Prenatal depression is defined as a form of clinical depression affecting women during pregnancy. It can also be a pre-cursor to post natal depression. It is estimated to affect 10% of women worldwide; with higher instances within third world countries.((World Health Organization:
Maternal Mental Health)) Evidence indicates that treating the depression of mothers leads to improved growth and development of the newborn and reduces the likelihood of diarrhea and malnutrition among them. Awareness of prenatal mental health is important in order to be your best as a parent and improving the health of your child. Have you ever contemplated what the impact could be of potentially unrecognised prenatal depression?
Leading Causes of Prenatal Depression
Although antenatal depression is more likely to occur among women who have a history of depression, it is by no means inevitable. It is important, however, that women with a history of mental health issues tell their midwife and/or GP, so they can discuss how this might affect their pregnancy and birth, and plan the right care and support. Other factors causing prenatal depression are previous difficulty conceiving, unplanned pregnancy, emotional and physical abuse as well as relationship and financial concerns.
In a recent article posted by The BabyCenter, the authors stated that:((The Baby Center: Depression during pregnancy)) "For years, experts mistakenly believed that pregnancy hormones protected against depression, leaving women more vulnerable to the illness only after the baby was born and their hormone levels plunged."
It is now understood that a potential contributing factor towards prenatal depression is actually an imbalance in hormones. More and more information is coming out as this myth has been debunked and more research is being funded. This also shows in the lack of information for parents to turn to in such cases. Common concerns can include:
- How mum feels about going through such a major life-changing event.
- How mum views herself including negative perceptions about physical changes, such as weight gain, swollen breasts, and other discomfort.
- The restrictions to mum's lifestyle that motherhood might incur.
- How mum's partner or family feel about the baby.
- How depression during pregnancy could impact relationships.
- Difficulties with previous pregnancies.
Whilst these concerns are common for all expecting parents, and have been understood to be expected concerns in the past. Since the change in understanding about the prevalence of prenatal depression, it is clear that obsessive and chronic focus on the above points is linked and a sign of prenatal depression.
Signs of Prenatal Depression
Antenatal depression can begin at any point during pregnancy and is characterized as having a higher than normal level of worry about the impending birth and parenthood. Whilst the majority of the following symptoms are common 'side effects' of pregnancy. The important factor to highlight here is if they become extreme, without break and/or multiple. There are many signs that can show prenatal depression; from the following list, if seeing or experiencing more than one symptom, I suggest you seek advice from a qualified medical professional.
- Lack of energy and extreme fatigue
- Feeling emotionally detached
- Tearfulness
- Chronic anxiety
- Feeling isolated and guilty
- Inability to concentrate and difficulty remembering
- Feeling emotionally numb
- Extreme irritability
- Sleeping too much or not enough, or restless sleep
- Desire to over eat, or not eat at all
- Weight loss/gain unrelated to pregnancy
- Loss of interest in sex
- A sense of dread about everything, including the pregnancy
- Persistent sadness
- Inability to get excited about the impending birth
- Inability to feel a bond with the growing baby
- Thoughts of suicide, or death
As previously mentioned, some of these factors are more commonly understood as 'symptoms' of pregnancy. Others are obviously more concerning. It's important to have an awareness, both by the mother to be and her partner, in order to halt any brewing depression in it's track. As with any mental illness, open communication about the matter is one of the most beneficial things that can be done to overcome it. That is a pre cursor to all of the following examples of how to manage prenatal depression to facilitate overcoming it.
How to Manage and Overcome Prenatal Depression
1. Speak out
Don’t try to be ‘superwoman’. Try to do less and make sure that you don’t get over-tired. Find someone you can talk to. If you don’t have a close friend you can turn to, there are many online support groups and even networks through social media. Your local group can be very supportive both before and after childbirth. Go to antenatal classes. If you have a partner, take them with you. If not, take a friend or relative.
2. Ask for help from your peers
Peer support in the right environment can be of great benefit to mothers affected by antenatal depression and PND. Speaking to someone who has been through what you’re going through, and who has recovered allows mums to see they can get better. However, do check that these groups are properly safeguarded with well-trained staff and volunteers, who have access to clinical supervision and support for themselves.
3. Antidepressants
Your GP may prescribe antidepressants which can help to ease many of the symptoms of moderate or severe antenatal depression. It is generally considered safe to take certain types of antidepressants when pregnant or breastfeeding, though do discuss this with your doctor who will ensure the ones selected for you are compatible. Don't stop (or change) antidepressant medication during pregnancy without medical advice. Around seven in 10 women who stop antidepressants in pregnancy relapse if they stop their medication. You need to discuss the risks and benefits of continuing treatment in pregnancy and while breastfeeding.
4. Counselling and therapy
Talking treatments, such as counselling and psychotherapy, offer you the opportunity to look at the underlying factors that have contributed to depression, as well as helping you to change the way you feel. If a friend or someone you know recommends a therapist, this can be a great way to find someone. If you don't feel that the method of therapy or the therapist isn't working for you, you can always change and try someone else. Private practitioners will charge a fee for their services, so this will probably be another factor in your decision. Whoever you choose, make sure your therapist is registered with an accredited body, such as the American Counseling Association (ACA) and the British Association for Counselling and Psychotherapy (BACP). You could also contact your Community Mental Health Team.
5. Spend time with your partner
Experiencing depression – particularly during pregnancy – can feel isolating and confusing, but you’re not alone. Try to talk about how you’re feeling and be positive about seeking help. It’s the best thing you can do. With the right help and support, particularly early on, things can get better.
6. Reduce inflammation
One traditional hypothesis of any type depression is that people who are depressed have a deficiency in monoamine neurotransmitters in the body, which leads to low levels of neurotransmitters like serotonin and norephinephrine in the brain. But growing evidence supports that at least some forms of depression may also be linked to ongoing low-grade inflammation in the body. Pregnancy causes amounts of inflammation as the body changes. Working to manage this inflammation can therefore be assumed to assist in reducing prenatal depression. Simple things such as spending time outside, meditation, hydration, eating plenty of green vegetables and regular gentle exercise have been shown to reduce inflammation.
7. Improve gut health
Continuing from the previous post, long term low level inflammation has a negative effect on gut health. The intestinal wall is our border with the outside world. Because the gut is where things from the outside (like food) are absorbed inside our bodies, the intestinal wall is designed to handle a many types of interactions with foreign matter. Considering the functions of our gut, it makes sense that most of our immune cells are located in the gut. Further, the gut is home to our microbiome, the trillions of beneficial microbes that live inside our gastrointestinal tract. When a potential threat is sensed in the gut, large, far-reaching inflammation occurs. This inflammation can travel directly from your gut to your brain, especially through the vagus nerve.
One of the most direct and quick ways to calm the vagus nerve is through dietary change. Just as emotions send messages to your gut, food sends messages to your brain. Spend time focussing on nutrition containing plenty of fibre from vegetable sources as well as including fermented foods to replenish your gut bacteria.
Myths About Pre & Post Natal Depression
Pre and post natal depression is often misunderstood and there are many myths surrounding it. These include:
- Postnatal depression is less severe than other types of depression? In fact, it's as serious as other types of depression.
- Prenatal depression is not possible due to hormonal changes? In fact, those hormonal changes can contribute.
- Postnatal depression is entirely caused by hormonal changes? It's actually caused by many different factors.
- Postnatal depression will soon pass? Unlike the "baby blues", postnatal depression can persist for months if left untreated. In a minority of cases, it can become a long-term problem.
- Postnatal depression only affects women? Research has actually found that up to 1 in 10 new fathers become depressed after having a baby.
Conclusion
Virtually all women can develop mental disorders during pregnancy and in the first year after delivery. But poverty, migration, extreme stress, exposure to violence (domestic, sexual and gender-based), emergency and conflict situations, natural disasters, and low social support generally increase risks for specific disorders. Prenatal depression can be extremely dangerous for the health of the mother, and the baby, if not properly treated. If you feel you might be suffering from antenatal depression, it is highly recommended to speak with your health care provider about it. Together you can discuss ways to help treat and cope with this mental illness. It's becoming more prevalent and more widely understood as more medical studies are being done. Antenatal depression was once thought to simply be the normal stress associated with any pregnancy, and was waved off as a common ailment. It can be caused by many factors, usually though involving aspects of the mothers personal life such as, family, economic standing, relationship status, etc. It can also be caused by hormonal and physical changes that are associated with pregnancy. Most important advice - if you believe you are at risk or may be developing symptoms, reach out for advice and speak to someone.
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