A Woman’s Perspective: Depression and Pregnancy, More Common Than Imagined
Depression is a common but serious mood disorder that affects women more than men. Simply put, it’s a biological illness that involves changes in brain chemistry. Studies show one in four women will be affected in their lifetime.
Depression during pregnancy is referred to as antepartum or prenatal. It is often the result of hormonal, genetic, and environmental factors. Triggers can include family or personal history of depression and/or anxiety, stress, isolation, abuse, and trauma. Even when a woman has depression that’s under control, hormonal shifts during pregnancy can lead to a relapse.
Approximately 14 to 23 percent of women struggle with symptoms of depression during pregnancy, according to the American Congress of Obstetricians and Gynecologists.
There are some symptoms of depression, such as fatigue and trouble sleeping, which are normal during pregnancy. If they last more than two weeks with other symptoms such as persistent sadness, dif culty concentrating, feelings of guilt, worthlessness, anxiety, or loss of interest in usually enjoyed activities, a mom-to-be should consult her health-care provider. Although it can be dif cult for some women to talk about mental health concerns, reassurance that the focus is on helping — not judging — is particularly important.
If left untreated, prenatal depression can lead to poor nutrition, smoking, drinking, and other unhealthy behaviors, which can result in low birth weight, premature birth, and developmental problems. Recent studies show babies born to untreated mothers with depression are often less attentive, less active, and more agitated than babies born to moms who are not depressed.
Treatment options for women with prenatal depression typically include support groups, private psychotherapy, medication, and light therapy. If a pregnant woman is dealing with severe depression, often a combination of psychotherapy and medication (with the smallest risk to baby) is recommended. While it’s natural to be concerned about taking medication when pregnant, the risks of taking an antidepressant during pregnancy are usually small and depend on the medication, the dose, and how long it is taken. Prenatal care providers and mental health specialists are trained to collaboratively weigh a medication’s short- and long-term bene ts and risks for mom and baby.
If for example, a woman was taking medication for depression before becoming pregnant, most medical experts agree she should not stop taking the medication without talking rst to her health-care provider for guidance. Suddenly stopping could be risky for both her and her baby. Experts also agree that if a woman takes antidepressants in her third trimester, her baby may experience withdrawal at birth, but that withdrawal will likely be mild and short-lived.
Coping with the physical, hormonal, and emotional changes of pregnancy and childbirth can be a challenge for mothers-to-be whether diagnosed with depression or not. The best approach for all pregnant women — and all women who have recently given birth — is to put self-care and self-awareness at the top of their to-do list. If a pregnant woman is struggling with depression, the most important step for her and her baby is to seek immediate care, support, and help. Additionally, if a woman becomes aware she has symptoms of depression in the first four to six weeks after giving birth, she should reach out to her health-care provider as she could have what is called postpartum depression or PPD. This is not to be confused with having “baby blues,” which go away in a week or two. A woman with PPD is often unable to handle daily responsibilities and might have thoughts of harming herself.
Ways to Manage
Many women ask me if there are natural ways or alternative medicine approaches to managing their symptoms of moderate depression. Some suggestions with proven results follow, with the caveat that all women with symptoms of depression consult their health-care provider for individualized optimum care, as well as proven treatment guidance and management.
- Exercise regularly. Exercise increases serotonin levels and decreases cortisol levels.
- Focus on nutrition. Avoid diets high in sugar, caffeine, artificial additives, and processed carbohydrates, and low in protein. They lead to mental and physical health issues.
- Get adequate sleep. Establishing a routine sleep schedule whenever possible. Lack of rest affects your body’s ability to handle stress and day-to-day challenges.
- Try acupuncture relief. Current studies show acupuncture helps relieve some symptoms of moderate depression in women.
- Omega-3 fatty acids. New reports show taking a daily supplement of omega-3 sh oils can decrease symptoms of depression. (Pregnant women should take a mercury-free version and check with their health-care provider and nutritionist for recommended amounts.)
- Herbal remedies. Data shows some herbal and vitamin supplements affect moods and the hormone serotonin. Some can’t be used in conjunction with antidepressants and should be evaluated by health-care providers and nutritionists for this as well as for safe pregnant women dosages.
I can’t emphasize enough to all women and men who think they may be struggling with depression that the most important step is to seek help. I also can’t emphasize enough that if a woman is pregnant with depression, getting the right help is important for both mom and baby. Become informed. Learn about treatment options. Do research. Ask questions. Most of all, remember that depression is an illness that can be treated and managed.
The Marin Independent Journal welcomed Dr. Lizellen La Follette as their health columnist from 2015-2018. Her A Woman’s Perspective column appeared every fourth week in the Journal during these 3 years.