Prenatal depression: How to spot depression in pregnancy

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  • Everyone’s heard of postnatal depression, but prenatal depression, also known as antenatal depression, seems to get 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.

    In fact, a recent, 2020 study from The Baby Show found that 70% (of 1,000 asked) of new and expectant mums experienced some form of mental health problem.

    What is prenatal depression?

    Most pregnant women can feel moody, upset, low, or experience mood changes at times, but if you have prenatal (also known as antenatal) depression, those feelings, or feelings of despair, 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 (including postnatal depression). It’s important to remember that you may only experience a few of them, or many of them. And, the NCT reports, some (such as lack of interest in sex), are common in many pregnancies.

    You may experience:

    • Anxiety
    • Higher level of worry than usual
    • Lack of energy
    • Feeling emotionally detached
    • Tearful
    • Feelings of guilt
    • Feelings of anxiety
    • Disturbed sleep
    • Lack of interest in sex
    • Lack of concentration
    • Sense of hopelessness about the future

    Factors that can contribute to prenatal depression

    No-one knows for sure what causes prenatal depression. It could be a chemical or hormonal imbalance (though NCT note this is unlikely to be the only cause), 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 (especially if you experience hyperemesis gravidarum, a severe form of sickness) 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. But remember that however much you prepare for the change, it will be a big adaption. If you are struggling to deal with that prospect, see our treatments and support section below.

    • 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.

    Other causes of prenatal depression may be that you are struggling with the pressures to ‘get things right’ during your pregnancy, or that you yourself had difficult experience in your childhood and are worried about a similar thing for your baby.

    You may also have a history of depression, or be experiencing isolation and lack of support during your pregnancy.

    But while there are things you can do to address the potential causes of prenatal depression, it’s important to remember that there are lots of treatment and support options available for you out there – you never have to face any kind of depression alone. 

    What prenatal depression treatments and support is available?

    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. Find out more HERE.

    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.

    Or, a combination of all of the above can help too. Many mental health charities also suggest that self-help methods (such as talking to loved ones, exercise, reducing sources of stress and mindfulness practises such as yoga) could begin to ease your feelings, alongside medical treatment listed above.

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