Prenatal Depression: Depression During Pregnancy

Prenatal depression, also known as antepartum depression, is a common struggle for pregnant women. Prenatal depression can happen at any stage during pregnancy. In fact, the prevalence rate of depression for each trimester falls between 7% and 20%3.

Throughout pregnancy, the body goes through a lot of change. The stresses of these changes can cause depression during pregnancy. Prenatal depression is a mental health condition that can benefit from treatment and support. Depression during pregnancy can affect overall health including the baby’s health.

What is Prenatal Depression? 

Pregnancy is commonly associated with emotional ups and downs. If persistent feelings of sadness and hopelessness occur often enough to begin to affect daily life, this may be prenatal depression. Prenatal depression is depression during pregnancy and can also be referred to as antepartum depression. To be diagnosed with depression during pregnancy, symptoms of depression must continue for at least two weeks on a daily basis.

Depression during pregnancy can cause a lack of drive or little energy to participate in self-care. Prenatal depression can lead to losing weight, decreasing activity levels, and problems with maintaining relationships at work and at home. With treatment, symptoms of prenatal depression can be reduced or eliminated.

Prenatal Depression Symptoms

Understanding the signs and symptoms of prenatal depression can help with discovering when to get help for depression during pregnancy. Many of the symptoms of prenatal depression are consistent with chronic depression otherwise known as Major Depressive Disorder (MDD).

Common symptoms of prenatal depression include11:

  • Mood swings
  • Irritability
  • Sadness
  • Hopelessness
  • Feeling overwhelmed
  • Frequent crying
  • Overeating or undereating
  • Oversleeping or undersleeping
  • Difficulty focusing
  • Indecisiveness
  • Problems with memory
  • Feelings of worthlessness
  • Feeling guilty

In addition to these symptoms, prenatal depression can cause physical changes like headaches, body aches, pains, or stomach problems. These physical manifestations of depression may be more difficult to spot. The feelings of morning sickness commonly associated with pregnancy can feel different than the physical symptoms of depression during pregnancy.

Signs of Prenatal Depression

Pregnancy is often characterized by many emotional ups and downs due to the body going through a multitude of changes. Prenatal depression, however, can cause feelings of an emotional down for more than 2 weeks. Looking out for signs of prenatal depression can help with getting treatment quickly and avoiding health consequences.

Signs of prenatal depression include4:

  • Excessive anxiety about the baby
  • Low self-esteem
  • Overwhelming thoughts about being an inadequate parent to the child
  • Losing interest in activities once enjoyed
  • Withdrawing from friends and/or family members
  • Inability to be reassured when feeling sad
  • Poor adherence to prenatal care
  • Smoking, drinking, and/or using illicit drugs while pregnant
  • Lack of adequate weight gain during pregnancy
  • Thoughts or comments about suicide

What Causes Prenatal Depression?

Antepartum depression comes about like other kinds of depression through imbalanced neurochemicals (i.e. norepinephrine, dopamine, and serotonin). There isn’t one cause that leads to prenatal depression1. However, experts believe that hormone changes that occur during pregnancy can lead to chemical changes in the brain.

Experts believe that there is a mix of different triggers that leads to the development of depression during pregnancy. Prenatal depression can be caused by a combination of physical, emotional, and environmental factors.

What Are the Risk Factors for Prenatal Depression?

Risk factors can increase the likelihood of developing prenatal depression. There is no guarantee that risk factors will cause depression to develop. However, watching out for these factors can help prevent depression during pregnancy.

Risk factors that may increase the likelihood of developing prenatal depression include9:

  • Previous history of anxiety and/or depression
  • Family history of anxiety and/or depression
  • History of smoking
  • History of domestic violence
  • Single motherhood
  • Unintended pregnancy
  • A lack of social support
  • A lower socioeconomic status
  • Experiencing life stressors

How Does Antepartum Depression Affect the Baby?

Antepartum depression during pregnancy can negatively affect the pregnancy and affect the baby’s development. Prenatal depression can make it difficult to show up for doctors’ appointments, follow healthy guidelines, or eat in a healthy manner. These actions can have consequences for the mother and baby.

Depression can make it difficult to participate in self-care practices and routines. The lack of motivation to participate in self-care can cause harm and trouble with the baby. Pregnancy involves nourishing and taking care of the body because the baby depends on it.

Dangers of Undiagnosed and Untreated Depression During Pregnancy

One of the most common complications that can occur from depression during pregnancy is the lack of weight gain. Women who are pregnant tend to follow a weight curve depending on pre-pregnancy weight. Mothers with prenatal depression may not gain weight at a healthy rate because of the side effects of depression.

A study in the Americal Journal of Obstetrics and Gynecology linked prenatal depression to lower birth weights5. The same study shows that women experiencing antepartum depression are more likely to go into preterm labor. This means that the babies are being born earlier than they should.

Babies born from mothers with severe depression during pregnancy are also at risk for sleeping issues during the first two years. Babies born from mothers with depression during pregnancy are more likely to develop behavioral issues down the line.

In addition, mothers are more likely to experience depression after giving birth. Postpartum depression can lead to issues with mother-child bonding. Postnatal depression may also lead to continued feelings of inadequacy and an inability to provide for the child.

Treatment Options for Prenatal Depression

Treatments for prenatal depression can help pregnant mothers cope. Reducing the number of negative feelings during pregnancy can help reduce problems for mother and baby.

An individualized treatment plan that is a collaborative effort between the mother and medical professional can produce the best results. This treatment plan can be based on the diagnosis and needs of the mother.

Therapy

Talk therapy, also known as psychotherapy, is typically the first-line treatment for prenatal depression. Two common psychotherapy strategies for pregnant women include Cognitive-behavioral therapy (CBT) and Interpersonal psychotherapy (IPT).

CBT is one of the most common treatments for individuals with depression and other mental health conditions. Research shows that it can be effective for all kinds of depression, including prenatal depression8.

CBT focuses on changing the thought processes about different events. CBT can help prenatal depression by changing the thought processes and behaviors associated with this disorder. This type of therapy can help provide tools to get through various situations that may be encountered during pregnancy.

IPT is an evidence-based treatment that can be used to treat depression during pregnancy10. IPT focuses on improving the quality of relationships and reducing the stress around life events. Repairing and strengthening relationships through IPT can help improve social functioning throughout the pregnancy.

Medication

Antidepressants are a common form of treatment for people with depression, but depression during pregnancy can be associated with more risks. Although some antidepressants may not cause harm to the baby, incompatible antidepressants can be destructive.

Some incompatible antidepressants can cause poor outcomes including2:

  • Birth defects
  • Miscarriage
  • Low birth weight
  • Premature delivery
  • Irritability
  • Feeding difficulty
  • Sleeping problems

If an antidepressant was taken prior to pregnancy, consultation with a healthcare provider can be important. The antidepressant previously prescribed may not be beneficial to the baby during pregnancy.

TMS

Transcranial Magnetic Stimulation (TMS) is an alternative treatment approach for pregnant women who are struggling with depression. TMS is a non-invasive and medication-free therapy that targets specific areas of the brain to help with depression symptoms. TMS targets the neurotransmitters serotonin, norepinephrine, and dopamine that appear to be less active in people with depression.

During treatment, an electromagnetic coil is placed on the top of the head and is used to stimulate the prefrontal cortex of the brain. TMS treatment involves 6-20 minute sessions 5 days per week for 25-30 sessions total. Unlike medications, there are minimal side effects to the mother and baby. So far, research proves it to be a low-risk treatment during pregnancy7.

Lifestyle Changes

One of the most common lifestyle changes for prenatal depression is exercise. Depressive symptoms may make it difficult to get out of bed and find motivation, but exercise can help improve mood6. Even light exercises like yoga and meditation can reduce the negative feelings that come with depression.

Journaling and mindfulness can be used as coping mechanisms and self-care practices. This can help with coping through emotional changes and with navigating through feelings before, during, and after a depressive episode.

Adding a self-care routine can increase mood on a daily basis. Blocking out time throughout the day can be essential, especially when struggling with mental health issues. Self-care routines not only can benefit the pregnant mother but can also provide care for the baby.

Consider joining a support group or communicating with loved ones. Whether talking with family or others who have gone through depression, benefits can be received from these interactions. Support can be crucial when recovering from prenatal depression and can help with the reduction of symptoms.

Receive Treatment

Prenatal depression is a common condition that can affect the mother and baby’s health during pregnancy. Treatment for depression during pregnancy can be vital in helping reduce health risks for both the mother and fetus. Treatments for prenatal depression can be individualized to best fit the needs of the mother.

If you or a loved one are struggling with depression during pregnancy, reach out to Brain Therapy TMS today. Our team can answer any questions you may have and give you a better understanding of our program. TMS therapy can help manage symptoms and increase the quality of life without the use of medications.

Sources

  1. APA. (2021, December 9). Depression during pregnancy. American Pregnancy Association. Retrieved March 21, 2022, from https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/depression-during-pregnancy/
  2. Carvalho, A. F., Sharma, M. S., Brunoni, A. R., Vieta, E., & Fava, G. A. (2016, August 11). The safety, tolerability and risks associated with the use of newer generation antidepressant drugs: A critical review of the literature. Psychotherapy and Psychosomatics. Retrieved March 18, 2022, from https://www.karger.com/Article/Fulltext/447034
  3. Dadi, A. F., Miller, E. R., Bisetegn, T. A., & Mwanri, L. (2020, February 4). Global burden of Antenatal Depression and its association with Adverse Birth Outcomes: An umbrella review – BMC public health. BioMed Central. Retrieved March 18, 2022, from https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-8293-9
  4. de Bellefonds, C. (2021, September 9). How to manage depression during pregnancy. Baby Center LLC. Retrieved March 21, 2022, from https://www.babycenter.com/pregnancy/health-and-safety/depression-during-pregnancy_9179
  5. Halbreich, U. (2005, October 1). The association between pregnancy processes, preterm delivery, low birth weight, and postpartum depressions-the need for interdisciplinary integration. American Journal of Obstetrics and Gynecology. Retrieved March 18, 2022, from https://www.sciencedirect.com/science/article/abs/pii/S0002937805003492
  6. Harvard Health Publishing. (2021, February 2). Exercise is an all-natural treatment to fight depression. Harvard Health. Retrieved March 18, 2022, from https://www.health.harvard.edu/mind-and-mood/exercise-is-an-all-natural-treatment-to-fight-depression
  7. Kim, D. R., Wang, E., McGeehan, B., Snell, J., Ewing, G., Iannelli, C., O’Reardon, J. P., Sammel, M. D., & Epperson, C. N. (2018, September 14). Randomized controlled trial of transcranial magnetic stimulation in pregnant women with major depressive disorder. Brain stimulation. Retrieved March 18, 2022, from https://pubmed.ncbi.nlm.nih.gov/30249416/
  8. Li, X., Laplante, D. P., Paquin, V., Lafortune, S., Elgbeili, G., & King, S. (2022, January 25). Effectiveness of cognitive behavioral therapy for perinatal maternal depression, anxiety and stress: A systematic review and meta-analysis of randomized controlled trials. Clinical Psychology Review. Retrieved March 18, 2022, from https://www.sciencedirect.com/science/article/abs/pii/S0272735822000149
  9. March of Dimes. (2019, March). Depression during pregnancy. Retrieved March 21, 2022, from https://www.marchofdimes.org/complications/depression-during-pregnancy.aspx
  10. Stuart, S. (2014, August 22). Interpersonal psychotherapy for postpartum depression. Clinical psychology & psychotherapy. Retrieved March 18, 2022, from https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC4141636/
  11. Taylor, M. (2021, April 26). Depression during pregnancy. What to Expect. Retrieved March 21, 2022, from https://www.whattoexpect.com/pregnancy/depression/

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