Understanding Antenatal Depression
Causes, Prevalence and Treatment of Low Mood in Pregnancy
Approximately 10-12% of pregnant women may suffer symptoms of depression. Possible causes may include hormonal changes and/or life stressors, however, antenatal depression is still a vague, neglected area requiring more research.
Symptoms of Antenatal Depression
Sufferers of antenatal depression may experience some or all of the following symptoms:
- Persistent feelings of sadness
- Difficulty concentrating
- Feelings of anxiety
- Feelings of irritability
- Obsessive compulsive tendencies, e.g. continual hand-washing
- Loss or increase in appetite
- Insomnia or over-sleeping
- Tiredness
Some sufferers describe feeling better soon after the child is born, whereas others may suffer with postnatal depression.
Prevalence of Antenatal Depression
The available research suggests that approximately 10-12% of women are affected by antenatal depression, though this data is concerned mostly with Western populations. It is difficult to estimate the number of women affected as some may not come forward about their symptoms.
There are also possible research weaknesses to account for. A study by Evans (2001) in the British Medical Journal was criticized for using scales that may not be adequate for measuring depression in pregnancy.
Causes of Antenatal Depression
The causes of depression remain unknown, though research points to a few possible causes or triggers for antenatal depression. The hormones in pregnancy are thought to be a relevant factor. The idea that pregnancy hormones actually protect women from depression is a popular misconception.
Women with a history of depression may be more vulnerable to depression during and after pregnancy. Other attributable factors may include life stressors such as financial problems, relationship difficulties and the pregnancy being unwanted or unexpected. Unpleasant physical symptoms (e.g. nausea) and previous complications in pregnancies, including miscarriage, may also be relevant factors.
Treatment of Antenatal Depression
Depression is a treatable illness but caution must be taken in pregnancy, and so a doctor should oversee any interventions used. There are a number of treatments available to pregnant women, including:
- Making lifestyle changes. Some exercises are safe and encouraged during pregnancy, though sufferers should check with their doctor and/or midwife first to see what’s suitable for them. A healthy diet can promote both good mood and good health to both the mother and baby.
- Psychotherapy/counseling. Although further research is desirable, a couple of small studies have shown psychotherapy to be beneficial in antenatal depression. Talking treatments allow a safe, judgement-free space and regular time for discussing problems.
- Antidepressants. This is a subject of contention and understandably may concern mothers-to-be. Antidepressants are generally not advised during pregnancy, however, some types appear to be low risk. These may be prescribed in severe depression where both the mother and child would be otherwise at risk. Mothers who were on antidepressants before conceiving are sometimes advised to stay on their medication so as to keep them well during their pregnancy.
- Complementary therapies. Besides talking treatments, there are many therapies available that can be tailored for pregnant women, such as aromatherapy massage.
Managing Antenatal Depression
Beside making lifestyle changes, there are other ways sufferers can help themselves. Talking to loved ones may be helpful, not only to get feelings out in the open, but also to help others understand what they are going through. There are also some online forums for sufferers and their carers to share their experiences.
Read Depression in Pregnancy for more information on antenatal depression, in particular, the use of antidepressants in pregnancy. Those who think they may be suffering symptoms of antenatal depression should seek advice from a qualified health practitioner.
Sources
Neonatal outcomes after prenatal exposure to selective serotonin reuptake inhibitor antidepressants and maternal depression using population-based linked health data, Archives of General Psychiatry, published August 2006, authors – Oberlander, T.F et al.
Cohort study of depressed mood during pregnancy and after childbirth, British Medical Journal, published in August 2001, Evans, J. et al.
Depressed mood during pregnancy and after childbirth, British Medical Journal, published December 2001, Lappins, J.
Psychosocial and psychological interventions for treating antenatal depression, Mental Health Specialist Library, accessed 17th May 200, no author specified.
