Depression During Pregnancy: More Than ‘the Blues’

By Makesha Joyner, MD

Pregnancy can be a joyful time. The months leading up to your baby’s arrival often are filled with anticipation, baby registries, nursery decorations, and choosing names. But pregnancy is not a positive experience for everyone. The American College of Obstetricians and Gynecologists (ACOG) estimates that 14 to 23 percent of pregnant women experience depression during pregnancy.

Changes in mood that occur during pregnancy (including persistent sadness, anxiety, loss of appetite, and feelings of hopelessness) can be debilitating and, if left untreated, can lead to serious health risks for mother and baby. Sustained depression in expectant mothers is associated with increased rates of premature birth, low birth weight, and fetal growth restriction. Some research shows that babies born to mothers suffering from depression may be less active, show less attention, and be more agitated than babies born to moms who are not depressed.

Recognizing Depression During Pregnancy

Just as you prepare for the birth of your baby by reading information on fetal development, nutrition, and birth options, it’s important to be aware of your mental health and alert to possible triggers for depression. These triggers can include relationship problems, previous pregnancy loss, complications during pregnancy, or a history of abuse or trauma. You can expect to be asked screening questions regarding depression and anxiety during your pregnancy (and at a postpartum check-up), but it’s still important to remain vigilant to the related symptoms.

Depression during pregnancy is much more than occasional feelings of sadness or uncertainty about the new chapter in your life. If any of the following symptoms affect your functioning for more than two weeks, contact your healthcare professional (primary care physician or OB/GYN) or a mental health professional. Thoughts of suicide or harm to you or your unborn baby necessitate an immediate visit to the emergency room.

You may or may not experience all these symptoms, but it is important to communicate with your healthcare professional if any of these are persistent:

• Overwhelming sadness or anxiety
• Uncontrollable crying spells
• Feelings of hopelessness, guilt, or helplessness
• Loss of appetite/change in eating habits
• Restlessness and irritability
• Increased fatigue not solely due to pregnancy
• Inability to muster up much energy or enthusiasm for anything
• Difficulty sleeping or over-sleeping

Treating Depression

The good news is that depression during pregnancy is treatable, typically with psychotherapy and/or medication. If you currently take psychotropic medication and become pregnant, do not take yourself off your medication without consulting your physician. Studies have shown that 68 percent of women who discontinue antidepressant therapy during pregnancy suffer a relapse, according to the ACOG.

Expectant mothers should talk with their doctors about all the medicines they are taking. When possible, women who are planning to get pregnant should talk with their doctors about medications even before they conceive. Together, you can discuss your treatment choices, including the risks and benefits, to determine the best option for you.

Taking care of yourself physically to preserve your mental and emotional well-being is important, perhaps even more so when you are pregnant. A healthy diet, exercise, good sleep habits, and self-care activities work in concert to optimize mental health.

Also, be sure to take a healthy approach to social media. If a newsfeed filled with posts about seemingly perfect pregnancies undermines your self-confidence and creates anxiety, unfollow the feed. Be mindful that what you see on social media is usually carefully selected to highlight people’s best days, not their reality. Another mother’s journey is not yours.

Focus on your own health, well-being, and happiness as you embark on this new exciting adventure of motherhood.

To learn more about depression, including symptoms, lifestyle management, and treatment, visit MAPMG’s Staying Healthy pages.

Makesha Joyner, MD, is a board-certified psychiatrist with Mid-Atlantic Permanente Medical Group. She sees patients at the Kaiser Permanente Gaithersburg and Largo Medical Centers.