Depression and Anxiety in Pregnancy
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Women can get
mental health problems during their pregnancy. Contrary to popular belief and
opinion pregnancy is not always a joyous and happy experience for every woman. Women
can get mental health disorders like depression and anxiety during pregnancy or
anytime in the first year after the birth of their baby and they can be serious
medical conditions. These dreaded feelings may crop up due to many reasons and
it is not caused by you doing something or not doing something. These disorders
can be treated with the help of mental health professionals.
What are
depression and anxiety?
Depression is
a feeling of sadness, emptiness, or when you feel down. Anxiety is a feeling of
nervousness, worry and scare. These are serious mental health conditions that
may occur during pregnancy or after birth. These feelings are not generally
what you might feel when you have a bad day or there is a big upcoming event. During
pregnancy, other people may shrug off your depression or anxiety as "just
feeling moody" or having the "baby blues." But they may be deeper
than just moodiness and baby blues.
Depression and
anxiety should be considered like any other illnesses you may get without any
stigma attached to them. These are very serious medical conditions that may get
in the way of you doing your everyday activities, like taking care of yourself
and your baby. These can be long-lasting if not treated in the right way, and they
won't go away on their own. This is why it's important to get help.
Depression in pregnancy
The symptoms of depression such as
changes in sleep, appetite, and energy are often difficult to distinguish from
the normal experiences of pregnancy, during the gestational period. It has been
noted that up to 70% of women report negative mood symptoms during pregnancy.
Every pregnant woman’s depression varies throughout pregnancy, they may report
a symptom during the first and third trimesters and then they may notice improvement
during the second trimester.
Depression is the most common
psychiatric disorder women may develop during pregnancy. Other disorders they
may suffer from are anxiety disorders, such as panic disorder,
obsessive-compulsive disorder, and eating disorders. It is rare for women to
develop these mental health problems for the first time but there are higher
chances of relapse for women previously diagnosed with some form of psychosis. In
pregnancy, depression is categorized as:
1. Postpartum Depression
Postpartum
depression is a common type of depression that mothers may experience after
pregnancy. Many women have postpartum depression, but many cases go unreported
as there are a lot of stigmas attached to it. The word "postpartum"
means "after birth," so when talking about "postpartum
depression" it is only about depression after you give birth to your baby.
Many women start feeling depressed sometime
within the first year after they have the baby.
2. Perinatal Depression
When women get
depressed during their pregnancy period it is known as perinatal depression. The
word "perinatal" is used to describe the time during pregnancy or
just after birth. Researchers have noticed that depression is one of the most
common mental health problems women experience during and after
pregnancy.
Anxiety disorders in pregnancy
Women may also
experience anxiety around the time of pregnancy which goes beyond just being
nervous about having a baby. Anxiety during and after pregnancy is also as
common as depression. Anxiety is another common disorder
that women may develop during pregnancy. During pregnancy, women are largely in
unknown territory and this may lead to them worrying as to how the pregnancy
period may go and have panic attacks as well. Some of the anxiety disorders are
panic disorder, obsessive-compulsive disorder, generalized anxiety disorder,
and social phobia.
The panic disorder during pregnancy
mainly varies and remains unclear. While in many cases it has been noticed that
the symptoms of pre-existing panic disorder in pregnant women decrease during
pregnancy, but many large-scale studies have suggested that there is no
decrease in symptoms for pregnant women with pre-existing panic disorder.
Many women may experience the first
symptoms of panic disorder during pregnancy. Women experiencing panic attacks
for the first time should also be screened for thyroid disorder. There has been
a correlation between anxiety and increased resistance in uterine artery blood
flow. There has also been a correlation between plasma levels of cortisol
in the mother and the foetus may affect the developing fetal brain. Treatments
for panic disorder in pregnancy include pharmacological therapies which will
give symptomatic relief, and includes antidepressants. Along with
pharmacological, nonpharmacological therapies such as cognitive behavioral
therapy, supportive psychotherapy, relaxation techniques, sleep hygiene, and
dietary counseling should also be done.
2.
Obsessive-compulsive disorder
Obsessive-compulsive disorder (OCD)
is the thoughts of a person that cannot be controlled known as obsessions and
repetitive behaviours or rituals that cannot be controlled or compulsions. It
has been noticed that many pregnant women are at an increased risk for the
onset of OCD and the postpartum period. In one study it was noticed that among women
who were diagnosed with OCD, 39% of the women reported that their OCD began
during pregnancy.
Treatments for OCD in pregnancy are
the same as they are in nonpregnant adults. It mainly includes cognitive
behavioural therapy and pharmacotherapy.
3.
Generalized anxiety disorder
There are fewer data available
regarding the prevalence or course of a generalized anxiety disorder (GAD)
through pregnancy. Most women will naturally worry about the health of the baby
and how they will go through with labour and physical changes that happen
during pregnancy. Excessive worrying is considered to be a symptom of generalised
anxiety disorder or depression.
Many women do not experience any
first-onset social phobia or pre-existing social phobia during pregnancy. A
very small number of women may experience tocophobia, which is an unreasonable
dread of childbirth. The study shows that these women are more likely to
develop postpartum depression if denied the delivery method of their choice i.e.,
caesarean section.
What are some
signs of depression and anxiety?
Women with
depression or anxiety during pregnancy may feel:
- Extremely sad or angry
- Foggy memory or have trouble completing tasks
- Feeling robotic i.e., just going through motions
- Feeling anxious around the baby
- Feeling guilty and feeling like they are
failing at motherhood
- Feeling unusually irritable or angry
- Little interest in things
- Having scary and upsetting thoughts
What are the
causes of depression and anxiety during pregnancy or after birth?
Several
factors make some women experience both anxiety and depression. Some are more
likely than others to experience one or both of these conditions.
These causes
can be:
- A history of depression or anxiety, either in
your earlier pregnancies or at other times.
- If there is a history of family depression or
anxiety
- A difficult pregnancy procedure or birth
experience
- If you give birth to more than one baby i.e.,
twins or triplets.
- Relationship problems with your partner
- Financial problems
- Having little or no support from family or
friends for your baby
- If it’s an unplanned pregnancy
Researchers believe
depression and anxiety during pregnancy may be a result of physical, emotional,
and environmental factors.
Do depression
and anxiety during pregnancy affect the baby?
Yes, these mental
health problems do not only affect you but can affect your baby too. Depression
may inhibit the early mother-child bonding that is important for your baby's
development. You may not be able to adhere to the needs of your baby. And, with
older children in the home, it can be more difficult to connect to your baby or
give any attention to your older children as well.
So, it is
important to start treatment as early as possible as it is important for your
and your baby’s health. The sooner you start the treatment you’ll start to
recover quickly.
Treatments for
depression or anxiety during pregnancy
Many
treatments can help you feel better. Treatment for mental health issues is
important as it can reduce your symptoms or make them go away completely. Your
doctor will provide you with many options for depression or anxiety during
pregnancy.
Your health
care professional may start with a set of questions this process is called
screening. They may do this to learn more about what you are feeling and find
the right form of treatment. Some treatments for depression and anxiety are:
1. Counseling
Some women might
find it helpful to talk about their feelings and concerns with a mental health
professional one-on-one. Your doctor can provide you with useful ways to manage
your feelings and tell you what changes to make to help ease the depression or
anxiety.
2. Medication
Several
medications can also be used for treating depression and anxiety. Your doctor
will give you medications that are safe for pregnant women and for
breastfeeding moms and their babies. You can also research and learn about mental
health drugs and their possible effects on a breastfed baby. There are some
things you can do, in addition to treatment, that may help you feel better.
How you can self-treat
your depression and anxiety?
- Connect with other mothers. You can look for a mother’s support
group in your community or online. These groups will help you in learning
from others who are going through or have gone through something similar. And,
they also encourage you to share your own feelings.
- Make time for yourself. The most important thing is self-care. You
should do something for yourself, start with getting out of the house, or
taking a long hot bath without interruption. During your self-care routine
have your partner, a family member, or a babysitter watch the baby.
- Do something you enjoy. Self-care is not the only thing you can do. Do
something that relaxes you like listening to music, reading a book, or
watching a favorite movie.
- Be realistic. Do not set unrealistic goals for yourself such
as having a perfect home. You don't have to do everything at the same
time just do what you can and leave the rest.
- Ask for help. Don't be afraid to ask for help from your
family members and friends. It can be for taking care of your baby or
doing some household chores.
- Rest when the baby rests. Sleep can be very effective and is just as
important for you as it is for the baby. You can try to sleep when the
baby sleeps, during the daytime and at night.
- Be with others. Don’t isolate yourself and surround
yourself with other adults, like family and friends who make you feel comfortable.
Regularly schedule a special time for you and your partner or spend a day
with your friend.
Remember this depression and anxiety that women experience
during pregnancy or after the birth of their baby are not things you can cause.
These are medical conditions that require proper medical and professional care.
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