Guide to Depression During or After Pregnancy

By May 16, 2019 May 21st, 2019 Guides and Information
Guide to Depression During or After Pregnancy Art

SUMMARY

  1. What is Depression?
  2. How common is depression during or after pregnancy?
  3. How do I know if I have depression?
  4. How does depression affect pregnant women?
  5. Are some women more at risk for depression during and after pregnancy?
  6. Different types of depression during and after pregnancy
  7. What should I do if I have symptoms of depression during or after pregnancy?
  8. Can my husband also experience postpartum depression?
  9. How is depression treated?
  10. If I take antidepressants during pregnancy, will they affect my baby?
  11. What can happen if depression is not treated?
  12. How can depression be prevented?
  13. Important Hotlines

What is Depression?

Major Depressive Disorder (MDD), or widely known as depression, is a common and serious mental disorder that causes a persistent feeling of sadness and loss of interest to things you used to enjoy. It negatively affects your life – on how you think, how you feel, and how you act. It is more widespread and more serious than many know it is. Fortunately, depression is treatable.
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How common is depression during or after pregnancy?

Depression is common during and after pregnancy. Research suggests that about 14 to 23 percent of all pregnant women struggle with depression during their pregnancy.
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How do I know if I have depression?

Normal changes during and after pregnancy can cause symptoms similar to depression. Due to this, you may be depressed during your pregnancy of after having a child, and not know it. However, if you experience the following symptoms for more than 2 weeks now, immediately call your doctor:

  • Feeling restless or moody
  • Feeling sad, hopeless, and overwhelmed
  • Crying a lot
  • Having no energy or motivation
  • Eating too little or too much
  • Sleeping too little or too much
  • Having Trouble focusing or making decisions
  • Having memory problems
  • Feeling worthless and guilty
  • Losing interest or pleasure in activities you used to enjoy
  • Withdrawing from friends and family
  • Having headaches, aches and pains, or stomach problems that don’t go away

Other signs and symptoms may include the following:

  • Excessive anxiety about your baby
  • Low self-esteem, such as feeling of inadequacy about motherhood
  • Poor response to reassurance
  • Poor adherence to prenatal care
  • Smoking, drinking alcohol or using illicit drugs
  • Thoughts of suicide

Lastly, specific medical conditions such as thyroid problems, brain tumor or vitamin deficiency can mimic the symptoms stated above. It is important to rule that out first.
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How does depression affect pregnant women?

Depression during pregnancy can lead to the following:

  • Trouble caring for oneself
  • Miscarriage
  • Delivering before the due date
  • Giving birth to a small baby

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Are some women more at risk for depression during and after pregnancy?

Yes. There are several factors that may increase the risk of depression during and after pregnancy such as:

  • A mother’s personal history of depression or another mental illness is the largest overall risk factor
  • A family history of depression or another mental illness
  • A lack of support from family and friends
  • Intimate partner’s personal and family
  • Anxiety or negative feelings about the pregnancy
  • Problems with a previous pregnancy or birth such as miscarriage
  • Marriage or money problems
  • Stressful life events
  • Pregnancy at young age
  • Substance use disorders
  • Family violence
  • Chronic illness

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Different types of Depression During and After Pregnancy

The Baby Blues

A mother, right after giving birth, may have sudden mood swings. One moment you are very happy, then another very sad. You may cry for no apparent reason, feel irritable, anxious. This is a very common yet temporary mental state of mothers after giving birth called “baby blues.”

Baby blues may sometime be synonymous to postpartum depression. However, baby blues is its least severe form. According to the American Pregnancy Association, 70 to 80 percent of all new mother may experience some kind of negative feelings or mood swings after giving birth.

Baby blues can occur 2 to 3 days after the birth and can last up to 14 days. Its symptoms can show for a few minutes to a few hours each day. Symptoms may include the following:

  • Experience mood swings
  • Feel sad, anxious, or overwhelmed
  • Cry for now apparent reason
  • Loss of appetite
  • Sleeping problems

Postpartum Depression

Unlike baby blues, postpartum depression is more severe and more serious. It’s not easy to detect and distinguish with baby blues. At the first few days, postpartum depression may look like baby blues as they share many similar symptoms such as mood swings, anxiety, sadness, uncontrolled crying, sleeping problems and irritability.

The difference is that it lasts longer, and its symptoms are more severe such as suicidal thoughts and inability to care for the baby.

Postpartum Psychosis

A woman may struggle with postpartum psychosis soon after giving birth. Unlike the previous types, postpartum psychosis is rarer, more serious and very different. It is also known as puerperal psychosis or postnatal psychosis. Hospitalization is an usual occurrence due to high risks of suicide or infanticide to keep both the mother and the baby safe.

Symptoms may include:

  • Hallucinations
  • Delusions
  • Extreme agitation and anxiety
  • Suicidal thoughts and actions
  • Confusion and disorientation
  • Rapid mood swings
  • Bizarre behavior
  • Loss of appetite
  • Sleeping problems
  • Thoughts of harming or killing your baby

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What should I do if I have symptoms of depression during or after pregnancy?

If you have the symptoms specified above, the best thing to do is to make an appointment and see your doctor as soon as possible. Your doctor knows what is the best next step for your treatment and may refer you to a mental health professional specializing in treating depression.

Some women are afraid to tell anyone about their symptoms because they feel embarrassed and ashamed of having depression when they are supposed to be happy about their new child. They feel inadequate and unfit to become parents.

In cases where you may hurt yourself or your baby, immediately call 911 or your local emergency hotline. Other options you can consider are the following:

  • Call your doctor or mental health professional
  • Call a suicide prevention hotline
  • Seek help from a friend or loved one you are comfortable with

You and your baby do not have to suffer. Remember, there is help.
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Can my husband also experience postpartum depression?

Yes. In fact, it is a relative common phenomenon. It affects 2 to 25 percent of husbands during or after the pregnancy. Unfortunately, it will increase the risk for the mother to also develop depression.
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How is depression treated?

Depression is treatable. According to American Psychiatric Association, about 80 to 90 percent of patients respond well to their treatment and almost all gain relief from their symptoms.

A diagnostic test is done to the patient first which includes an interview and physical examination. As said previously, other medical conditions that mimic symptoms of depression must be ruled out first. This diagnostic evaluation helps the doctor on how to diagnose and how to give treatment to the patient. There are plenty of treatment that can be given to the patient such as the following:

Medication

Brain chemistry perhaps is one of the main contributors to depression. That is why antidepressants may be prescribed to the patient to help alter his or her brain chemistry. Improvements to the patient may be seen as soon as the first week of use and two to three months to see its full benefits.

Psychotherapy

In cases of baby blues or mild depression, psychotherapy or “talk therapy” may be given. Talk therapy can also be given for moderate to severe depression alongside the antidepressant treatment. Most common type of talk therapy given is Cognitive Behavioral Therapy (CBT). It has been found to be effective on recognizing the patients distorted thinking and changing his or her behavior and thinking. Talk therapy may be on one-on-one basis but it can also be in a group with other depressed patients. Treatment can last for a few weeks (perhaps longer depending on severity). Improvements can be seen as soon as 10 to 15 sessions of psychotherapy.

Electroconvulsive Therapy (ECT)

In cases where the patient with severe depression did not respond well with the previous treatment, Electroconvulsive therapy may be given. A team of trained medical professionals (includes a psychiatrist, an anesthesiologist, and a nurse or physician assistant) gives a brief electrical stimulation of the brain to a patient under anesthesia. Patients receives ECT twice to trice a week totaling to 6 to 12 sessions.
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If I take antidepressants during pregnancy, will they affect my baby?

You may think that you should stop taking medications immediately when you are pregnant. Remember, if your depression is left untreated it may cause more serious problems. You should seek the advice from your doctor first before stopping any medication.

Newborn babies to mothers taking antidepressants may show symptoms such as irritability, fast breathing and tremors. However, this symptoms usually pass quickly within 2 weeks. More serious problems are very rare.
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What can happen if depression is not treated?

If your depression is left untreated, it may indirectly affect your baby or your other children. Mothers dealing with depression may have a hard time caring for their children. One moment they are loving and caring, then another responding negatively or not at all.

Moreover, the attachment that is integral for your child’s development may also be affected. Attachment is a deep emotional bond between the mother and the baby. Secure attachment helps the baby’s long term emotional health making them feel safe and secure. This also helps the baby to trust others. According to Canadian Paediatric Society, depression may produce “insecure attachment” which can later cause problems later in their childhood.

Babies who struggled developing secure attachment may:

  • have trouble interacting with their mother
  • have sleeping problems
  • have delayed development or growth
  • have more colic
  • become passive

Toddlers and preschoolers whose mothers are depressed may:

  • be less independent
  • have a hard time socializing with others
  • have trouble accepting discipline
  • be more aggressive and destructive
  • not excel in school

School-aged children may:

  • have behavior problems
  • have trouble learning
  • have higher risk of attention deficit hyperactivity disorder (ADHD)
  • not excel in school
  • have a higher risk of anxiety, depression, and other mental health problems

Teens whose mothers are depressed may:

  • have higher risk of attention deficit hyperactivity disorder (ADHD)
  • have a higher risk of anxiety, depression, and other mental health problems
  • not excel in school
  • have higher risk of substance abuse

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How can depression be prevented?

Living a healthy lifestyle is the first step in preventing depression. Sleep early at night and wake up when the sun rises. Exercise helps in creating a positive mood for the day. Eat plentiful of healthy breakfast food. Avoid common depressants such as alcohol. Cut off negativity.
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Important Hotlines

For people residing in the United States:

  • National Postpartum Depression Hotline: 1-800-PPD-MOMS
  • Postpartum Support International Helpline: 1-800-944-4773
  • National Suicide Prevention Lifeline: 1-800-273-8255
  • Suicide Prevention Hotline: 1-800-SUICIDE
  • American Psychological Association: 800-374-2721
  • Mental Health America: 800-969-NMHA

For people residing in the United Kingdom:

  • Pandas Foundation Helpline: 0843-28-98-401
  • The Association for Postnatal Illness Helpline: 020-7386-0868
  • Cry-sis Helpline: 08451-228-669
  • MAMA Helpline: 0845-120-3746

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References:

  1. Caring for kids. (2017, March). Depression in pregnant women and mothers: How it affects you and your child. Retrieved on May 15, 2019, from https://www.caringforkids.cps.ca/handouts/depression_in_pregnant_women_and_mothers
  2. Parekh, R. (2017, January). What is depression? Retrieved on May 16, 2016, from https://www.psychiatry.org/patients-families/depression/what-is-depression
  3. American Academy of Pediatrics. (2018, December). Depression during & after pregnancy: you are not alone. Retrieved on May 16, 2019, from https://www.healthychildren.org/English/ages-stages/prenatal/delivery-beyond/Pages/Understanding-Motherhood-and-Mood-Baby-Blues-and-Beyond.aspx
  4. Mayo Clinic. (2016, November). Depression during pregnancy: you’re not alone. Retrieved on May 16, 2019, from https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/depression-during-pregnancy/art-20237875
  5. Mayo Clinic. (2018, September). Postpartum depression. Retrieved on May 16, 2019, from https://www.mayoclinic.org/diseases-conditions/postpartum-depression/symptoms-causes/syc-20376617
  6. Smith, M et. al. (2019, May). Postpartum depression and the baby blues. Retrieved on May 16, 2019, from https://www.helpguide.org/articles/depression/postpartum-depression-and-the-baby-blues.htm/
Megan Collins

About Megan Collins