Pregnancy: prenatal depression

Pregnancy is generally a happy time, but pregnant women are not immune from depression. Some expectant mothers won’t admit that they feel depressed or will avoid seeking help because they’re worried they’ll be judged.

Depression during pregnancy

When a pregnant woman says that she’s feeling down or depressed, her friends and family should pay attention and listen. If she is also showing signs of persistent sadness or loss of interest in her usual activities, she could be depressed.

If you find yourself in this situation, talk about it as soon as possible with your partner and consult a health care professional, whether or not they are monitoring your pregnancy.

Depression can vary in intensity. Research has shown that around 18 percent of pregnant women experience mild depression during pregnancy, and 7 to 12 percent of women may experience moderate to severe depression. In addition, a woman is more likely to become depressed during pregnancy if she has suffered from depression in the past, if she experiences a lot of anxiety or stress while pregnant, if she doesn’t feel supported, or if she reports difficulties in her relationship.

Fathers-to-be can also be vulnerable to depression. According to several studies, depression affects anywhere from 6.5 to 11.5 percent of fathers during their partner’s pregnancy. A study published in 2015 indicates that in Quebec, that figure is closer to 13 percent. Men who reported difficulty sleeping and who felt less socially supported were more likely to experience depression. In addition, research indicates that the risk of depression in fathers is greater if their partner is depressed during the perinatal period.

Like expectant moms, expectant dads have concerns during pregnancy and can experience stress. Couples who are about to have a child need to be able to talk about their expectations, fears, thoughts, and emotions without feeling judged.

The symptoms of depression

Mood swings, fatigue and disrupted sleep and appetite are common at certain times of pregnancy. However, they can also be symptoms of depression if they are persistent and very intense. Other symptoms of depression to watch out for include:

• Constant sadness, irritability, or high anxiety
• Loss of interest or pleasure in activities you used to enjoy
• Feelings of hopelessness, guilt, and worthlessness
• Difficulty concentrating or making decisions
• Excessive or lack of appetite (i.e., a more significant change in eating habits than would be considered normal during pregnancy)
• Inability to sleep or feel tired
• Recurrent thoughts of death or suicide

The greater the number of symptoms present and the more severe they are, the more serious the individual’s depression.

A pregnant woman who is depressed may have a harder time taking steps to look after her health or that of her baby. For example, she might skip prenatal appointments, not eat properly, or not get enough rest. She might also engage in problematic behaviours with potentially negative consequences for the baby, such as using tobacco, alcohol, or drugs.

Treating prenatal depression

Pregnant women who are feeling depressed or experiencing symptoms of depression should talk to their doctor or a psychologist. In many cases, it can be helpful to include their partner in their treatment.

Mild to moderate depression

There are several things you can do to help reduce depressive symptoms, such as eating well, exercising regularly, getting enough sleep, seeking social support, and doing activities that relieve stress (relaxation exercises, yoga, mindfulness, etc.). Some women may need to talk to a psychologist or a recognized psychotherapist.

Severe depression

In some cases, if your symptoms are severe, you could be prescribed medication. Feeling depressed during pregnancy is a risk factor for postpartum depression, so it’s important to discuss the pros and cons of taking medication with a doctor. This will help you make the best choice for you and your baby. Medication can also be combined with the various intervention strategies used to treat mild to moderate depression.

The consequences of prenatal depression

Studies show that 30 to 60 percent of mothers with postpartum depression were already experiencing symptoms of depression during their pregnancy.

Feeling emotional or anxious for the first two weeks after giving birth is normal. During this period, a new mom needs rest and support from her friends and family.

However, if the signs of depression are constant or persist beyond the first two weeks, they need to be addressed. An estimated 15 to 20 percent of women experience postpartum depression. Both parents should consult a physician or psychologist to determine how to treat the symptoms. It’s easier to treat depression when it’s detected early, before it becomes too severe.

For this reason, it’s important to intervene as early as possible during pregnancy to limit the impact on the mother and her family. A pregnant woman who is depressed may also interact less with her baby later on, potentially hurting their bond.

A number of studies have also shown a link between prenatal maternal depression and cognitive and behavioural problems in the child, such as attention deficit hyperactivity disorder or oppositional disorder. In addition, children whose mothers were depressed during pregnancy have been reported to experience issues such as depression and anxiety into adolescence.

Things to keep in mind

• Pregnant women are not immune to depression.
• If you experience symptoms of depression during pregnancy, it’s important to talk to a health care professional.
• Some antidepressants can have side effects, but leaving depression untreated also carries risks.

Scientific review: Dr. Nicole Reeves, psychologist Research and copywriting: The Naître et grandir team Updated: March 2022

Photo: iStock.com/monkeybusinessimages