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What is Antepartum Depression?

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Though stigma still surrounds the issue of mental health, we’ve all heard of postpartum depression. What isn’t as well known is antepartum depression, also known as prenatal depression. Depression during pregnancy has long been thought impossible with doctors believing that the hormones of pregnancy protect the mother from mood disorders. This is not the case. According to the American Congress of Obstetricians and Gynecologists (ACOG), between 14-23% of women will struggle with depression during pregnancy. Considering that depression affects one in four women at some point in their life, it shouldn’t be much of a surprise that it can affect pregnant women as well. All too often, depression is not diagnosed properly during pregnancy because people think it is just another type of hormonal imbalance. This assumption is dangerous for the mother and the unborn baby. Depression is an illness, and it can be treated and managed, even during pregnancy.

The signs of depression in pregnancy often mimic symptoms of pregnancy, so it is important to be open and honest with your doctor about what you are feeling, how strongly and how often. Women with depression usually experience some of the following symptoms for two weeks or more:

  • Persistent sadness
  • Difficulty concentrating
  • Extreme irritability, agitation or excessive crying
  • Sleeping too little or too much
  • Extreme or never-ending fatigue
  • A desire to eat all the time or not wanting to eat at all
  • Loss of interest in activities that you usually enjoy
  • Recurring thoughts of death, suicide, or hopelessness
  • Anxiety
  • Feelings of guilt or worthlessness
  • Change in eating habits

Possible triggers of depression during pregnancy include:

  • Change in hormones during pregnancy
  • Relationship problems
  • Family or personal history of depression
  • Infertility treatments
  • Previous pregnancy loss
  • Stressful life events
  • Complications in pregnancy
  • History of abuse or trauma

Untreated depression during pregnancy can be potentially very dangerous to both mother and baby because it leads to poor nutrition, drinking, smoking and suicidal behavior, which can cause premature birth, low birth weight and developmental problems. It is also important to note that a woman who is depressed often does not have the strength or will to adequately care for herself or her growing baby. Babies born to mothers who are depressed may be less active, show less attention and be more agitated than those born to mothers who are not depressed. This is why getting help is so important.

Treatment options for women who are pregnant include:

  • Support groups
  • Private psychotherapy
  • Medication
  • Light therapy

The safety and long-term effects of antidepressants taken during pregnancy have long been debated. Some research shows that certain antidepressant medication may be linked to problems in newborns such as physical malformations, heart problems, pulmonary hypertension and low birth weight. Women need to know that all medications will cross the placenta and reach their babies. There is not enough information about which drugs are entirely safe and which ones pose risks. Talk with your OB/GYN and your mental health provider to determine the best course of treatment for your depression. It is possible for a mother experiencing mild to moderate depression to manage her symptoms without medication. Your personal treatment plan, however, is ultimately what you and your physicians determine to be the best option for you and your baby.

References:

Montgomery, S. (June 2017). 10 Things A Woman With Prenatal Depression Needs To Hear From Her Doctor. Romper. Retrieved from https://www.romper.com/p/10-things-a-woman-with-prenatal-depression-needs-to-hear-from-her-doctor-63653

Sharps, L. (December 18, 2012). Prenatal Depression Warning Signs: Here’s What to Look For. Huffpost. Retrieved from http://www.huffingtonpost.com/the-stir/prenatal-depression_b_1967991.html

(2017). Depression in Pregnancy. American Pregnancy Association: Promoting Pregnancy Wellness. Retrieved from http://americanpregnancy.org/pregnancy-health/depression-during-pregnancy/

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