Living With: Depression During Pregnancy
Depression during pregnancy is a very difficult and sensitive subject. Statistics from the American Congress of Obstetricians and Gynecologists suggest that between 14 and 23 percent of women suffer from some form of depression during pregnancy. There are many questions that the pregnant woman and her family must struggle with. Is she truly suffering from depression or is her behavior caused by normal pregnancy hormones? If she is suffering from depression, what can she do? What can her family do? Are there any treatments that won’t harm the baby?
Because of hormonal changes during pregnancy, a woman may not realize that she is suffering from depression. At first, depression may not seem different from the anxiety, fatigue, difficulty concentrating and many other symptoms that are typical of pregnancy. However, when a woman is depressed these symptoms are more frequent and severe. If she is depressed, the symptoms last for more than two weeks and prevent the woman from anticipating the joy of bringing a new life into the world. She may also experience other symptoms that are clearly associated with depression such as persistent sadness, feelings of worthlessness or thoughts of suicide.
If a woman has suffered from depression in the past, she may be quicker to realize her situation than a woman who has never had depression before. It is important that anyone with depression seek help, so a woman who doesn’t recognize her depression is at greater risk than a woman who is aware of her situation. A depressed pregnant woman may not have the will to take care of herself and her unborn baby. She may not eat properly. She may drink or smoke or engage in life-threatening behavior. As a result, her baby could be born with developmental problems.
Treatments
Once she has agreed to seek medical care, a pregnant woman with depression will look for treatments that will not harm her unborn child. She should not assume that the only treatment for depression is antidepressant medication. There are many other therapies that may help her cope with mild depression. Such therapies include exercise, acupuncture, psychotherapy and support groups.
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- Exercise helps ease depression by releasing neurotransmitters and endorphins in the brain, which elevates mood. It reduces immune system chemicals that can worsen depression and increases body temperature, which has a calming effect.
- Researchers have recently shown that acupuncture can alleviate depression symptoms. A 2010 study at the Stanford School of Medicine concluded that depression-specific acupuncture reduced depression symptoms in pregnant women who were diagnosed as being at risk of a major depressive disorder. This type of acupuncture targets the acupuncture points known to be associated with depression relief.
- Psychotherapy has been used to treat depression for many years. This approach may include interpersonal therapy, which focuses on reducing strain in relationships, and cognitive-behavioral therapy, which identifies pessimistic thoughts and beliefs and works to change them.
- Support groups have consistently been proven to reduce symptoms and improve self-esteem in people suffering from depression. There are depression support groups everywhere, including online, and it is important to find one that the patient is comfortable participating in.
These therapies, accompanied by the support of family and friends, might be enough to manage a woman’s depression during her pregnancy. They should be the first choice of action for women who have been diagnosed with mild or moderate depression.
Medication
In cases of severe depression or if alternative therapies do not alleviate depression symptoms, many medical professionals believe that antidepressant drugs are the best choice to protect the health of mothers and babies. Pregnant women are justifiably concerned about the long-term effects of taking medication during pregnancy. Although all medications cross the placenta, retrospective studies have shown that many of the major antidepressants on the market have been used by pregnant women with no known ill effects. Doctors are particularly comfortable prescribing the class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs) to pregnant women. Evidence shows that the rate of infants with birth defects born to women who took SSRIs during pregnancy is the same as the rate of those who did not. There is similar evidence about tricyclic antidepressants.
Pregnant women contemplating using drugs to treat their depression will want to consider all their options and ask their doctor about possible health problems in the newborn or developmental delays in the future. It is important to weigh the health issues that could affect the unborn child due to depression symptoms against the possible ill effects of an antidepressant drug. SSRIs are so well-regarded by the medical community that experts may recommend that a woman with severe depression during her pregnancy continue her medication after the baby is born in order to stave off the possible onset of postpartum depression.
Woman Who Become Pregnant while Taking Anti-Depressants
Up to this point, this discussion has been about the care and treatment of a woman who develops depression during her pregnancy. What about women who become pregnant while taking antidepressants? In this situation, the woman and her doctor must weigh the pros and cons of continuing this medication. Research suggests the greatest risk to the fetus would be in the first trimester, so a woman and her doctor must address this issue as early in the pregnancy as possible.
What Can Family Members Do?
If you are a friend or family member of a pregnant woman whom you suspect is suffering from depression, you should do what you can to support her and encourage her to seek help. Do not ignore her expressions of sadness and despair, but instead listen with understanding and patience. Encourage her to seek a diagnosis and treatment, and follow up with her to ensure that the treatment is effective. It is imperative that a pregnant woman know if she is suffering from depression because it affects her health and the health of her baby.
Research on the treatment of depression is ongoing and researchers are developing new therapies all the time. The important thing is to recognize when a pregnant woman may be depressed and to encourage her to seek treatment as quickly as possible. That way she can take good care of herself and her developing child.
View Resources
- Unc.edu – Perinatal Mood and Anxiety Disorders
- Columbia.edu – Childhood Asthma Linked to Depression during Pregnancy
- CDC.gov – Reproductive Health
- AHRQ.gov – Acupuncture helps with depression during pregnancy
- FDA.gov – Drugs
