It’s pretty much a given that pregnancy is a time when you are expected to be happy and full of the joys of the world. You should be brimming with optimism and glowing with good health (apart from morning sickness, of course!). However, according to a study carried out by Dr Jonathan Evans at Bristol University, around ten per cent of women experience some form of antenatal depression during pregnancy.
Although the stereotypical image of pregnancy is of a serene, happy, glowing mum-to-be, in reality it is actually a very stressful time not least as it is a very major life changing event. Many women experience anxiety over the health of their developing baby, feel overwhelmed at how their body is changing without their control, are tired from working hard yet concerned about what will happen to their career after maternity leave, worried whether they’ll be able to juggle motherhood with work and even anxious about whether they will still be able to relate to their friends once they become a mother. All in all there are a lot of things going on and these feelings can lead to depression especially if friends, a partner or family are unsupportive.
Until recently it was thought that during pregnancy women were almost immune from depression both mentally (overwhelming joy at being an expectant mother was thought to cancel out the risk of developing depression) and physically (pregnancy hormones were thought to be protective against depression). However, contrary to these beliefs new research has found that women are potentially more susceptible to depression while they are pregnant than at any other time in their lives.
Unlike postnatal depression, which is widely publicised and for which there is a great deal of support, antenatal or prenatal depression is often brushed over as women are lead to believe that pregnancy should be happy time or that those “unseemly feelings” are just part of the normal pregnancy moodiness. In this article we look at what causes antenatal depression, what are the symptoms, what the effects are, what you can do about it, and where to go to get further support.
What Causes Antenatal Depression?
No one knows for definite why some women get it and others don’t. It goes without saying that most women do experience mood swings during their nine months, but some are more affected by these than others. Hormones certainly play their part, but others also contribute.
The root cause of antenatal depression is thought to be centred on a pregnancy related hormone imbalance however it’s this combined with any number of life stressors that are likely to be responsible for determining the development of depression in pregnancy.
Any major event has lasting effects on you and pregnancy is not different. It is a significant and life changing experience and that can bring its own set of stress and uncertainty with it. If other traumatic things happen during your pregnancy (death of a loved one, losing your job, moving house, etc) then you are more likely to suffer from antenatal depression.
Your history and that of your family can also be a cause. For example, if you have suffered abuse (whether that be physical, verbal, emotional, or sexual) then it is quite possible that pregnancy can prove a very upsetting time.
Similarly, your family history can be a tell-tale sign. If depression is something that has affected you or a close family member previously, then you may be more likely to suffer from it during pregnancy.
And finally, pregnancy complications can also trigger depressive feelings. Women who have experienced difficulties conceiving, or who have had a miscarriage in the past will often worry for the safety of the baby and this often takes an emotional toll.
Signs Of Depression
Most women will have mood swings during pregnancy, so by no means should you think you are depressed just because you shout or cry at your partner. That is perfectly normal! However, if you are constantly feeling down, angry, anxious, or that you just can’t cope then this may be more than a temporary mood swing.
As a general rule of thumb you should apply the same standards as when you are looking for signs of “normal depression”, because essentially the symptoms are exactly the same. They include:
-
Anxiety
-
Extreme irritability with others and yourself
-
Obsessive compulsive tendencies – eg washing your hands over and over again.
-
Persistent sadness
-
Inability to enjoy anything anymore
-
Extreme fatigue
-
Feelings of isolation or loneliness
-
Inability to concentrate
-
Difficulty making decisions
-
Severe feelings of guilt
-
Inability to have fun
-
Sleep problems – either too much or too little
-
Overeating or lack of desire to eat
-
Agoraphobia – scared to leave the house or be in social situations
It’s worth noting that many of these symptoms will surface at some point during pregnancy and in isolation are not necessarily an indicator of depression.
Does Antenatal Depression Mean Postnatal Depression?
Opinions are divided on this point. Let me start by saying that if you experience antenatal depression it doesn’t necessarily follow that you will develop post natal depression. Research shows that many women recover completely as soon as their baby arrives. Similarly, if you experience depression during one pregnancy, it doesn’t necessarily follow that you will suffer from it in your next. However, when all is said and done, it appears that around 50% of women who experience depression in pregnancy go on the have postnatal depression.
So, the advice is to seek help if you suffer from antenatal depression because if you do go on to experience postnatal depression then the support and help structures should already be in place once the baby is born (and, remember, postnatal depression is quite common, so you’ve nothing to be worried about it).
Treating The Blues
Treatment ranges from simple measures such as increasing your level of self-care to medications in the case of severe depression, so in the case of continued depression you should seek professional advice. There are also a number of actions you can take to help you stay on top of things and here are some tips to assist you in feeling well again:
-
Eating small regular meals can stabilise blood sugar levels and increase your energy
-
Avoid foods that contain aspartame, like diet foods and diet soft drinks
-
Avoid high-fat foods and caffeine
-
Try acupuncture and acupressure
-
Increase your relaxation activities such as yoga, baths and time for yourself
-
Try to fit in plenty of pregnancy friendly exercise such as walking and swimming
-
Get as much rest as possible
-
Look for support people, such as family and friends, and ask them for help
-
Attend face to face, or group support sessions with support people, psychologists or psychiatrists
-
Learn anxiety-modifying and relaxation techniques such as meditation
-
Talk to your Doctor or Midwife
Admitting you are feeling depressed is not a sign of weakness but a sign you are a good mother, putting yours and your baby’s health first. At the end of the day, you are not alone and the doctors have seen it all before and will be able to help you.
Where To Get Help & Support
If you think that you may be experiencing antenatal depression it’s important that you seek help from your healthcare provider, your doctor, and/or your midwife. It is equally important that you speak to someone as soon as possible. Unfortunately, depression does have a stigma attached to it which is why people are reluctant to talk to others about their experience. Yet depression is an illness that has symptoms and treatments like many others and talking will help you to work through any anxieties you have and help your loved ones better understand what you’re going through.
Professional Support Providers
The Black Dog Institute is an educational, research and clinical group with expertise in depression. It is attached to the Prince of Wales Hospital and affiliated with the University of New South Wales in Sydney.
Beyondblue is a national, independent, not-for-profit organisation that specialises in depression and anxiety.
PANDSI is the Post and Antenatal Depression Support and Information Incorporated.
Black Dog and Beyond blue both have depression self-test resources available on their websites. The Black Dog’s test is specific to antenatal depression. The Black Dog Institute also lists antenatal depression contacts around the country.
