Pregnancy Blues
Untreated condition carries significant prenatal risks
08/01/2008By Rachel Lefebvre, Ph.D.
Pregnancy has traditionally been considered a time of emotional well-being, but recent studies suggest that between 10 percent and 20 percent of women suffer from mood or anxiety disorders during this time. Contrary to popular belief, pregnancy hormones do not protect a woman from becoming depressed. It is actually believed that the rapid increase in hormone levels at the start of pregnancy can disrupt brain chemistry and lead to depression.
More importantly, recent research demonstrates that untreated maternal depression during pregnancy can have substantial prenatal risks. It can lead to poor nutrition, drinking, smoking and suicidal behavior, which can then cause premature birth, low birth weight, preeclempsia and developmental problems. A woman who is depressed often does not have the strength or desire to adequately care for herself or her developing baby, which is why problems arise.
There are many reasons why depression during pregnancy is often overlooked and not diagnosed properly.
First, many people attribute symptoms of depression during pregnancy as just another type of hormonal imbalance. Also, symptoms of depression can be difficult to recognize or treat because some of the normal pregnancy changes cause similar symptoms. Such symptoms include tiredness, problems sleeping, stronger emotional reactions and changes in body weight. Anemia and hypothyroidism (which can happen during pregnancy) can also cause a lack of energy and symptoms similar to depression.
What is depression anyway?
Depression can be described as feeling sad, blue, unhappy, miserable or down. Most of us feel this way at one time or another for short periods. But true clinical depression is a mood disorder in which feelings of sadness, loss, anger or frustration interfere with everyday life for an extended time. Depression can be mild, moderate or severe. Symptoms of depression during pregnancy include:
* Two or more weeks of depressed mood (feeling blue, sad or "empty") for most of the day, every day
* Decreased interest or pleasure in activities
* Changes in appetite (eating too much or loss of appetite)
* Changes in sleep patterns (trouble sleeping or sleeping too much)
* Fatigue or loss of energy, difficulty concentrating
* Excessive feeling of guilt or worthlessness
* Thoughts of suicide
* Extreme restlessness, irritability or excessive crying
Are you at risk?
There are several factors that may put you at risk for depression during pregnancy. It is a good idea to be aware of one's risk to be able to take proper steps to reduce them.
During pregnancy, these factors may increase a woman's chance of depression:
* Personal history of depression or anxiety
* Family history of mental illness
* Relationship (marital) difficulties
* Little support from family and friends
* Anxiety about the fetus
* Problems with pregnancy
* Previous pregnancy loss
* Fertility treatments
* Difficulties with previous birth
* Stressful life events
* Financial problems
* History of abuse
* Being young or single
* History of substance abuse
* Unplanned pregnancy
Treatment
The good news is that depression can be treated. Medications and psychotherapy are the most widely used treatments. Therapy involves talking with a trained professional (psychologist, psychiatrist, clinical nurse or social worker). Therapy alone can work in mild to moderate cases, but for more severe cases medications may be needed. Many women are concerned that taking antidepressants may harm their baby. A mother's depression can affect her baby's development, so getting treatment is important for both mother and baby. The risks of taking medicine have to be weighed against the severity and the risks of depression. It is a decision that women need to discuss carefully with their doctors.
Self-help tips
Along with professional treatment, there are several other things that you can do to help yourself feel better.
Support
Ask for help with housekeeping, preparing meals and other daily tasks. Don't feel you have to do it all yourself.
Exercise
The benefits of exercise in depression are well-documented. Be sure to discuss any changes you make in your exercise routine with your health care provider. Exercise helps treat depression by releasing the body's mood-elevating hormones. Walking is perhaps the most accessible form of exercise because it costs nothing and you can start it immediately.
Stress management
Depression can also be made worse by stress. Pregnancy and the anticipated changes that come with the new baby add new stresses to a woman's life. Learning to deal more effectively with stress may reduce depression.
Promote sleep
Adequate sleep is important to promote a healthy pregnancy and prevent worsening of depression. Sleep is often disrupted during pregnancy due to changing hormone levels and physical discomfort, especially as the baby grows bigger. Try different sleeping positions and bedtime "props" such as body pillows or extra pillows. Take care to keep your sleep cycle regular by going to bed and waking around the same time.
Dietary changes
Eating a well-balanced diet and regularly scheduled meals is important. Be sure to follow the recommendations of your obstetrician or nurse midwife regarding additional caloric intake and dietary supplements such as vitamins, even if you don't feel hungry.
Spend time with others
Depressed women often withdraw from others because they mistakenly feel they would not be good company. Being with others is another way to gain perspective, which helps with the symptoms of depression. Consider joining a support group for pregnant mothers or even a support group for others experiencing problems with depression.
Make time to do what you enjoy
Depressed women sometimes temporarily lose the ability to enjoy themselves. Avoiding enjoyable activities only makes this worse. Continue doing pleasurable activities even if you don't feel like it. You will soon find that you have come to enjoy yourself again, at least for short periods.
Give yourself a break
The initial demands on a new mother are exciting and tremendous. Feeling better takes time. You will feel like yourself again and better able to handle the everyday pressures as well as the demands of pregnancy and motherhood. Be realistic about the demands and expectations you make on yourself.
About half of women who suffer from depression during pregnancy go on to develop postpartum depression but getting treated during pregnancy can reduce your chances dramatically. So don't be afraid to talk to your doctor about depression.
Dr. Lefebvre is a licensed psychologist with Girlfriends Health PLC. She specializes in infertility, pregnancy and postpartum related issues, and stress management. She can be reached at 536-1724 or you can visit her online at www.girlfriendshealth.com.
Mothers-to-be support group
A new support group for pregnant women struggling with depression and anxiety will be meet on Mondays at 7:30 p.m. Dr. Rachel Lefebvre, a licensed psychologist, will lead the groups and teach mothers-to-be how to use relaxation techniques, work on negative thoughts and prepare for the fourth trimester. The group is free.
For more information or to register, Call Dr. Lefebvre at 536-1724 or visit her online at
www.girlfriendshealth.com.
