Symptoms
If the depression symptoms were mild or moderate, most doctors would rather use psychotherapy or group therapy in place of antidepressants. In those cases where pregnant women are suffering major depression, the risk of a relapse after stopping antidepressant medication is greater than the risks posed by treating it with medication.
If a woman’s health habits are not good because of depression, that could have a negative impact on her pregnancy. For instance, if a woman is not eating, not sleeping, feeling stressed or anxious, these could have a detrimental impact on a developing fetus.
Another concern is suicidal feelings which pose other adverse risks associated with depression. Untreated depression can interfere with a woman's ability to care for herself. It can also impair nutrition, increase the use of tobacco, alcohol, and drugs, lead to premature labor and low-birth-weight babies, and interfere with bonding feelings with an unborn child. Untreated major depression during pregnancy may also cause infants to have an increased sensitivity to stress.
In cases of major depression, women need both psychotherapy and antidepressant medication. The more multidisciplinary the treatment, the more likely they are to see positive results. Using both therapy and medication greatly increases a woman's chance of seeing an improvement in her symptoms.
13 The Safety of Antidepressants & Pregnancy
When the symptoms of depression warrant psychotherapy as well as antidepressant medication, the good news is that certain drugs can help treat depression with little to no risk to an unborn child. There is no evidence to suggest that taking antidepressants during pregnancy comes with a risk of congenital defects. Having stated that, it is important to keep in mind that no one can say for certain that antidepressants are 100 percent safe to take during pregnancy.
According to U.S. studies, women who took antidepressant drugs throughout their pregnancies, both selective serotonin reuptake inhibitors (SSRIs) such as Prozac and Zoloft and tricyclic antidepressants, had children with normal preschool and early-school development. On the other hand, the study data also suggested that depressed, untreated pregnant women and those suffering from long-term depression or multiple episodes of depression can have children with behavioral problems and delayed cognitive and language development.
These results can be interpreted in different ways. One, the depression of the mothers could lead to issues in raising the child. Two, the antidepressants could lead to yet unknown chemical changes in the unborn child’s brain chemistry. Either interpretation at this point is equally valid.
12 Concerning Labor
The foremost concern with treating women suffering from depression is premature labor. An anecdotal view of medical records has shown a corollary between treatments with SSRIs during pregnancy and an increased risk of premature delivery before the 36-week viability period is reached. A woman treated with another variety of antidepressants called tricyclics carried no increased risk of premature birth. The risks associated with SSRIs is not grave enough to suspend the use of said medication while pregnant if their condition warrants medication. There is also no risk of birth defects associated with SSRIs.
In the U.S., antidepressant use has increased 400 percent since the late '70s. Depression is a very real and debilitating disease, and when combined with pregnancy, it can be an all-consuming void. It's crucial that women are open and honest with their care providers to obtain the best and safest care possible. Remember, don't ever make changes to her dose or quit taking any medication without first consulting her care provider. Mood stabilizing drugs are powerful and should be respected. Women are more than twice as likely to suffer depression as men, according to the American Psychological Association. And women are most likely to be depressed during their childbearing years, between 20-50 years of age.
11 Medication Dependency and Withdrawal
There is an additional concern whether a newborn baby whose mother took antidepressants during pregnancy will suffer from symptoms of withdrawal. While the SSRIs such as Zoloft, Prozac, and Paxil, are unlikely to cause any major birth defect, several, including Prozac and Paxil, have been reported to increase the risk of withdrawal symptoms in the newly born child, especially if they are used in the third trimester.
Studies that assessed the risk of SSRIs taken during pregnancy showed that Paxil could cause withdrawal symptoms, such as jitteriness, vomiting, and irritability in infants. Research has shown the cause of the symptoms is not entirely clear. They were not able to say definitively whether the symptoms were a result of withdrawal, the toxicity of the drugs, or other unknown factors. There is a certain level of data noise when dealing with newborns, as their bodies are still adjusting to the external world.
10 What are the Signs of Depression?
Antenatal depression is when a woman experiences depression during pregnancy. Women experience a wide range of emotions during pregnancy, ranging from joy and excitement to stress and apprehension. The physical changes can also have an impact on a woman's mood and feelings. For some women, an unplanned pregnancy can be a destabilizing experience, particularly if it happens in a stressful situation, if she is on her own, still in her adolescence, or just not quite ready. There is no right or wrong way to feel during pregnancy. Her reactions and emotions will depend on her situation, although it can be hard to know whether her feelings are within the 'normal' range when she is not under her 'normal' circumstances.
The symptoms of pregnancy depression are many. One symptom is having a prolonged low mood and/or feeling numb. Sudden unexplained feelings inadequacy, like failure or feeling guilty, ashamed, worthless, hopeless, helpless, empty or sad are excellent examples of oncoming depression. Many women spend all day often feeling close to tears even when pretending to be happy. A woman may have persistent, irrational anger, feeling irritable or resentful at times, directing these feelings to her other children or her partner. She may fear for the baby or fear of being alone with the baby or the baby being unsafe in her presence, despite having no desire to cause the child harm.
Some women develop a fear of being alone or going out. There can be a total loss of interest in things that she enjoys; this can be precipitated by insomnia. Insomnia is being unable to fall asleep or get back to sleep after night feedings, sleeping excessively, or having troublesome nightmares. A woman can have extreme appetite changes that can be expressed by not eating or overeating to cope with emotional turmoil. When a woman feels unmotivated and unable to cope with the daily routine withdrawing from social contact and looking after herself properly, this is also a sign of depression.
A woman may have decreased energy and feel exhausted. If a woman feels like she is having trouble thinking clearly or making decisions, demonstrating a lack of concentration and poor memory, this can be a sign of depression. If a woman has thoughts about harming herself or the baby, ending her life, or wanting to escape or get away from everything, she could be critically depressed.
As long as her mental state is cared for and not dismissed offhand, mild depression is nothing to be overly concerned about. It is quite common to experience symptoms of anxiety as well as depression.
9 What Triggers Depression?
There are many factors that color the emotional landscape of the most stable pregnant women. Relationship problems can exaggerate feelings of isolation and loss. Another trigger is family or a personal history of depression. Those who suffer from depression are more easily taken by depression. Infertility treatments can also trigger bouts of depression from out of nowhere. The hormone injections that increase the likelihood of conception also plays havoc with emotional coping mechanisms and a sense of equilibrium.
When a woman has had a miscarriage or difficulty conceiving the stress of having a successful pregnancy can lead to depression. Previous pregnancy loss is an ever-present trigger for depression. There can be feelings of inadequacy that are especially traumatic. While pregnant, even simple life stresses can become the crippling depression. Paying bills or cleaning the house could become crippling. Stressful life events can be blown out of proportions. What is really a simple task feels like an epic battle with demons.
If there are complications in pregnancy, they will more likely lead to nervousness and anxiety over the well-being of the child. If the mother in question has a history of abuse or trauma, the mother may not feel secure, and feelings of insecurity can turn into feelings of anxiety or the post-traumatic stress can manifest itself due to the stress of the pregnancy.
8 Can Depression During Pregnancy Harm the Baby?
Yes, depression can have harmful side effects to an unborn child. Depression that is not treated can have potentially dangerous risks to both the mother and the baby. Untreated depression can lead to poor nutrition, drinking, smoking, and suicidal behavior, which can cause premature birth, low birth weight, and developmental problems. A woman who is depressed often does not have the strength or desire to adequately care for herself or her developing baby. Without proper nutrition, fetal development is dramatically impacted.
Babies born to mothers who are depressed may be less active, show less attention and be more agitated than babies born to moms who are not depressed. This is why getting the right help is important for both mom and baby. The long-term effects of depression on both the body and the mind are in many ways more destructive than simple physical injuries. Depression can cause major chemical imbalances, which can leave a woman susceptible to illness and negative self-destructive thoughts. If a woman is suffering from depression, she must seek help and monitor her condition closely. With very little prompting a depressive state can escalate.
7 What are the Best Treatments for Depression During Pregnancy?
If an expectant mother feels she may be struggling with depression, the most important step is to seek help. She should talk with her healthcare provider about her symptoms and her struggles. Her healthcare provider wants the best for her and her baby, and if he/she thinks her condition warrants it, she may discuss options with her for treatment.
Treatment options for women who are pregnant can include support groups, private psychotherapy, medication, and light therapy. Therapy can help expectant mothers, women who are facing postpartum concerns, and the partners of these women to address the various issues that pregnancy and childbirth are likely to cause. Women who experienced mental health issues before pregnancy may fear that the added challenge of motherhood will exacerbate their conditions or cause further concerns to develop, but the support of a therapist or counselor throughout their pregnancy may help them feel more at ease. Women who experience postpartum depression or psychosis may find therapeutic treatment, combined with medication when necessary, has a beneficial effect.
6 Stress Reduction During Pregnancy
During pregnancy, stress reduction is considered to be one of the most important ways an expectant mother can achieve better health and prevent certain pregnancy complications. The causes of stress (stressors) during pregnancy are often varied. A woman may become stressed as her body begins to change, and also as she experiences the effects of pregnancy-related hormones, or as a result of anxiety or fears about pregnancy and childbirth. Individuals who experience negative or catastrophic life-changing events during pregnancy or who have chronic stress, such as PTSD, or other mental health concerns may also experience greater levels of stress during pregnancy.
A health care professional will most likely advise a woman experiencing stress to cut back on stressful activities, to stay healthy and fit by eating nutritious foods, and to keep as active as possible. A woman should maintain a support network and keep in contact with friends and family, seek and accept help when needed, participate in childbirth education classes, and take up relaxation techniques such as prenatal yoga or meditation. Professional help from a therapist or counselor may also be recommended for the best long-term health benefit.
5 Coping With Pregnancy Loss
Pregnancy loss is devastating for both parents and those close to the family. No matter when it happens or under any circumstance, the loss is crushing. With time and effort comes healing. Allow all affected to mourn her pregnancy loss and accept what happened and then look toward to the future. There may be a range of emotions she has to go through in order to come to peace. At first, it might be impossible to grasp what happened. She might find herself in shock or disbelief. Guilt is the most common emotion, felt first by those suffering the loss of their unborn child. She might wonder if she could have done anything to avoid the loss.
4 The Difference Between Grieving and Depression
The difference between grieving and depression is summed up best as such: depression is a constant feeling of negativity that stems from a chemical imbalance in the brain. There are many types of depression, and someone with depression may feel the symptoms briefly or over many years. Emotional influences like stress don’t cause depression but they can intensify it. Depression is often treated with medication and therapy.
Grief, on the other hand, is an acute, profound grief that causes long periods of suffering after losing a loved one. Many doctors believe that it’s related to adjustment disorder, which happens when she shows a long and intense response to stress. Many doctors are now discovering that profound grief has many features of a disorder. Doctors once avoided giving treatment to people who were grieving. Profound grief has long been considered a personal, non-medical struggle. However, new evidence shows that profound grief can make her feel worthless and suicidal, which is similar to depression. Because of this, doctors now seek to treat profound grief like a disorder, suggesting therapies and treatments to lessen the draining hurt of profound grief.
3 The Cause of Profound Grief
Grief is most commonly caused by the death of someone her love or a major loss of a key item associated with her sense of self. If her significant other or a close family member dies suddenly, she may have trouble accepting her loss. She may feel intense sadness for years. Her relationships with friends, family, and coworkers may suffer. She may even completely withdraw from her personal and professional life.
Profound grief doesn't have any identified biological causes as depression does. Profound grief does have some things in common with depression. It is believed it may happen because of genetics, body chemistry, personality, and her environment. Precise data is not available on the number of people suffering with profound grief that verges on depression.
According to a study, between 10-20 percent of people who grieve have severe enough symptoms to be thought of as having profound grief. Depression is well documented. According to the National Institute of Mental Health, nearly 7 percent of adults in the United States experience depression each year.
2 Profound Grief's Impact on the Brain
The concept of pathological mourning has been around since Sigmund Freud but it began receiving formal attention more recently. In several studies of widows with severe, long-lasting profound grief in the '80s and '90s, researchers noticed that antidepressant medications relieved such depressive feelings as sadness and worthlessness, but did nothing for other aspects of profound grief, such as pinning and intrusive thoughts about the deceased. The finding suggested that complicated, profound grief and depression arise from different circuits in the brain. The grieving process is unpredictable. Mourners move through different stages of grief much like a bullet rockets from steel wall to steel wall. This process continues until the person is able to reconcile their emotions with the reality of their loss.
On the other hand, profound grievers are forever bouncing back and forth through the stages of grief without resolution. New findings show that their brains process grief differently from those who are able to reconcile the loss of a loved one. The difference seems to be in the style of longing for their lost loved ones and in despairing for the future that prevents them from sufficiently working through the grieving process.
1 Treatment Options for Profound Grief
Her doctor may recommend therapy to treat her profound grief. Profound grief therapy involves techniques like repeatedly telling the story of her loved one’s passing. Profound grief may also help her focus on building her personal relationships and reaching her personal goals. Research shows that antidepressants can help treat profound grief if she is also having therapy. Depression symptoms can result from profound grief and make her grief worse. Profound grief can also worsen pre-existing depression.
Antidepressants can help restore the brain imbalances that cause depression and help her through her grief. Talk to her doctor about antidepressants, and decide if antidepressants are the right choice for helping her confront and accept her loss. The grief process can be complicated by depression, anxiety, post-traumatic stress disorder, or substance abuse. It’s best to see a professional counselor who can determine the right treatment.
Sadly, some people do not get treatment and end up taking their own lives. It is never so bad as to lose a life. We hope this article is useful to women suffering the major trials of pregnancy depression and/or the loved ones who may be trying to help.