Breaking the Silence: Understanding and Coping with Prenatal Depression

What Is Prenatal Depression?

The depression one experiences during pregnancy is called antenatal or prenatal depression. It is a common condition that affects about 13 percent of all pregnant women. Usually, a woman passes through emotional ups and downs during the pregnancy period. Still, when these feelings of blues, sadness, anxiety, mood swings, and other negative emotions last longer and interfere with daily activities, it might be due to depression.

The affected person will show withdrawal, fatigue, and anxiety and may have sleeping issues. The condition may occur at any time during the pregnancy period. The depression that occurs after childbirth is called postpartum depression. Both postpartum depression and prenatal depression require treatment. The good thing is that most cases of prenatal depression improve with proper treatment.

Who Are the Ones More Likely to Develop Prenatal Depression?

Those who are at greater risk of developing prenatal depression include those with a history of:

• Panic disorder.

• Mood disorders like depression.

• Anxiety disorders.

• Obsessive-compulsive disorder.

The condition is more common among:

• Unplanned pregnancy.

• Teenage pregnancy.

• Those with stressful life events like financial struggles, divorce, career issues, etc.

• Unsupportive partner and family.

• Single motherhood.

• Family history of depression.

• Having multiple pregnancies (twins or more than one child).

• If the developing child has a health issue.

• Lower socio-economic status.

• History of smoking.

• Previous history of miscarriages or stressful birth experiences.

What Are the Symptoms of Prenatal Depression?

The symptoms of prenatal depression are:

• Sadness.

• Mood swings.

• Feeling guilty.

• Anger.

• Irritability and feeling hopeless.

• Poor or sudden changes in appetite result in unexplained weight loss or weight gain.

• Difficulty concentrating and problems with decision-making.

• Disturbed sleep.

• Loss of interest in activities.

• Withdrawal from friends, family, and social life.

• Chronic anxiety.

• Fatigue, frequent crying spells, and memory issues.

• No interest in sex.

• Poor adherence to prenatal care.

• Physical symptoms like muscle aches, headaches, and gastrointestinal issues are unrelated to other medical conditions.

• Loss of self-esteem.

• Suicidal tendency.

What Are Perinatal Mental Health Disorders?

Perinatal mental health is a collective term for mental health during the perinatal period, from pregnancy to one year after childbirth. These include a group of disorders called Perinatal Mood and Anxiety Disorders (PMADs). These include:

1. Perinatal Depression:

Perinatal depression is depression experienced during pregnancy or after childbirth.

The symptoms of perinatal depression are

• Sleep disturbances.

• Mood swings.

• Excessive sadness.

• Withdrawn feeling.

• Anger.

2. Perinatal Anxiety:

Perinatal anxiety is the anxiety a woman develops during the perinatal period, the symptoms of which include:

• Sleeping difficulty.

• Restlessness.

• Racing thought.

• Agitation.

• Excessive worry.

3. Postpartum OCD (Obsessive Compulsive Disorder):

Postpartum OCD is one of the most misdiagnosed perinatal disorders.

The symptoms include:

• Obsessions (intrusive thoughts) are repetitive thoughts related to the baby.

• Compulsions mean the mother keeps doing certain things again and again.

• Hypervigilant when it comes to protecting the infant.

• High anxiety.

• Often, mothers recognize that their thoughts are bizarre.

4. Postpartum Psychosis:

Postpartum psychosis is a condition that needs immediate medical attention. The mothers often fail to recognize that their thoughts are bizarre.

The symptoms include:

• Hallucinations.

• Paranoia.

• Delusions (strange thoughts).

• Mood swings.

• Extreme irritation.

How Is the Condition Diagnosed?

Depression during pregnancy is not a rare condition; it affects one in every seven to ten pregnant women. Therefore, properly screening pregnant women for depression and anxiety during prenatal visits is important. If one develops symptoms of prenatal depression, one should get the condition evaluated by a health care professional. The healthcare professional will analyze the symptoms' severity and provide adequate treatment.

What Are the Risks of Not Treating Prenatal Depression?

The symptoms of prenatal depression can vary from mild to severe. If left untreated, the condition affects the mother and the baby.

The risks of untreated prenatal depression are:

• The affected woman may not adhere to prenatal care and miss important prenatal visits.

• Complications during pregnancy and labor.

• This can lead to substance use, hurting the mother and the fetus.

• Increase the risk of a low birth weight baby.

• Increase the risk of preterm birth.

• Poor appetite may lead to inadequate nutritional supply to the fetus.

• Increases the risk of developing postpartum depression, affecting mother-infant bonding, breastfeeding, child development, etc.

• In rare cases, suicidal thoughts may develop, harming both the mother and the baby.

• Increases the risk of behavioral, developmental, and mental health issues for the child in later life.

What Are the Self-Care Measures One Can Take?

Apart from seeking medical treatment, the self-care measures one can take include:

• Regular exercise.

• Adequate sleep.

• A balanced diet with a good amount of prenatal vitamins.

• Avoid smoking, alcohol, and substance use.

• Yoga, meditation, and breathing exercises to avoid stress.

• Adhere to prenatal care appointments.

• Find a supportive network that allows one to connect with other expecting parents and share their concerns.

• Staying active.

• Attending antenatal classes.

What Are the Treatment Options?

1. Cognitive Behavioral Therapy:

Cognitive behavioral therapy is a type of psychosocial intervention that focuses on short-term, problem-focused skill development in the following key areas:

• Emotions.

• Thoughts.

• Behavior.

• Environment.

• Physiology.

2. Antidepressants:

Antidepressants are indicated in those cases where the patient has moderate to severe depression and:

• Psychological therapy failure cases.

• The patient is unwilling to undergo psychological therapy.

• The patient prefers pharmacological treatment.

3. Mind Body Activities:

Mind-body activities help lower stress and anxiety. These mind-body activities include meditation, yoga, breathing exercises, reiki, visualization techniques, tai chi, etc. These help keep the mind calm and build resilience and a positive outlook on life. Just setting aside a few minutes daily for such activities can reduce the risk of depression to a great extent.

Can the Condition Be Prevented?

Certain psychological treatment options, like cognitive behavioral therapy and counseling, may help prevent perinatal depression in those falling into the risk group of developing prenatal depression. As per the American College of Obstetricians and Gynecologists' recommendation, healthcare providers should screen for anxiety and depression at least once during pregnancy. A standardized screening questionnaire is used for such screening.

Conclusion

Prenatal depression is a common condition that is treatable. But if neglected and untreated, the condition can worsen and hurt the mother and the baby. Proper screening for anxiety and mood disorders during the pregnancy period at least once is essential.