Pregnancy depression
May 13, 2003 | 12:00am
Pregnant? Depressed? Despite the widespread, long-standing notion that pregnancy is a time of happiness and emotional well-being, sometimes pregnancy does not protect women from mental illness. Like their non-pregnant counterparts, pregnant women experience new and recurrent mood, anxiety and psychotic disorders. According to Stephanie Zisook, M.D., and Vivien K. Burt, M.D., Ph.D. (Psychiatric Times January 2003), as much as 20 percent of pregnant women experience minor or major depression. Moreover, premature discontinuation of antidepressants during pregnancy can precipitate a relapse of depressive symptoms.
Like most expectant moms who experience highs and lows throughout their pregnancy, Racquel (not her real name), 30, blamed her bad moods to her physical state and looming life changes. Already the mother of a six-month-old, during her second pregnancy, she found herself feeling increasingly overwhelmed and unhappy about becoming a mother again. Still, Racquel didn’t believe her negative outlook would last long. "I never considered that I was depressed," she says. "I contributed it to hormones."
But Racquel’s sadness didn’t ease as she had hoped. Instead, it grew more serious and family members urged her to seek help. Like many women – more than the number of those who suffer from antepartum and postpartum depression, according to a recent study – Racquel was experiencing depression during pregnancy.
While depression following the birth of a baby often makes headlines, depression during pregnancy isn’t as well known. But according to a 2001 study for more than 9,000 mothers during and after pregnancy, symptoms are more common during pregnancy than after. Some evidence suggests that mood during pregnancy may affect the unborn child, according to the study published in the British Medical Journal. As a result, the studies’ authors called for more emphasis to be put on understanding, detecting and treating depression during pregnancy.
"I was depressed and did not know it," says Carmela, 40, mother of three. "I felt too old to be pregnant and wasn’t thrilled to be called a geriatric mother. My kids were quite grown and I was starting a new phase in my life when this pregnancy came around. I had severe morning sickness and I felt rotten for most of the pregnancy. I was in denial about the pregnancy and did not take my vitamins and prenatal care too seriously. I was always tired and always sad. I had terrible mood swings, tawa-iyak – sometimes at the same moment. My husband was worried and told me to snap out of it. But I could not! Many people were congratulating me, telling me the baby is a blessing. I thought hard about those who wanted a baby but couldn’t conceive and I realize the injustice in that. I felt guilty because I could not bring myself to be happy about this pregnancy."
Jan Anderson, 40, a British freelance writer and humorist for www.womanofa-certainagepage.com fills us in:
"When we finally met our obstetrician, he immediately launched into a bulletin of depressing statistics on the chances of a woman over 35 conceiving a child with some degree of chromosomal abnormality, such as Down Syndrome. He also talked about the increased risks of miscarriage, pre-eclampsia, pre-term labor and multiple births.
Apparently, even if I did succeed in producing a full-term, healthy baby, my tortured pelvic muscles would cause everything to collapse. My bladder and reproductive organs would dangle precariously between my legs evermore. My breasts would probably metamorphose into two flaps of skin, as they had done before, after many months of breast-feeding my previous children, but this time, they would stay flapped."
Often, pregnancy hormones, such as estrogen and progesterone, are to blame, says Diane Sanford, a St. Louis psychologist and author of "The Postpartum Survival Guide." Significant changes in your hormone levels can affect your levels of neurotransmitters, the brain chemicals that regulate mood. You’re most likely to experience these changes at around six to 10 weeks and then again in the third trimester as your body begins to prepare for labor and delivery. All women respond differently to these changes – some women experience mood swings; others feel more depressed or anxious. What’s more, pregnancy can be a stressful and overwhelming time. You may be overjoyed at the thought of having a baby one day, then just as quickly begin wondering what it is you’ve gotten yourself into. You may be worried about whether you’ll be a good mom, whether the baby will be healthy, how your relationship with your partner and your other children will be affected – whether you’ll still be able to give them the attention they need, and how you’ll handle future financial challenges. Even if your baby is very much wanted, there may be times when you feel "trapped" by the pregnancy.
Other causes for depression include:
• Family or personal history of depression. If depression runs in your family, or if you have had past bouts yourself, you may be more likely to become depressed now that you’re expecting.
• Stressful life events. Are you moving to a bigger home in anticipation of your baby’s arrival? Are you having trouble at work? Any major life change such as a move, divorce, or job loss, can send you into a serious funk.
• Problems with the pregnancy. A troubled pregnancy – for instance, one that requires weeks of bed rest or numerous genetic tests – can take its emotional toll.
• Infertility or previous pregnancy loss. If you experienced many difficulties trying to get pregnant, or have miscarried in the past, you may find yourself worrying about the safety of this pregnancy.
• Loss of control. Pregnancy can trigger painful memories in women who have survived emotional, sexual, physical, or verbal abuse. Your body is changing beyond your control, which can bring up long-buried issues and baggage. Your loss of control over your changing body may mirror the loss of control you felt when you were being abused.
Natural mood elevators may offer some relief.
• Try sunbathing under the morning sun for an hour daily. When light enters the eye, it stimulates the brain to produce serotonin. This triggers a cascade of chemical changes in the brain that significantly improves mood.
• Eat folic acid-rich foods (dark green leafy vegetables) so you’ll get a good balance of B vitamins. In many cases, the only sign of a folic acid deficiency is a feeling of sadness. Check with your doctor about supplements because some may be too strong for pregnant women.
• Try aromatherapy. Specific odors can trigger vivid memories and nostalgic feelings – and if the memories they evoke are pleasant ones, your stress level is lowered and your mood is improved.
Citrus, chocolate, peppermint, vanilla – you’ll need to find what makes you happy.
If your mood swings, sadness, change in sleeping and eating habits, and extreme fatigue last for more than two weeks and you don’t seem to be getting any better, tell your doctor and ask for a referral to a counselor. You may be among the 10 percent of expectant women who battle mild to moderate depression during their pregnancies. Or if you notice that you’re frequently nervous or anxious, you can be suffering from some sort of anxiety disorder. Finally, if your mood swings become more frequent and intense, you may have a condition called bi-polar disorder, in which you may swing from periods of depression to manic activity or euphoria.
If you suspect that you have any of these conditions, it’s crucial that you get professional help in treating them while you’re pregnant. Both psychotherapy and safe medication can be very effective and will ensure your well-being and that of your baby.
Like most expectant moms who experience highs and lows throughout their pregnancy, Racquel (not her real name), 30, blamed her bad moods to her physical state and looming life changes. Already the mother of a six-month-old, during her second pregnancy, she found herself feeling increasingly overwhelmed and unhappy about becoming a mother again. Still, Racquel didn’t believe her negative outlook would last long. "I never considered that I was depressed," she says. "I contributed it to hormones."
But Racquel’s sadness didn’t ease as she had hoped. Instead, it grew more serious and family members urged her to seek help. Like many women – more than the number of those who suffer from antepartum and postpartum depression, according to a recent study – Racquel was experiencing depression during pregnancy.
While depression following the birth of a baby often makes headlines, depression during pregnancy isn’t as well known. But according to a 2001 study for more than 9,000 mothers during and after pregnancy, symptoms are more common during pregnancy than after. Some evidence suggests that mood during pregnancy may affect the unborn child, according to the study published in the British Medical Journal. As a result, the studies’ authors called for more emphasis to be put on understanding, detecting and treating depression during pregnancy.
"I was depressed and did not know it," says Carmela, 40, mother of three. "I felt too old to be pregnant and wasn’t thrilled to be called a geriatric mother. My kids were quite grown and I was starting a new phase in my life when this pregnancy came around. I had severe morning sickness and I felt rotten for most of the pregnancy. I was in denial about the pregnancy and did not take my vitamins and prenatal care too seriously. I was always tired and always sad. I had terrible mood swings, tawa-iyak – sometimes at the same moment. My husband was worried and told me to snap out of it. But I could not! Many people were congratulating me, telling me the baby is a blessing. I thought hard about those who wanted a baby but couldn’t conceive and I realize the injustice in that. I felt guilty because I could not bring myself to be happy about this pregnancy."
Jan Anderson, 40, a British freelance writer and humorist for www.womanofa-certainagepage.com fills us in:
"When we finally met our obstetrician, he immediately launched into a bulletin of depressing statistics on the chances of a woman over 35 conceiving a child with some degree of chromosomal abnormality, such as Down Syndrome. He also talked about the increased risks of miscarriage, pre-eclampsia, pre-term labor and multiple births.
Apparently, even if I did succeed in producing a full-term, healthy baby, my tortured pelvic muscles would cause everything to collapse. My bladder and reproductive organs would dangle precariously between my legs evermore. My breasts would probably metamorphose into two flaps of skin, as they had done before, after many months of breast-feeding my previous children, but this time, they would stay flapped."
Often, pregnancy hormones, such as estrogen and progesterone, are to blame, says Diane Sanford, a St. Louis psychologist and author of "The Postpartum Survival Guide." Significant changes in your hormone levels can affect your levels of neurotransmitters, the brain chemicals that regulate mood. You’re most likely to experience these changes at around six to 10 weeks and then again in the third trimester as your body begins to prepare for labor and delivery. All women respond differently to these changes – some women experience mood swings; others feel more depressed or anxious. What’s more, pregnancy can be a stressful and overwhelming time. You may be overjoyed at the thought of having a baby one day, then just as quickly begin wondering what it is you’ve gotten yourself into. You may be worried about whether you’ll be a good mom, whether the baby will be healthy, how your relationship with your partner and your other children will be affected – whether you’ll still be able to give them the attention they need, and how you’ll handle future financial challenges. Even if your baby is very much wanted, there may be times when you feel "trapped" by the pregnancy.
Other causes for depression include:
• Family or personal history of depression. If depression runs in your family, or if you have had past bouts yourself, you may be more likely to become depressed now that you’re expecting.
• Stressful life events. Are you moving to a bigger home in anticipation of your baby’s arrival? Are you having trouble at work? Any major life change such as a move, divorce, or job loss, can send you into a serious funk.
• Problems with the pregnancy. A troubled pregnancy – for instance, one that requires weeks of bed rest or numerous genetic tests – can take its emotional toll.
• Infertility or previous pregnancy loss. If you experienced many difficulties trying to get pregnant, or have miscarried in the past, you may find yourself worrying about the safety of this pregnancy.
• Loss of control. Pregnancy can trigger painful memories in women who have survived emotional, sexual, physical, or verbal abuse. Your body is changing beyond your control, which can bring up long-buried issues and baggage. Your loss of control over your changing body may mirror the loss of control you felt when you were being abused.
Natural mood elevators may offer some relief.
• Try sunbathing under the morning sun for an hour daily. When light enters the eye, it stimulates the brain to produce serotonin. This triggers a cascade of chemical changes in the brain that significantly improves mood.
• Eat folic acid-rich foods (dark green leafy vegetables) so you’ll get a good balance of B vitamins. In many cases, the only sign of a folic acid deficiency is a feeling of sadness. Check with your doctor about supplements because some may be too strong for pregnant women.
• Try aromatherapy. Specific odors can trigger vivid memories and nostalgic feelings – and if the memories they evoke are pleasant ones, your stress level is lowered and your mood is improved.
Citrus, chocolate, peppermint, vanilla – you’ll need to find what makes you happy.
If your mood swings, sadness, change in sleeping and eating habits, and extreme fatigue last for more than two weeks and you don’t seem to be getting any better, tell your doctor and ask for a referral to a counselor. You may be among the 10 percent of expectant women who battle mild to moderate depression during their pregnancies. Or if you notice that you’re frequently nervous or anxious, you can be suffering from some sort of anxiety disorder. Finally, if your mood swings become more frequent and intense, you may have a condition called bi-polar disorder, in which you may swing from periods of depression to manic activity or euphoria.
If you suspect that you have any of these conditions, it’s crucial that you get professional help in treating them while you’re pregnant. Both psychotherapy and safe medication can be very effective and will ensure your well-being and that of your baby.
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