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Prenatal depression: How to spot depression in pregnancy

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Pregnant woman, antenetal depression
Everyone's heard of postnatal depression, but prenatal depression, also known as antenatal depression, gets far less attention.

Experiencing depression during pregnancy isn't as rare as you might think - in fact, it's estimated that one in 10 pregnant women experience it to some degree.

What is prenatal depression?

Most pregnant women (and indeed, women and men in general) feel moody or low at times, but if you have prenatal (also known as antenatal) depression, those feelings will be fairly permanent. You may also feel guilty because you 'should' be feeling happy to be pregnant, and might frequently be tearful, irritable, angry, anxious and overwhelmed.

Some women might find these symptoms of depression much worse in the early months, especially if they are suffering from uncomfortable pregnancy symptoms or the pregnancy came as a shock. For others it gets worse at the end, with fears about giving birth and what life will be like with a new baby to look after.

Prenatal depression symptoms

There are some general symptoms of prenatal depression, many of which overlap with wider forms of depression.
  • Anxiety
  • Higher level of worry than usual
  • Lack of energy
  • Feeling emotionally detached
  • Tearful
  • Feelings of guilt
  • Feelings of anxiety


  • Factors that can contribute to prenatal depression

    No-one knows for sure what causes prenatal depression. It could be a chemical or hormonal imbalance, or it could be that some women are just more prone to it than others.

    If you've suffered depression in the past you are more likely to have antenatal depression, but there are many other possible reasons you may be experiencing these feelings:

    Your pregnancy was unplanned


    Finding out you're pregnant can be devastating if it's not something you want or feel ready for. Maybe you think you're too young, or too old. Maybe you're single or newly divorced, or maybe you think you just can't cope with another child, but it's important to remember that you shouldn't feel guilty or ashamed if you're feeling overwhelmed.

    What can I do?
    Confide in your GP or health visitor, who can offer advice on the best course of care. If you're still with your partner, share your fears or concerns with them too - you may find they're experiencing similar emotions, and it will be easier for both of you to work through them together.

    You're feeling very sick or ill


    Morning sickness is often misunderstood. For a start, it doesn't just happen in the morning; it can continue for 24 hours a day and it can make you feel absolutely dreadful. But because it usually starts early in pregnancy (at around six weeks), many women feel they have to keep it a secret.

    Life can suddenly feel very lonely and miserable if you're coping with permanent nausea, sickness and tiredness but have no-one to confide in, and also feel under pressure to 'carry on' as normal.

    What can I do?
    Break the 'rule' of secrecy and tell someone you trust what's happening - a workmate or a good friend. Knowing other people understand, can be an enormous help. If you think your sickness may be affecting your work, tell your boss too, and don't be afraid to seek medical advice if your morning sickness is especially severe. It is a real condition and you will be taken seriously.

    You're worried about having a miscarriage


    If you've experienced fertility problems, have been trying to conceive for a long time, or have had a miscarriage before, you may be terrified something will 'go wrong' again. This fear is completely understandable and the anxiety it causes can make you really depressed.

    What can I do?
    The first thing that you should know is that many women who have had miscarriages in the past go on to have normal pregnancies and deliver a healthy child. Tell your GP or hospital consultant how you feel - they will be able to help you separate real fears from imagined ones, and check any symptoms you might be feeling worried about.

    You're worried about the change to your life


    Whether it's your first baby or your sixth, your life will still change dramatically once he or she is born. You're bound to feel anxious about this - everyone does. Giving up your job, having less money and less independence are big changes, and so are the responsibilities that being a mum brings. But if the anxiety is taking over your life, it's time to get help.

    What can I do?
    Make as many preparations as you can in advance of the baby's arrival, so you can reduce the list of things to be concerned about. Remember you can't know how you're going to feel about being a mum until it actually happens - and whilst it's hard, try to stay positive. You may be surprised how easy you find staying at home all day once you have that baby in your arms!

    You're worried about the changes to your body


    While some women laugh off the changes to their bodies, others are much more sensitive about them, and it's understandable. Gaining weight and getting stretch marks can make some women feel very upset - if you've spent a lifetime 'being careful' about what you eat, or have suffered from an eating disorder, watching yourself getting bigger and 'losing control' can feel overwhelming and often, quite traumatic.

    What can I do?
    Confide in your midwife or health visitor if these sort of feelings are bothering you. You aren't being silly, just honest, and you won't be the only other mother who has felt like this. Talking therapies can be very effective for antenatal depression - your GP can refer you. You may also be prescribed an antidepressant which is safe to take during pregnancy.

    What prenatal depression treatments and support is available?



    Counselling and therapy

    Talking-based therapy can help you understand and potentially change the way you are thinking. It can be really helpful to open up to someone separate from your situation and a trained professional could unearth some of the deeper reasons behind the way you are feeling.

    You will probably have to pay for your therapy privately, it is a good idea to seek recommendations from your GP or friends and you should always check that your therapist is registered with an accredited body.

    Medication

    If you are suffering from symptoms relating to depression it's important to speak to your GP as soon as possible. Once you have discussed your symptoms with your doctor, they may be able to prescribe you some medication to help, such as anti-depressants. Some anti-depressants are unsuitable for breastfeeding mothers so you may have to take this into account.

    Support groups

    If you are feeling isolated and craving the company of people that understand what you're going through, joining a support group could give you the forum and friendships that you need. There are antenatal support groups all over the country, but NCT's antenatal groups are a good place to start.

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