Depression in pregnancy is a medical condition that can be treated and managed; that is why it is important to be on the lookout for signs of depression during pregnancy.
Depression is a complex, common mood disorder. Approximately 12-15% of women experience depression at some point during their pregnancy. The risk of depression is higher in the second and third trimester of pregnancy. However, depression is often overlooked in pregnancy since the symptoms of depression are similar to the symptoms of pregnancy.
Risk factors for depression in pregnancy include stressful life events, a lack of prenatal care, use of tobacco, alcohol, or other harmful substances, a history of prior depressive episodes, or a family history of psychiatric disorders. Other factors include age, an unplanned pregnancy, and an unsupportive environment. Around 26% of pregnant adolescents have been found to develop major depression.
Pregnant women feeling depressive symptoms are at increased risk of a miscarriage, premature birth, respiratory distress, or having a baby with low birth weight or growth retardation. Prenatal maternal depression can even negatively impact the mental health of the offspring and contribute to childhood emotional difficulties and behavioural problems.
Untreated depression during pregnancy can lead to postpartum depression and other harmful consequences in both the mother and child. This is not the same as the short-term mood swings caused by a mild form of postpartum depression (‘baby blues’), which are experienced by 80% of new mothers.
It is imperative that depression during pregnancy is promptly diagnosed in order to maintain the wellbeing of both mother and baby. Signs of depression during pregnancy include dramatic changes in mood, sleep, appetite, libido, and concentration levels, a lack of interest in the pregnancy, and even suicidal thoughts in severe cases.
Changes in mood
Although fluctuations in mood and emotional swings are extremely common in pregnancy, significant differences may indicate depression. Persistent feelings of great sadness, despair, or worthlessness and crying for no reason for long periods of time during pregnancy may be signs of depression. Additional signs can include feeling emotionally detached, angry, guilty, or irritable. An unusual amount of worry about giving birth and parenthood can also point towards a mood disorder.
Changes in sleep
Depressive symptoms consist of either having trouble sleeping or sleeping too much. If you are suffering from constant fatigue and lack of energy, it can affect normal functioning and may be a cause for concern. It is crucial that disturbed sleep and diminished energy in pregnant women are resolved as quickly as possible to protect their strength and physical condition.
Changes in appetite
Changes in eating habits – either eating too much or having little interest in food – can be a symptom of depression in pregnancy. A diminished appetite is unhealthy for both the mother and growing baby. If you have lost interest in food, it is vital that you talk to a health professional to prevent any complications in your pregnancy.
Decreased libido
A reduced sex drive is common in all pregnancies. However, a continually lowered libido can be a sign of depression in pregnancy. It could even worsen depression in some cases as it may affect the relationship with your partner and your quality of life.
Impaired concentration
Poor levels of concentration and an extreme lack of focus are potentially symptoms of depression. There is an association between depression and concentration difficulties – it is important to observe situations in which you find yourself getting easily distracted, confused, or experiencing hallucinations or memory loss.
A lack of interest in the pregnancy
Loss of interest in yourself or the pregnancy can be a sign of depression, in addition to withdrawing from family, friends, work, or hobbies. A lack of excitement or joy about your pregnancy and social withdrawal are key symptoms of prenatal depression.
Suicidal thoughts
Recurring thoughts of death and suicide is a symptom of major depression. Low self-esteem, panic attacks, feelings of regret, and a reduction in the ability to experience pleasure (anhedonia) may contribute to suicidal thoughts and depression. Please ask for help if you do have any suicidal feelings.
Treatment options
If a pregnant woman is suffering from a number of these symptoms for longer than two weeks, it could be due to depression. It is important that pregnant women do not feel embarrassed or guilty about experiencing unexpected, negative emotions during pregnancy. Please seek medical advice and healthcare if you are experiencing symptoms of depression during pregnancy.
Depression in pregnancy can be treated through non-pharmacologic methods, such as an improvement in nutrition and diet, getting adequate rest, elimination of smoking, caffeine, and alcohol, and further education on prenatal and postpartum depression. Support groups can be useful to share experiences and struggles with other women in similar situations. Antidepressant medications can also be safely used in the treatment of severe depressive symptoms in pregnant women.
Written by Albina Babu, MSc
References
- Wichman, C.L. and Stern, T.A. (2015). Diagnosing and treating depression during pregnancy. The Primary Care Companion for CNS Disorders, 17(2).
- Depression in pregnant women and mothers: how children are affected (2004). Paediatrics & Child Health, 9(8), pp.584-586.
- Depression during pregnancy (2019). American Pregnancy Association. Retrieved from: https://americanpregnancy.org/pregnancy-health/depression-during-pregnancy/
- Kirby, N., Kilsby, A. and Walker, R. (2019). Assessing low mood during pregnancy. BMJ, 366.
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