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Depression and Pregnancy

Pregnancy brings joy and excitement of a new life.

For some pregnant women, pregnancy is also mingled with feelings of sadness, stress, anxiety, sleeping problems, and decreased appetite.
Depression is more than just feeling sad or upset for a brief period or grieving after a loss. It affects your thoughts, feeling, behavior, and physical health. It also affects your daily activities and relationships with your family, friends, and co-workers.
Depression, Pregnancy, Anxiety, sleeping problems, Postpartum depression, stress, partner violence, mental health, Loss of appetite, Psychotherapy, cognitive-behavioral therapy, conjoint therapyIf you are suffering from depression know that you are not alone.

Does pregnancy cause depression?

Your body goes through a lot of changes during pregnancy. For some women, the stress of pregnancy can trigger depression. Although depression is common during pregnancy, not all expecting mothers suffer from depression. It affects about 1 in 10 pregnant women. 
If you have experienced depression in the past, your symptoms may return or if you have been depressed before becoming pregnant, your depression may worsen. With appropriate treatment, depression is treatable during pregnancy.
Depression during pregnancy should be discussed with your healthcare provider as it may extend after delivery. Postpartum depression is more common in women who have been depressed during their pregnancy.

 

Why is depression during pregnancy often overlooked?

Changes in sleep, energy level, appetite, and libido are some of the symptoms of depression that are similar to those of pregnancy. As a result, you or your healthcare provider may associate these symptoms to your pregnancy rather than depression.
Due to the stigma associated with depression, women may be reluctant to discuss changes in moods during pregnancy with their health care providers. There is also a tendency to focus more on women’s physical health rather than mental health during pregnancy.

 

What are the risk factors for depression during pregnancy?

Some of the risk factors for depression during pregnancy include:

Depression, Pregnancy, Anxiety, sleeping problems, Postpartum depression, stress, partner violence, mental health, Loss of appetite, Psychotherapy, cognitive-behavioral therapy, conjoint therapy

What are the signs of depression during pregnancy?

The signs of depression can mimic the normal ups and downs of pregnancy. It is natural to have a bad day now and then. However, it is important to know the signs of depression. If you experience any of these signs for at least 2 weeks, talk to your healthcare provider. 
  • Depressed mood most of the day, nearly every day
  • Loss of interest in work or other activities
  • Excessive anxiety about your baby
  • Low self-esteem, such as feelings of inadequacy about parenthood
  • Feeling guilty, hopeless, or worthless
  • Sleeping more than normal or having trouble sleeping
  • Loss of appetite, losing weight, or eating much more than normal and gaining weight
  • Feeling very tired or without energy
  • Having trouble paying attention, concentrating, or making decisions
  • Being restless or slowed down in a way that others notice
  • Thoughts about death or suicide
Feel free to ask for support! Depression, Pregnancy, Anxiety, sleeping problems, Postpartum depression, stress, partner violence, mental health, Loss of appetite, Psychotherapy, cognitive-behavioral therapy, conjoint therapy
Talk to your partner, a trusted friend, a family member, or your doctor

How can untreated depression affect you during pregnancy?

If you have untreated depression during pregnancy, it can make it harder for you to take care of yourself.  You may not seek optimal prenatal care, eat healthy foods, or get enough sleep. You may also find it difficult to develop a bond with your baby as you may feel emotionally isolated. If you were on antidepressants before pregnancy, you may become depressed again if you stop taking them. Untreated depression during pregnancy increases your risk of developing depression after your baby is born.

 

Will depression during pregnancy affect your baby?

If you experience depression during pregnancy, you may have trouble taking care of yourself. This can affect not only your own health but also your baby’s.
Untreated depression during pregnancy has been linked to various problems, including:
  • Your baby not growing well in the uterus
  • A higher likelihood of your baby being born early 
  • Having a low-birth-weight baby 
  • Health complications for your baby after birth. 

Depression, Pregnancy, Anxiety, sleeping problems, Postpartum depression, stress, partner violence, mental health, Loss of appetite, Psychotherapy, cognitive-behavioral therapy, conjoint therapy

Untreated depression during pregnancy may also increase the risk of problems in your baby, like:
  • Your newborn may cry more and be harder to comfort.
  • Children may also be at greater risk of emotional, developmental, and behavioral problems later in life.

 

Is screening available for depression during pregnancy?

Screening for depression during pregnancy may help you become aware of your risk of depression. All healthcare providers should perform a full assessment of mood and emotional well-being at least once during pregnancy.

 

How can depression be treated during pregnancy?

Depression, Pregnancy, Anxiety, sleeping problems, Postpartum depression, stress, partner violence, mental health, Loss of appetite, Psychotherapy, cognitive-behavioral therapy, conjoint therapy

Treatment of depression involves both medical and nonmedical approaches. 
Nonmedical treatment of depression in pregnancy eliminates any known or unknown risks linked with fetal drug exposure. Your healthcare provider will provide you information on depression during pregnancy and after your baby is born. 
Psychotherapy, cognitive-behavioral therapy, conjoint therapy (with your partner) are excellent treatment options. Other nonmedical treatment options include improvement in nutrition and diet, elimination of caffeine, nicotine, and alcohol intake, and proper sleep hygiene. Reducing stressors and practicing relaxation techniques may also be beneficial. Some women who deal with depression throughout pregnancy and after the baby is born will benefit from referrals to local support groups.
If you are struggling with moderate to severe symptoms of depression, medical treatment options should be seriously considered. Antidepressant medication is often needed to bring relief from severe depression. However, there are concerns about using medications to treat depression during pregnancy since they cross the placenta and may harm the baby. Despite the severity of their symptoms, some women adamantly refuse to take any medications during pregnancy, and others are more comfortable using medication for depression during pregnancy. When deciding treatment options, you and your healthcare provider should balance the possible risks of medication against the severity of depression.

 

What is psychotherapy?

Psychotherapy is also known as talk therapy where a therapist will work with you to:
  • Identify any issues
  • Develop ways to address issues
  • Control troubling symptoms
Therapy can improve your well-being and help you heal. There are variety of methods and formats of therapy. Some types of treatment, for example, can help you change how you think and behave, while others can help you better understand the underlying difficulties. You can have one-on-one treatment (with just you and the therapist) or group therapy (with a therapist and other people who have similar difficulties to you). Family or couples therapy is another option, in which you and your family members or your partner work with a therapist.

 

Are antidepressants an option during pregnancy?

In addition to counselling, the choice to use antidepressants during pregnancy is based on a balance of risks and benefits. A serious concern is usually the risk of birth defects as a result of antidepressant use. Overall, babies born to women who take antidepressants during pregnancy have a very low risk of birth defects and other issues. Some antidepressants, on the other hand, have been linked to an increased risk of complications for your baby. Discussing your symptoms and treatment options with your healthcare provider will help you make an informed decision.
If you use antidepressants during pregnancy, your healthcare provider will try to reduce medication exposure to your baby. This can be achieved by prescribing a single medication at the lowest effective dose (monotherapy), especially during the first trimester.
If depression is mild to moderate, experts would recommend psychotherapy alone.

 

Can taking antidepressant medication harm your baby?

Antidepressants do not appear to increase the risk of miscarriage, premature birth, or low birth weight. Untreated depression and anxiety, on the other hand, have been shown to increase the risk of premature birth and caesarean section.
About 1 in 3 babies born to mothers on antidepressants will experience mild symptoms like jitteriness, poor feeding, agitation, and fast breathing. These symptoms normally disappear without the need for treatment. However, there is no evidence that discontinuing or reducing your dose near the end of your pregnancy reduces your baby’s risk of experiencing these symptoms. It may also increase your chances of a postpartum recurrence.
These babies are also at a slightly higher risk of developing a disorder called Persistent Pulmonary Hypertension of the Newborn (PPHN). PPHN is a rare but possibly fatal condition that causes breathing difficulties in newborns. PPHN affects about 2 out of every 1000 mothers who are not on antidepressants, while it affects about 3 out of every 1,000 women who are taking antidepressants. However, these effects become less significant when other factors are also considered, suggesting that antidepressants are not the cause.

 

Takeaway

Know that depression is not your fault and treatment can help you feel better. You may feel like you don’t want to do anything, but it is important to make sure you take of yourself. Talk to your friends, partner, or your family. If you ask for help, you will often get it.
It’s not easy to figure out how to deal with depression during pregnancy. The risks and benefits of taking medications during pregnancy must be carefully considered. Consult your doctor to make an informed decision that will offer you — and your baby — with the best chance of long-term health.

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