Depression During Pregnancy

Depression can be confusing for women when it occurs during pregnancy, since having a baby is expected to be a very happy occasion. Unfortunately, however, depression commonly accompanies pregnancy , and up to 10% of pregnant women will experience depression.

What causes depression during pregnancy?

Historically, it was thought that elevated levels of the hormones estrogen and progesterone “protected” pregnant women from depression, but recent studies suggest that this is not the case.  Heredity is a more likely indicator.  Women who become depressed during pregnancy are likely to have a personal or family history of the illness.

What are the symptoms of depression during pregnancy?

Pregnant women should watch for the same symptoms of depression as anyone else.  Within that list, the most common symptoms affecting pregnant women are:

It is easy to attribute these symptoms to the pregnancy itself, which is why depression is sometimes misdiagnosed or ignored in pregnant women, causing them to suffer needlessly. 

Left untreated, severe depression can have long-term consequences for both mother and baby. Lack of proper nutrition, adequate rest, or prenatal care may contribute to premature births and low birth-weight infants. And studies have also shown that postpartum depression is more likely to occur if depression during pregnancy goes untreated.

Treating depression during pregnancy

Depression is treatable, even during pregnancy. In fact, addressing the symptoms of depression is just as important as treating any other health concern impacting a pregnant woman. 

Medication

Antidepressant medications are an important treatment option for women with moderate to severe depression. Research has demonstrated that many of the most effective and well-tolerated antidepressant medications are safe for use during pregnancy, as well as after the birth of a baby and during breast feeding.  Read more about antidepressants here, then talk with your healthcare provider about whether an antidepressant might be right for you.

Herbal remedies, dietary supplements and alternative medicine

Unfortunately, very little scientific evidence supports alternative treatments for depression, and because these remedies are not regulated, there is no standardized information about ingredients or dosing instructions.  Some supplements or remedies may have a negative interaction with antidepressants or other medications you may be taking during pregnancy.  Be sure to talk to your healthcare provider before taking any herbal or dietary supplements.

Psychotherapy

Either alone or in combination with medications, psychotherapy, sometimes called “talk therapy,” has been shown to be effective in helping patients manage the symptoms of depressive illnesses.  Two approaches, Cognitive Behavioral Therapy (CBT) and Interpersonal Psychotherapy (IPT) are particularly effective in the treatment of depression.  If you’ve been diagnosed with depression, discuss these treatment options with your healthcare provider.

Self-Care

In addition to pursuing medication and psychotherapy as strategies to treat your depression during pregnancy, there are a number of actions you can take on your own to help manage your symptoms and feel better. The Take Care of Yourself section of this website contains useful information about incorporating the following self-care strategies into your treatment plan:

Support
Pregnant women commonly feel fatigued and overwhelmed, whether or not they are depressed.  A good support system is important during pregnancy, including finding help with housekeeping, meals and other daily tasks.  Don’t feel you have to do it all yourself.

Exercise
For improving both physical health and mood, there’s no substitute for physical activity.  Most experts suggest striving for 30 minutes of physical activity, three times a week, but as little as 10 minutes a day has been shown to be beneficial.  Happily for pregnant women, the activity doesn’t have to be strenuous to make a difference. A brisk walk is all it takes.

Stress management
Adjusting to pregnancy and preparing for the changes that will come with a new baby can bring on stress, and stress can make depression’s symptoms worse.  Some of the stressors of particular concern to pregnant women are marital difficulties, the needs of other children in the household, poor overall health, alcohol or drug use, and limited social support.

Another potential source of stress: the high expectations pregnant women place on themselves.  The demands of motherhood can seem overwhelming, especially when you’re feeling fatigued and possibly depressed.  Feeling better takes time; set realistic expectations about what you can accomplish, give yourself time to rest and relax, and make it a priority to participate in activities you enjoy.  Read more about stress and stress-relievers here, and talk to your healthcare provider about establishing a plan to keep stress in check during pregnancy.

Sleep
Getting enough good quality sleep is important for promoting a healthy pregnancy and is essential for managing the symptoms of depression.  Unfortunately, sleep is often disrupted during pregnancy due to hormone levels as well as physical discomfort (which can increase as the baby grows). Take time to learn about establishing good sleep habits, and make sleep a priority.

Nutrition
Sound nutrition is important for both a healthy pregnancy and for managing your depression.  In addition to the nutrition advice available on this website, which is focused on controlling the symptoms of depression, your healthcare provider may make specific recommendations about foods to eat or avoid, as well as vitamin and mineral supplements to take during your pregnancy.

 

More information about depression in women at different life stages: