Introduction:
A much-talked-about topic in the recent era is postnatal or postpartum depression. But, it is common for women to experience depression even during pregnancy. This is called antenatal or prenatal depression, but it is a less known and relatively less discussed topic. The phase of pregnancy can be both overwhelming and stressful. About 12 % of women experience antenatal or prenatal depression. Considerable mood swings are normal during pregnancy, but feeling low, hopeless, and losing interest in things for an extended period during pregnancy requires medical help.
Is Antenatal Depression Common?
Depression is a mood disorder that results in a continuous feeling of sadness and disinterest in certain things. It is the most common psychiatric issue in the general population. It is twice more common in women than in men. The early onset of depression peaks when a woman is in her reproductive years. The incidence of antenatal depression is usually high in low and middle-income group countries.
Why Does Antenatal Depression Often Go Unnoticed?
A few symptoms of depression, like alterations in sleep patterns, energy levels, libido, and appetite, mimic pregnancy symptoms. Hence, these are often mistaken to be pregnancy symptoms rather than depression. Due to the stigma linked with depression, many pregnant women hesitate to discuss these symptoms with family members or healthcare professionals. Also, more importance is given to a woman’s physical health during the antenatal period (pregnancy) rather than mental health.
Who Is Susceptible to Being Affected by Antenatal Depression?
Anyone can develop antenatal depression, but those with the following family histories are at greater risk of developing antenatal depression.
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Anxiety disorders.
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Mental illness like obsessive-compulsive disorder (OCD-a condition characterized by obsessive fears and thoughts that occur for no reason and result in compulsive behaviors).
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Mood disorders like postpartum depression and depression.
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Panic disorder.
Antenatal depression is also common among the following:
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Those expecting twins or triplets.
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Those carrying a child with special needs or other health issues.
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Those facing stressful situations in life like divorce, financial issues, work pressure, or other health issues.
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Those who did not plan to get pregnant.
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Those who experienced difficulty in getting pregnant, like in cases of infertility.
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Those who do not have supportive and caring family members, husbands, or friends.
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Previous history of depression, miscarriages, or difficult birth experiences.
What Are the Reasons for Antenatal Depression?
Antenatal depression occurs as a result of various factors, the most common of which is the family history of mood disorders. Antenatal depression can also occur due to alterations in the hormonal levels during pregnancy that can influence a pregnant woman's mood. Depression usually occurs due to a poor balance of chemical levels in the brain.
Many women also worry about the changes that take place in their bodies during pregnancy and can experience pregnancy discomforts. A few women also worry about their new responsibilities and financial burdens. Those who are at a higher risk of depression can find it difficult to handle these symptoms.
What Are the Signs and Symptoms of Antenatal Depression?
Most of the symptoms of antenatal depression mimic that of normal depression in the general population. However, a few cues can help identify antenatal depression, which are as follows:
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Being excessively anxious about the baby.
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Smoking, alcohol consumption, or substance abuse.
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Suicidal thoughts, or thoughts of harming others.
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Feeling irritable, angry, sad, or crying a lot of the time.
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Not able to enjoy certain activities that seemed to be enjoyable previously.
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Low self-esteem, like feeling incapable of handling parenthood.
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Poor weight gain due to decreased food intake.
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The mood does not lift even if reassurance is given by close ones.
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Poor prenatal care.
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Lack of concentration and difficulty making decisions.
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Feeling hopeless, guilty, or blaming oneself for all the problems.
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Fatigue, difficulty sleeping, or sleeping more than usual.
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Headaches, gastrointestinal issues, or muscle aches that develop but are not a consequence of any health issues.
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Poor interest in sex and trouble connecting with one’s partner.
A few researches show that depressive episodes are more frequent during the first and third trimesters.
How to Diagnose Antenatal Depression?
It is recommended by the American College of Obstetricians and Gynecologists that healthcare professionals should screen for anxiety and depression with the help of a standardized tool at least once during the antenatal period. This enables one to be aware of one’s current status and risk of developing anxiety and depression during pregnancy. Besides, if one feels that they have symptoms of depression, it would be great if one discusses it with their physician.
The physician will inquire about the symptoms, frequency, and when it started. Based on this, they may refer one to a mental health professional like a counselor, psychologist, or a therapist. These professionals offer the necessary treatment to overcome depression. It is also important that one mentions their previous or family history of depression to their therapist.
How Can One Overcome Antenatal Depression?
Antenatal depression can be treated in the following ways:
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Cognitive Behavioral Therapy (CBT): It is a type of therapy in which a person’s concerns and behaviors are made to think in a different way. With consistent practice, one develops new thinking patterns. Also, one learns to react to situations with a positive outlook.
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Interpersonal Therapy (IPT): This therapy helps one to refine their way of interacting with others. It aids one to build relationships and acquire support from social groups.
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Psychotherapy: This is also known as talk therapy, enabling one to talk through their emotions and find ways to cope. An experienced therapist can assist one in feeling better and managing mood changes.
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Medications: Medications like tricyclic antidepressants (TCA) and selective serotonin reuptake inhibitors (SSRIs) are available to treat depression. However, one must consult their physician to know which medications are safe during pregnancy and breastfeeding.
Why Is It Important to Treat Antenatal Depression?
Suppose antenatal depression is not checked and treated at the right time. In that case, a pregnant woman might not give proper attention to prenatal care and diet. She will not have sufficient energy to take care of themselves, which could eventually affect the unborn baby. This also increases the risk of postpartum depression, and one might find it difficult to establish a bond with the baby. Based on the severity of depression, treatment options include psychotherapy, antidepressants, or a combination of both.
What Are the Self-Help Methods to Cope With Antenatal Depression?
The following are a few self-help methods:
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Though difficult, one must find ways to reduce stress by practicing meditation, mindfulness, pregnancy yoga, relaxation techniques, and eating healthily.
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Talking with family members and friends and taking help from others if needed.
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Attending antenatal classes for support.
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Refraining from smoking, alcohol consumption, and caffeine intake as these can worsen the symptoms and are not indicated in pregnancy.
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Going outside for a walk and doing moderate exercise after consulting with one’s gynecologist.
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One should not stop or change the antidepressant medication during pregnancy since it has been found that doing so resulted in a relapse in seven out of 10 pregnant women.
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One can attend peer support groups, provided they are run by well-trained staff and volunteers with access to clinical support and supervision. Interacting with other expecting mothers can help share one's concerns and learn about the ways others use to overcome depression.
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Learning about the baby’s growth and milestones can help one feel confident and prepared to handle childbirth and parenthood.
Conclusion:
It is normal to feel anxious, emotional, or worried during pregnancy, but handling the situation matters. If one experiences symptoms of depression for a prolonged time in the antenatal phase, one must not ignore these symptoms and hesitate to seek help. Untreated depression can affect the health of the baby. Antenatal depression cannot be prevented, especially if one has a previous personal or family history of mood disorders. Medications, therapy, lifestyle changes, or a combination of these can help one overcome antenatal depression. Pregnant women must know that help is always available to overcome antenatal depression and must seek appropriate help since a happy mother delivers a happy baby.
