Depression During Pregnancy

Pregnant women with depression face complicated treatment decisions because of the risks associated with both untreated depression and the use of antidepressants. A new report from The American College of Obstetricians and Gynecologists (ACOG) and the American Psychiatric Association (APA) attempts to help doctors and patients weigh the risks and benefits of various treatment options. Depression is common during pregnancy-between 14 percent and 23 percent of pregnant women will experience depressive symptoms while pregnant. In 2003, approximately 13 percent of women took an antidepressant at some time during their pregnancy.

Both depression symptoms and the use of antidepressant medications during pregnancy have been associated with negative consequences for the newborn. Infants born to women with depression have increased risk for irritability, less activity and attentiveness, and fewer facial expressions compared with those born to mothers without depression. Depression and its symptoms are also associated with fetal growth change and shorter gestation periods. Pregnancy is supposed to be one of the happiest times of a woman's life, but for many women this is a time of confusion, fear, sadness, stress, and even depression. About 10-20% of women will struggle with some symptoms of depression during pregnancy, and a quarter to half of these will suffer from major depression.

For years, experts mistakenly believed that pregnancy hormones protected against depression, leaving women more vulnerable to the illness only after the baby was born and their hormone levels plunged. They now believe that the rapid increase in hormone levels at the start of pregnancy can disrupt brain chemistry and lead to depression. Hormonal changes can also make you feel more anxious than usual. Anxiety is another condition that can and should be treated during pregnancy. Depression and anxiety may go undiagnosed because women often dismiss their feelings, chalking them up to the temporary moodiness that often accompanies pregnancy.

The Risks of Untreated Depression during Pregnancy:
Depression, especially if it isn't treated, carries serious risks for the pregnant woman and her baby. Depressed mothers are often less able to care for themselves or their children, or to bond with their children. Babies born to women with depression may be more irritable, less active and less attentive than other babies. They may also be born prematurely or have low birth weight.

» Poor prenatal care
» Preeclampsia, a type of high blood pressure that occurs during pregnancy
» Poor weight gain
» Unhealthy eating habits
» Use of drugs or alcohol to self-medicate
» Suicide

It may be hard to diagnose depression during pregnancy. Some of its symptoms are similar to those normally found in pregnancy. For instance, changes in appetite and trouble sleeping are common when a woman is pregnant. Other medical conditions have symptoms similar to those for depression. For instance, a woman who has anemia or a thyroid problem may lack energy but not be depressed.

Treatment options for women who are pregnant can include:
» Support groups
» Private psychotherapy
» Medication
» Light therapy

If your symptoms are severe, your health care provider may want to prescribe medication immediately. There are medications that have been used during pregnancy without adverse affects. Discuss with your health care provider what he/she feels is safest for your baby but still beneficial to you. If you do not feel comfortable talking with your health care provider about your feelings of depression, find someone else to talk with. The most important thing is that someone knows what you are dealing with and can try to help you. Never try to face depression alone. Your baby needs you to seek help and get treatment.

The first thing that anyone facing depression should understand is that there are many ways of dealing with depression. You have to come to grips with how you feel. For pregnant women, it is especially important to recognize that depression is not a sign of weakness and does not mean that you are unfit to be a mother. Remember that depression is a biological illness, the same as other health issues like diabetes and high blood pressure. It usually occurs because of an inherited gene passed down from generation to generation.

When you are depressed, things may feel out of control, making it real easy to start to feel like life is hopeless. You may feel like retreating and just waiting for life to get better. But it is important to not keep all this inside. You need to find someone you can speak to openly and honestly.