As many as one in four women will suffer from depression throughout their lifetime, and often will experience it during the childbearing years. Depression is one of the most common complications during and after pregnancy.
Pregnant women were once considered immune to depression; however, doctors now believe that pregnancy can actually trigger it. The physical and emotional changes a woman experiences during and after pregnancy, such as fatigue, weight gain and insomnia, can resemble symptoms associated with depression, and can go unrecognized and untreated.
Deborah Kim, MD, a psychiatrist at the University of Pennsylvania Health System says, “If a woman is experiencing prolonged sadness, guilty feelings, hopelessness or low self-esteem, she may be suffering from depression. These symptoms can make it difficult to ask for help.”
Depression that occurs during pregnancy is called perinatal depression. The following factors may increase a woman’s chance of depression during this time:
Depression during pregnancy can affect the weight of the baby and cause the baby to be delivered prematurely. Limited research suggests that women with perinatal depression improve when treated with therapy and/or medication prior to delivery. Many women may be concerned that treatment of depression with medication may be harmful to the fetus if taken during pregnancy, or that the baby may have symptoms from medication exposure after delivery.
Sharon Young Byun, MD, an obstetrician and gynecologist at the University of Pennsylvania Health System, comments, “ The most recent reviews of medical treatment of depression have shown that the risks to the mother and baby from not receiving adequate antidepressant treatment outweigh the risks of harmful effects on the infant from medication.”
Postpartum depression can occur anytime within the first year after childbirth. Throughout pregnancy, progesterone and estrogen levels increase greatly; however, during the first 24 hours of childbirth, the amount of these hormones drops rapidly. This rapid change in hormone levels may trigger depression.
Symptoms of postpartum depression include sadness, lack of energy, trouble concentrating, anxiety and feelings of guilt and worthlessness. Postpartum depression seriously affects a woman’s well-being and keeps her from functioning properly.
A variety of factors can contribute to postpartum depression, including:
Many women feel guilty and ashamed about being depressed during what is supposed to be a very happy time in their life. It is important to understand that depression is a medical problem, and to contact a health care provider to find out how to get help. “An obstetrician can help a woman decide whether her symptoms are signs of depression and if further treatment by a psychiatrist is necessary,” comments Dr. Kim.
In addition to seeking professional help during this time, women can also follow these helpful tips to deal with the symptoms they are experiencing:
Postpartum psychosis is rare and begins in the first six weeks after delivery. If you experience delusions, hallucinations or have obsessive thoughts about your baby, contact your health care provider immediately.
Perinatal and postpartum depression can happen to any woman. Talk to family and friends about how you are feeling. Support from others is vital during this time. It is also important to receive the appropriate professional treatment, either during or after your pregnancy, so that depression does not adversely impact your life or the life of your baby.
“In certain instances, postpartum depression can be a true medical emergency and women should seek immediate medical attention for these symptoms. Patients, their family, friends and co-workers should be aware of the symptoms of depression and postpartum psychosis,” says Dr. Byun.
Talk to your doctor or midwife about the steps you can take if you experience symptoms of depression, including seeing a mental health professional.