At what should be one of the happiest times in a woman’s life, many pregnant women experience fatigue, irritability, sadness and mood changes. When these feelings also include trouble sleeping, inappropriate guilt or hopelessness, and a sense that nothing is enjoyable anymore, this is characteristic of depression. If you are experiencing these mood disturbances and behavior changes, make an appointment with your doctor immediately.
The American Congress of Obstetricians and Gynecologists (ACOG) estimate that 14-23% of pregnant women experience depression at some point in their pregnancy. Given the hormone surges during pregnancy, women often feel “highs and lows”. Even so, if these hormonal fluctuations cause dramatic changes in mood and behavior, such that you are having thoughts of harming yourself or your baby, immediate action should be taken by seeking medical help.
When symptoms of depression are mild, such as intermittent fatigue and sadness, women might misinterpret these as normal and thus might not seek help. With 1 out of every 10 pregnant women feeling “blue”, it is no wonder that many women dismiss this as a normal part of pregnancy. It’s important to know your personal and family risk for depression and to report any symptoms, such as changes in mood or behavior so that you and your health care provider can decide if your situation will improve “naturally” or with assistance from counseling or treatment.
In the case of a pregnancy loss, women might also experience considerable sadness, grief and/or depression. During this time, many women benefit from talking to other women who have also experienced similar loss. As well, women should engage their spouse or partner as they are also likely coping with feelings of guilt or sadness.
Finally, sadness following childbirth, also called postpartum depression, is very common, with as many as 80% of women experiencing “baby blues”. Sadness with weeping, irritability, and an inability to sleep typically happens a few days to a week after delivery and may persist for 1-2 weeks. Such “blues” is often improved in the first 2 months by obtaining adequate sleep, returning to a pre-pregnancy routine of caring for yourself and enjoying a short outing, as well as seeking assistance with your baby’s care. If medical treatment is needed, alert your doctor if you are breastfeeding, to ensure that this is considered in his or her recommendation for treatment.
Each instance of depression can be medically treated by psychotherapy and antidepressant medications. Home remedies such as St. John’s worts should not be taken without your doctor’s permission, as they have not been clinically proven to be safe and effective during pregnancy. To prevent or shorten periods of depression, women can also engage in non-prescription practices of relaxation, stress management, healthy eating, regular exercise, and coping by social support. Many women find adequate relief of tension and anxiety by being active, eating right and engaging others in the care of their baby. In instances when these daily maintenance practices are not enough, don’t hesitate to seek help. Your decision might improve the quality of life for you and your baby.