Prenatal (Antenatal) Depression

Depression is a mood disorder that manifests as a persistent feeling of sadness, lack of energy, and loss of interest in things you used to enjoy.

It can happen during pregnancy and make the journey more difficult for you and your developing baby.

Depression during pregnancy

Depression is common during pregnancy. It affects up to 1 in 10 pregnant women.

Evidence suggests that depression can occur due to the hormonal changes and the stresses that comes with pregnancy.

Women who have had depression in the past or were living with depression before getting pregnant are likely to have the symptoms return or get worse during pregnancy.

Some of the risk factors that may trigger depression during pregnancy include:

• Life stress

• Poor social support

• Unintended pregnancy

• First pregnancy

• Violence in the relationship

• Loneliness

• Sleep problems

• Anxiety

What are the signs and symptoms of depression?

The symptoms of depression often appear like normal mood swings. But when such mood changes are persistent, you may have depression. Generally, the symptoms of depression include:

• Low mood most of the day on most days of the week

• Low energy or feeling exhausted

• Lack of interest in work or other activities

• Sleeping more than normal or having trouble sleeping

• Loss of appetite, losing weight, or eating too much and gaining weight

• Feeling guilty, hopeless, or worthless

• Having trouble paying attention, concentrating, or making decisions

• Thinking about death or suicide

How does depression affect a pregnancy

If you leave depression untreated during pregnancy, you may have trouble taking care of yourself and may not eat healthily or get enough rest. If you have severe depression, you may be at risk of harming yourself. Moreover, having untreated depression during pregnancy also raises your risk of postpartum depression.

Apart from the problems for yourself, untreated depression during pregnancy can increase the risk of problems for the baby, such as the following

• The baby’s development could get affected

• There may be health complications after birth

• The child may have emotional and behavioral problems when they grow up

How is depression treated during pregnancy?

The available treatments for depression include:

Counseling

This includes cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT)

Support groups

These are groups of people who meet together or go online to share their feelings and experiences about certain topics. You may ask your therapist to help you find a support group or look for them online

Medication

When necessary, doctors prescribe medicines called antidepressants. They may prescribe one medicine or a combination of medicines. Don’t start or stop taking any medicine for depression that is not prescribed by your doctor

Electroconvulsive Therapy (ECT)

When drugs fail, a psychiatrist may recommend this treatment. It involves passing electric currents through the brain to restore the balance of neurochemicals in the brain. This treatment is considered safe to use during pregnancy.

You and your doctor will decide the treatment that is suitable for you. It may be a combination of treatments instead of just one.

How safe are antidepressants during pregnancy?

Growing evidence suggests that many available antidepressant medicines are relatively safe for treating depression during pregnancy — they have little or no risk of harming your baby. However, the long-term effects have not been determined. Your doctor will explain the risks/benefits to you before prescribing any antidepressant.

Thank you note

This article about maternal mental health was made in collaboration and with the support of the Mali Family Health Co., Ltd

Medical check

Ketsupa Jirakarn (Mental health specialist)

Sources

• Depression during pregnancy, March of Dimes https://www.marchofdimes.org/complications/depression-during-pregnancy.aspx 

• Depression During Pregnancy, Cleveland Clinic https://my.clevelandclinic.org/health/articles/9310-depression-during-pregnancy 

• Depression during pregnancy: You're not alone, Mayo Clinic https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/depression-during-pregnancy/art-20237875 

• Depression during pregnancy, American College of Obstetrics and Gynecologists https://www.acog.org/womens-health/faqs/depression-during-pregnancy