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Having a baby is a big change. Depressive symptoms can add to the stress, making things difficult. Help is available.
What is depression during pregnancy?
Perinatal depression refers to depression that occurs during or following pregnancy. It is a form of clinical depression that can affect expectant parents at any time.
Like other types of depression, it includes feelings of sadness, anxiety, emptiness, and a loss of interest in previously enjoyable activities. Depression in pregnancy can have a major impact on the pregnant person, as well as the development of the fetus and attachment following birth. This makes it especially important to identify and treat the condition as soon as possible.
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What causes depression in pregnancy?
A mixture of hormonal changes, genetic factors, personal stressors and health problems can cause perinatal depression. Hormonal shifts that occur during pregnancy can affect mood. Additionally, people with a history of depression or a family history of mental health conditions are particularly vulnerable.
Stress related to pregnancy, financial worries, relationship problems, as well as health complications for both the pregnant person and the fetus, can also play a role. Lack of social support, previous experiences of abuse or trauma, and negative feelings about body changes and self-image can increase the risk.
Early detection and treatment, which may include psychotherapy and, in some cases, medication, is important to support the wellbeing of both the pregnant person and baby.
Symptoms of depression during pregnancy
The symptoms of depression in pregnancy can be similar to those of clinical depression. However, these symptoms occur specifically during pregnancy. It can be particularly difficult to identify depression in pregnancy because some symptoms, such as fatigue or changes in sleep and eating patterns, can resemble normal symptoms of pregnancy. Here are some specific signs and symptoms that may indicate depression during pregnancy:
- Persistent sadness, anxiety or “emptiness”: Feelings of hopelessness and helplessness that don’t go away and affect daily activities.
- Loss of interest or pleasure: A noticeable decrease in interest or pleasure in activities that are normally satisfying. This can include lack of interest in the pregnancy.
- Changes in appetite and weight: Significant weight loss or gain not directly related to pregnancy, or changes in eating behaviour.
- Sleep problems: Difficulty falling asleep, sleeping through the night, or excessive sleepiness.
- Increased irritability or frustration: Even over small or insignificant things.
- Feelings of worthlessness, guilt or self-criticism: Especially guilt about pregnancy or being a good parent.
- Loss of energy and fatigue: Feelings of exhaustion and lack of energy for daily tasks, beyond what is normal during pregnancy.
- Difficulty concentrating, remembering details or making decisions: Cognitive changes that affect work and daily activities.
- Recurrent thoughts of death, suicidal thoughts or suicide attempts: Thoughts of harming oneself or the baby.
It is important to distinguish between common pregnancy symptoms and signs of depression. If a pregnant person experiences any of the above symptoms to a degree that affects their quality of life, it is important to seek professional help. Treatment for depression during pregnancy can include psychotherapy, support groups and in some cases medication, all under the close supervision of a health care provider.
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PTSD
Pregnancy can trigger or worsen post-traumatic stress disorder (PTSD) in people with a history of trauma, such as sexual or physical violence. Hormonal changes, increased stress, and fear of childbirth can intensify PTSD symptoms such as flashbacks, avoidance behaviours, negative thoughts, and increased irritability. Interactions with health care providers can also trigger traumatic memories. Treatment is important for the health of both the pregnant person and child. This may include psychotherapy, such as cognitive behavioral therapy or eye movement desensitization and reprocessing (EMDR), and possibly medication after risk assessment. Early intervention with healthcare providers is crucial for a safer pregnancy and delivery.
Postpartum psychosis
Postpartum psychosis is a rare but serious mental illness that occurs shortly after childbirth, usually within the first two weeks. This condition includes extreme mood swings, confusion, hallucinations, delusions, anxiety and difficulty sleeping. The risk of postpartum psychosis increases with factors such as genetic predisposition, hormonal changes after childbirth, lack of sleep and a history of mental illness. Treatment, which usually requires hospitalization, may include antipsychotic and mood-stabilizing medications, as well as supportive psychotherapy and family support. Early treatment is critical to recovery, and most people recover fully with the right care. If you have symptoms of psychosis, you should contact 911 or go to your nearest emergency room.
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Treatment of depression during pregnancy
Treatment of depression during pregnancy includes psychotherapy, such as cognitive behavioural therapy and interpersonal therapy. Additionally, treatment may include antidepressants, especially SSRIs. Lifestyle changes such as exercise, good sleep, a nutritious diet and stress management are also important. Early intervention and collaboration between the pregnant person, their family and health care providers is essential to ensure safe and effective treatment.
Depression in family members during pregnancy
Expectant non-pregnant parents, adoptive parents, and other family members can also experience depression during early parenthood. It can be triggered by emotional stress, financial worries, concerns and fears about the future and parenting, and lack of support. The symptoms are similar to typical depressive symptoms and treating this form of depression often involves therapy and sometimes medication, with an emphasis on the importance of communication and lifestyle factors. Recognizing and managing depression is crucial to giving both expectant partners the support they need during pregnancy or early parenthood.
12 frequently asked questions about depression in pregnancy
What is depression in pregnancy?
Perinatal depression refers to depression that occurs during and after pregnancy. It is a form of clinical depression that can affect expectant parents at any time during pregnancy.
What are the symptoms of depression in pregnancy?
The most common symptoms include persistent sadness, lack of energy, sleep problems, anxiety, a reduced appetite, and feelings of guilt and inadequacy. Consultation with a psychologist or therapist can help make a diagnosis.
How is depression during pregnancy diagnosed?
Diagnosing depression is usually done through interviews and questionnaires that assess your well-being. If you have symptoms, go to your family doctor, OB-GYN or walk in clinic.
How is depression in pregnancy treated?
Treatment options often include a combination of medication, therapy and lifestyle changes. Cognitive behavioural therapy (CBT) is a common form of psychological treatment.
Can lifestyle factors help?
Yes, lifestyle factors such as exercise, keeping a routine, eating well, trying to sleep, asking for help and spending time with people you trust can be helpful.
How long is a treatment for depression?
The length of treatment depends on the severity of the depression and is tailored to the individual.
Can depression affect my relationship with my child?
Yes, depression can affect both how you feel during pregnancy and your relationship with your child, so it is important to seek help if you experience symptoms.
What to do if you have experienced trauma and are pregnant?
If you have experienced trauma and have symptoms of PTSD, it is important to talk to your healthcare provider about it so that it can be taken into account in your treatment plan.
What other mental health concerns can occur during childbirth?
You may also experience anxiety or postpartum psychosis. If there are symptoms of psychosis, you should contact an emergency room or call 911.
What can I do if I feel uncomfortable seeking help?
If you experience symptoms of depression, it is important to seek professional help. Our psychologists and therapists are available for online consultations and can help you make the difficult things easier.
Can I be depressed as a family member?
Family members can also experience depression as a result of having a child and the changes that come with it. In this case, it is also important to seek help.
Where can I get help?
If you experience symptoms of depression, it is important to seek professional help. Go to your family doctor, OB-GYN or walk-in clinic. If you are experiencing thoughts of suicide, self-harm, or symptoms of psychosis, call 911 or go to your local emergency room.
Tips for managing depression during pregnancy
Treatment of depression during pregnancy is mainly done through your family doctor, but here is an overview of the steps that can be included in therapy.
Step 1: An initial assessment session
The first meeting with your psychologist or therapist is usually an assessment to review your mental and physical health. Prepare for questions about your life situation, feelings, thoughts and behaviours. You may also complete assessment forms.
Step 2: Goal setting
This is where you and your therapist set concrete goals for the therapy, both short and long term.
It can define which areas of your life are most affected by your depression and how you would like to change them.
Step 4: Treatment for depression
This is the actual treatment phase, which may include treatment such as cognitive behavioural therapy (CBT). Talk therapy, exercises, and homework assignments aim to give you tools to overcome your depression.
Step 5: Monitoring and evaluation
Your therapist will regularly monitor treatment to see how well the therapy is working. If necessary, the treatment plan can be adjusted or renewed.
Step 6: Ending and looking ahead
As the therapy comes to an end, it is time to reflect on the progress made. You will also receive a plan on how to use the tools and strategies you have learned in the future.
If you or someone close to you is seeking professional help for depression, do not hesitate to book a session with one of our qualified psychologists or therapists. If you have thoughts of self-harm or suicidal thoughts, call 911, call or text the national suicide hotline at 988 or go to the nearest emergency room.
