Loneliness and Depression During Pregnancy

While many people are aware of postpartum depression, a condition that occurs shortly after the birth of a baby, less talked about is depression occurring during pregnancy, which is called prenatal depression.

Although estimates vary, one study found that around 25% of women experienced prenatal depression. However, it also isn't uncommon for women to experience some depressive symptoms even though they may not be severe enough for a diagnosis of depression.

Experiencing depressive symptoms during pregnancy can increase the risk of developing postpartum depression. Experts recommend that all women should be screened for depression both during and after pregnancy.

Symptoms

Many of the signs of depression mimic pregnancy symptoms. It can be hard to determine what is normal fatigue in pregnancy and what is actually depression. This can lead to an under-reporting and misdiagnosis of the problem.

There is also a tendency to ignore depression in pregnancy simply because this is supposed to be a happy time in life. Symptoms of depression include:

• Changes in eating habits
• Crying more than usual
• Fatigue
• Feeling anxious
• Feeling blue
• Feeling detached from your baby
• Feeling guilty, overwhelmed, or worthless
• Having recurrent headaches and stomachaches
• Irritability
• Isolating yourself from others
• Problems concentrating
• Sleeping too much or too little

Causes

Prenatal depression can affect any woman regardless of age, income, race, education, or culture. It does not have a single cause, but research suggests that both genetic and environmental factors likely play a role. Potential triggers of prenatal depression include:

• Abuse or trauma: A history of trauma or abuse may trigger prenatal depression.
• Family history: If depression runs in your family, you may be at a higher risk.
• Hormones: Research has shown that hormones affect the areas of our brains that control mood and the difference in hormonal levels during pregnancy may trigger depression in some women. However, while hormones are often blamed for many of the mood swings and other emotional and psychological happenings in pregnancy, they are usually only one part of the whole picture when it comes to pregnancy and depression.
• Previous depression: If you have ever been diagnosed with depression before you became pregnant, your risk during pregnancy is higher than for women who have never had depression.
• Stress: Sometimes the stress of pregnancy brings on depressive symptoms, even when the pregnancy was planned. These feelings might intensify if your pregnancy is complicated or unplanned. If life itself is stressful—for instance, if you have financial difficulties or relationship issues—this can also lead to depression. 

Risks

There are many reasons why it is so important to get treatment for prenatal depression. Some of the risks of untreated depression during pregnancy include:

• It can have a negative impact on prenatal care, especially in the areas of nutrition, sleep habits, exercise, and following instructions from your doctor or midwife. This can result in gaining too much or not enough weight, missing doctor appointments, and difficulty sleeping, all of which are harmful to your baby.
• It increases the risk of substance abuse, including alcohol, drugs, and cigarette smoking.
• It can cause problems for the baby, such as low birth weight and/or premature birth. Babies who are born to mothers who are depressed also tend to be less active and more agitated.
• It can lead to postpartum depression. Your risk of staying depressed after your baby is born increases, which makes it difficult to parent.

Not seeking treatment for prenatal depression can also cause your symptoms to grow worse over time. Fortunately, a number of treatment options are available that have been shown to be effective in reducing symptoms of prenatal depression.

Treatment

Proper treatment for prenatal depression is essential for both the health of the mother and the baby. Your doctor may recommend therapy, medications, or a combination of the two. With treatment, many women experience reduced symptoms and improved well-being.

Treatment during pregnancy involves several avenues, including:

• Lifestyle modifications: Your doctor might recommend certain lifestyle changes that might alleviate your symptoms or help you cope with them more effectively. Eating a healthy diet and engaging in regular physical activity, for example, may help you feel better. However, you should always talk to your doctor before you make any diet or exercise changes during your pregnancy.
• Medication: Antidepressants can also be used during pregnancy under the care of a practitioner who has experience with prescribing antidepressants and other medications during the course of pregnancy and breastfeeding. While prevalence estimates vary, research suggests that around 6.6% of women take antidepressants during pregnancy.
• Psychotherapy: Talking to a professional counselor or therapist can also be very beneficial, particularly since pregnancy brings major changes in your life. Specific types of psychotherapy that can be helpful for treating prenatal depression include cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT). CBT works to identify and change negative thoughts while IPT focuses on improving communication, relationships, and support networks.
• Support network: Developing your social support network is extremely valuable. Being surrounded by supportive individuals can be beneficial, particularly if they have experienced the same feelings you're going through. This can include joining an online or community support group as well.

If your symptoms are related to seasonal affective disorder, your doctor might also recommend light therapy. Using a therapeutic light box may help naturally improve your symptoms, especially if you live in an area that's often cloudy and/or it's winter.

Getting Help

The key to preventing the problems that stem from depression in pregnancy is getting the support and help you need as soon as you realize that you are experiencing it. With many pregnant women having depressive symptoms, it's important to recognize that you're not alone, and that help is available.