“Why are you so sad? You’re growing a life inside you, this is supposed to be the best time of your life. You should be happy! You should be glowing!” Every time I heard someone say this to me, I hid further and further within myself, afraid to share how I was truly feeling.
I was angry and anxious and sad. On top of that, I was also feeling shame because I wasn’t thoroughly enjoying my pregnancy. I was ashamed people thought I wasn’t excited for my new baby (which couldn’t be further from the truth). I kept telling myself that I would feel better after I stopped with the morning sickness, which lasted from week 6 to well beyond week 20, returning for the last few weeks of pregnancy. Anyone who threw up daily would feel the same, right? Everyone who has experienced morning sickness was miserable, right? Also who said I should be glowing or that this was the best time of my life? There is nothing great about being hot all the time or suffering from symphysis pubis dysfunction.
Deep down, I knew that my misery went far beyond what I continued to chalk up as “crazy pregnancy hormones.” After the nausea finally subsided, it was replaced with extreme rage. At the time, I felt out of control. My mind began to spin, thinking I wasn’t going to be a good mother of two because I couldn’t handle a rough pregnancy. My kids would begin to suffer at what I began to call “the rage monster”. Instead of getting the help I knew I should get, out of fear and shame, I suffered through the remainder of my pregnancy.
It is estimated that 10-20% of all pregnant women experience a pregnancy related mood disorder. It's difficult to diagnose due to its similarity to pregnancy symptoms, and as such, most often prenatal depression is missed in pregnant women. It could account for a large increase in the number of women who experience it. It has been estimated 86% of women expressed significant depressive symptoms and reported to their OB/GYNs, yet received no further treatment.
The Washington Post claims that prenatal depression may be the most extreme form of maternal depression because it is often more severe than other forms of depression. Perhaps due to the increase of hormones in the system, the stress of difficult pregnancies or the anxiety of becoming a new mother can increase the chances of pregnancy related depression. Feelings of shame are also very common in women who experience pregnancy related mood disorders. They feel like they should be enjoying pregnancy more and wondering why it is that they feel so sad and anxious.
Instead of trying to find the root of the problem, many women trudge along, ignoring the symptoms, avoiding a conversation with their doctors, or refusing to take antidepressants since they worry their unborn babies could be harmed. The irony is that the risks of taking an antidepressant during pregnancy has the same risks that undiagnosed depression has: preterm labor and low birth weight.
While I was happy that I was pregnant and grateful that my daughter was growing healthy inside of me, she came a bit ahead of schedule. We knew that in a few months of getting settled we were going to try for another child. We had just moved into our newly built home and decided that year was going to be one of calmness. When the word pregnant appeared on that test, my mind began to spin as I called for my husband.
Yes, I had been nauseous for weeks. Yes, I had thrown up on Christmas Day a few days prior. But these same symptoms had revealed itself after my first postpartum period a few months prior, so I figured I was just experiencing extreme PMS. Immediately, all my poor choices and my intense fear of having another child began to flood my mind and I burst into tears. I was not ready yet. A new baby was not the calmness I craved after two moves in six months, building a new home, and raising an 18-month-old. I immediately fell into a shame spiral. I was just out with friends and I had a glass of wine. What kind of mother doesn’t know she’s pregnant, despite all the obvious symptoms?
Then the intense guilt hit me that I was crying over something I knew I wanted eventually and that so many women struggled with. Yet here I was, blessed with our happy surprise (I will never call her an accident). The feelings of sadness and extreme anxiety coupled with guilt and shame for feeling that way constantly lurked in my thoughts, creating a wall between my excitement for a new baby and my fear of yet another tough pregnancy.
I am not alone. Many mothers experience extreme anxiety and depression during pregnancy and it can make an already turbulent experience that more difficult. The trouble is also that undiagnosed prenatal depression can lead to an increase in other undesirable outcomes: poor nutrition, lack of care for growing fetuses or for themselves, low birth weight, premature babies, and in extreme cases, suicidal behaviour and psychosis.
I remember sitting in my doctor’s office for a normally scheduled appointment, staring at a poster of a pregnant woman, who appeared to be extremely sad. I read that same poster every single time I came in for a prenatal visit (and mamas, you know that’s a lot in the final months of pregnancy). It begged me to take down the information regarding prenatal depression and anxiety; pleaded with me to finally open up to the doctor about the sadness and rage that had taken over my pregnancy.
But I always chickened out. My doctor would ask me how I was feeling, and instead of telling her about the mental anguish I was experiencing, I would complain about my physical body. By the end of the appointment, I had convinced myself I was being silly; I just needed to survive the next few months and I would have my baby girl in my arms and all would be well again.
The problem with that mentality was that I was not just being silly. I was putting both my unborn child and myself at a greater risk for complications and postpartum depression. My undiagnosed prenatal depression and anxiety led to my immediate diagnosis of postpartum depression even before leaving the hospital. Often times, undiagnosed prenatal depression can result in a higher risk of developing postpartum depression after the baby is born.
Since the 1990s, the diagnosis of prenatal depression has increased significantly. Many attribute this to the social demands of being a mother, the increased cost of living, financial pressures, and the lack of options to stay home with their babies after birth. It is harder to be a mother today than it may have been in generations past due to the increase in stress and a more fast-paced life. Social media and the rise in technology didn’t this help matter, only placing additional stress on pregnant and new mothers portraying their “perfect” life.
The key is getting mothers to feel comfortable enough, without feelings of shame or judgment, and to encourage them to share their symptoms with their doctors or a trusted friend. The more mothers feel safe and that they are not alone in their feelings, the more they can be diagnosed and can start to feel better again.
If you feel like something is not right, act on it. Doctors put up those posters to educate pregnant women who are feeling a certain way and don’t know it’s actually an issue. How many women have blamed their pregnancy hormones for an emotional outburst over practically nothing? I sobbed at the end of Christina Yang’s run on Grey’s Anatomy, SOBBED. But there is a difference between the occasional outburst and the symptoms of prenatal depression and anxiety. And you are not alone.