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Having a baby is a life-changing event. Between the hormonal shifts, changes in responsibilities, and financial stressors it's no wonder that many people struggle with depression during pregnancy. Here we explore depression that strikes during pregnancy and how you can get help.
What is depression during pregnancy?
Depression during pregnancy, also called peripartum depression, is a form of clinical depression that can affect expectant mothers at any time during pregnancy.
Like other types of depression, it is characterized by 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 woman, the development of the fetus and later attachment to the newborn, making it important to identify and treat the condition.
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What causes depression in pregnancy?
Depression in pregnancy can be caused by a mixture of hormonal changes, genetic factors, personal stressors and health problems. Hormonal shifts that occur during pregnancy can affect mood. Women with a history of depression or a family history of mental health conditions are particularly vulnerable.
Stress related to pregnancy, financial worries, relationship problems, and health complications for both the mother and baby 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 as well.
Early detection and treatment, which may include psychotherapy and medication in some cases, is important to support the well being of both mother and baby.
Symptoms of depression during pregnancy
The symptoms of depression in pregnancy can be similar to those of clinical depression, but they occur specifically during the pregnancy period. 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 in pregnancy. However, 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, including 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 behavior.
- 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 can be expected from 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 woman experiences any of the above symptoms to a degree that affects her 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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Post-traumatic stress disorder (PTSD)
Pregnancy can trigger or worsen post-traumatic stress disorder (PTSD) in women 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 behaviors, negative thoughts, and increased irritability. Interactions with health care providers can also trigger traumatic memories. Treatment is important for the health of both mother and child and may include psychotherapy such as cognitive behavioral therapy or EMDR as well as medication if deemed appropriate. 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 in women shortly after childbirth, usually within the first two weeks. This condition is characterized by 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 women recover fully with the right care. If you have symptoms of psychosis, you should contact 911 or go to the nearest emergency room.
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Treatment of depression during pregnancy
Treatment of depression during pregnancy includes psychotherapy, such as cognitive behavioral therapy and interpersonal therapy. Drug treatment with antidepressants, especially SSRIs, may be carefully considered by the treating physician. Lifestyle changes such as exercise, good sleep, a nutritious diet and stress management are also important. Early intervention and collaboration between the pregnant woman, her family and health care providers are essential to ensure effective treatment and protect the health of both the mother and the baby.
Depression in family members during pregnancy
Expectant fathers and other family members can also become depressed during pregnancy. 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 depression 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 paternal prenatal depression is crucial to giving both expectant mothers and fathers the support they need during pregnancy.
12 frequently asked questions about depression in pregnancy
What is depression in pregnancy?
Depression during pregnancy, also called peripartum depression, is a form of clinical depression that can affect expectant mothers 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 confirm a diagnosis.
How is depression during pregnancy diagnosed?
Diagnosing depression is usually done through interviews and questionnaires that assess your well being and safety.
How is depression in pregnancy treated?
Treatment options often include a combination of medication, therapy and lifestyle changes. Cognitive behavioral 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 does treatment for depression last?
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 problems can occur after childbirth?
You may also experience anxiety or the very serious condition of postpartum psychosis. If there are symptoms of psychosis, you should contact an emergency room or call 911.
Can exercise help with depression?
Yes, regular physical activity has been shown to improve mood and mental health. But it should not replace professional care and medication.
Can non-pregnant family members be depressed?
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. Our psychologists and therapists are available for online consultations at your convenience.
Steps for managing depression during pregnancy
Seeking help for depression while pregnant is a big step, and it is normal to feel unsure about the upcoming process. Here is an overview of the steps usually included in therapy to manage and regulate depression.
Step 1: Diagnostic evaluation
What this means: The first meeting with your psychologist or therapist is usually a diagnostic evaluation in which you review your mental and physical health.
What to expect: Expect questions about your life situation, feelings, thought patterns, and behaviors.
Step 2: Goal setting
What it means: You and your therapist set specific goals for therapy based on your symptoms and circumstances.
What to expect: Discussion about which areas of your life are most affected by your depression and how you would like to change them.
Step 3: Choosing a form of therapy
What it means: Depending on your situation and goals, different forms of therapy may be more or less appropriate.
What to expect: Your therapist will recommend a form of therapy, such as CBT (cognitive behavioral therapy) or psychodynamic therapy.
Step 4: Treatment
What it means: This begins the actual treatment phase, where you start working towards the goals you’ve set.
What to expect: Talk therapy, exercises, and perhaps homework assignments aimed at giving you tools to manage and regulate your depression.
Step 5: Follow-up and evaluation
What it means: After a certain period of time, a follow-up is done to see how well the therapy is working.
What to expect: If necessary, the treatment plan can be adjusted or renewed.
Step 6: Closing and looking ahead
What it means: As therapy comes to an end, it’s time to reflect on progress and plan for the future.
What to expect: Talk about how you can use the tools and strategies you’ve learned going forward in life.
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.
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