Depression in pregnancy

To read the Introducton to Pregnancy Click Here

Symptoms

Depression can occur in pregnancy. In fact, it is probably just about as common in pregnancy as it is after delivery. It can be hard to identify depression in pregnancy because many of the symptoms overlap with the ‘symptoms’ of pregnancy. This is especially so for the first 12-14 weeks of the pregnancy.

Tiredness

Many women become very tired during the first third or even half of their pregnancy. For many this is worse than the nausea. People don’t realise this and therefore the tired, pregnant mother doesn’t get the same amount of sympathy as those who are nauseated. Clinical depression can also make you feel incredibly tired – so how do you tell the difference? (See below).

Adjustment to pregnancy

Finding out you are pregnant is not always happy news. Even when it is there can be many new worries. For first time mothers, especially it is a huge new experience affecting every dimension of your life.There are body changes, emotional changes, and changes to your work expectations and role. It also affects important relationships with your partner, friends and family/whanau. All of this can cause worries about whether you will be able to cope with the adjustments needed.

Is this normal in pregnancy or is this depression?

How to tell the difference:

• Look at whether other symptoms of depression are present.
• It is more likely to be depression if she is having negative thoughts about herself or others, feeling really down and not getting enjoyment out of anything.
  
• Look at how well she is coping with day-to-day tasks.
• If she is physically well, preganancy can be expected to slow her down but it doesn’t lead to a significant reduction in her ability to get things done.
• Look at whether she is improving or getting worse.
• Symptoms of pregnancy usually improve after the first few weeks, if a depression is significant it will usually continue to get worse.
• If someone is feeling very low, hopeless or suicidal then she needs to be seen urgently by a mental health professional.

Treatment

Depression can be treated just as effectively in pregnancy as after delivery but the issues around the use of medications are more complex. (See the sections on Treatments and Medications).

The following are important

• Most of the medications that help also pass through the placenta to the baby. The baby is exposed to higher levels of the medication this way than when they are being breastfed. Balancing the possible negative effects of using medication against the possible negative effects of untreated depression or anxiety is complicated.
• It is known that stress and anxiety, major depression and other major mental illnesses can have a significant effect on the developing baby whereas significant problems have not been identified with most medications (there are some important exceptions to this – see Medications section).
• Failure to adequately treat depression or anxiety can be very dangerous for both mother and baby.
• It is very important to discuss all these issues with your doctor and to feel comfortable that you understand.
• Ask questions and have a support person present.
• Ask if other treatments rather than medications might be suitable for you.

A healthy mother is the most important factor for a healthy baby.

Lucy’s Story

Lucy was in her second pregnancy. She had previously had depression and been on antidepressants. This is her story.

“I felt quite depressed throughout the pregnancy. I knew that it was best not to take any medication at all in pregnancy. I didn’t think that I was able to take antidepressants in pregnancy. I struggled on, feeling terrible, blaming my hormones, thinking that I would just have to put up with it all.

I went to my midwife for a routine check-up at about 30 weeks. I told her that I felt terrible and I did not want this baby. I felt as though I was in a black pit with no way out. I couldn’t shake these feelings of despair. My midwife told me to see my doctor,who recognised that I was depressed and needed help. My doctor put me onto an antidepressant medication, which made me feel heaps better. I could start to see a way out of the black pit.

Two weeks before my baby was born I got worse again. I couldn’t stand my baby and felt that I wouldn’t be able to cope after he was born. I remained on antidepressants after the birth and managed quite well. I am pleased that I went on antidepressants although I worried about any side-effects that it might have on my baby.”

Anxiety	Pregnancy	Bipolar Disorder

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