Depression and Anxiety in Pregnancy

 Depression and Anxiety in Pregnancy

Depression and Anxiety in

Women can get mental health problems during their pregnancy. Contrary to popular belief and opinion pregnancy is not always a joyous and happy experience for every woman. Women can get mental health disorders like depression and anxiety during pregnancy or anytime in the first year after the birth of their baby and they can be serious medical conditions. These dreaded feelings may crop up due to many reasons and it is not caused by you doing something or not doing something. These disorders can be treated with the help of mental health professionals.

What are depression and anxiety?

Depression is a feeling of sadness, emptiness, or when you feel down. Anxiety is a feeling of nervousness, worry and scare. These are serious mental health conditions that may occur during pregnancy or after birth. These feelings are not generally what you might feel when you have a bad day or there is a big upcoming event. During pregnancy, other people may shrug off your depression or anxiety as "just feeling moody" or having the "baby blues." But they may be deeper than just moodiness and baby blues.

Depression and anxiety should be considered like any other illnesses you may get without any stigma attached to them. These are very serious medical conditions that may get in the way of you doing your everyday activities, like taking care of yourself and your baby. These can be long-lasting if not treated in the right way, and they won't go away on their own. This is why it's important to get help.

Depression in pregnancy

The symptoms of depression such as changes in sleep, appetite, and energy are often difficult to distinguish from the normal experiences of pregnancy, during the gestational period. It has been noted that up to 70% of women report negative mood symptoms during pregnancy. Every pregnant woman’s depression varies throughout pregnancy, they may report a symptom during the first and third trimesters and then they may notice improvement during the second trimester.

Depression is the most common psychiatric disorder women may develop during pregnancy. Other disorders they may suffer from are anxiety disorders, such as panic disorder, obsessive-compulsive disorder, and eating disorders. It is rare for women to develop these mental health problems for the first time but there are higher chances of relapse for women previously diagnosed with some form of psychosis. In pregnancy, depression is categorized as:


1.    Postpartum Depression

Postpartum depression is a common type of depression that mothers may experience after pregnancy. Many women have postpartum depression, but many cases go unreported as there are a lot of stigmas attached to it. The word "postpartum" means "after birth," so when talking about "postpartum depression" it is only about depression after you give birth to your baby.   Many women start feeling depressed sometime within the first year after they have the baby. 

2.    Perinatal Depression

When women get depressed during their pregnancy period it is known as perinatal depression. The word "perinatal" is used to describe the time during pregnancy or just after birth. Researchers have noticed that depression is one of the most common mental health problems women experience during and after pregnancy. 

Anxiety disorders in pregnancy

Women may also experience anxiety around the time of pregnancy which goes beyond just being nervous about having a baby. Anxiety during and after pregnancy is also as common as depression. Anxiety is another common disorder that women may develop during pregnancy. During pregnancy, women are largely in unknown territory and this may lead to them worrying as to how the pregnancy period may go and have panic attacks as well. Some of the anxiety disorders are panic disorder, obsessive-compulsive disorder, generalized anxiety disorder, and social phobia.

1.    Panic disorder

The panic disorder during pregnancy mainly varies and remains unclear. While in many cases it has been noticed that the symptoms of pre-existing panic disorder in pregnant women decrease during pregnancy, but many large-scale studies have suggested that there is no decrease in symptoms for pregnant women with pre-existing panic disorder.

Many women may experience the first symptoms of panic disorder during pregnancy. Women experiencing panic attacks for the first time should also be screened for thyroid disorder. There has been a correlation between anxiety and increased resistance in uterine artery blood flow. There has also been a correlation between plasma levels of cortisol in the mother and the foetus may affect the developing fetal brain. Treatments for panic disorder in pregnancy include pharmacological therapies which will give symptomatic relief, and includes antidepressants. Along with pharmacological, nonpharmacological therapies such as cognitive behavioral therapy, supportive psychotherapy, relaxation techniques, sleep hygiene, and dietary counseling should also be done.

2.    Obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD) is the thoughts of a person that cannot be controlled known as obsessions and repetitive behaviours or rituals that cannot be controlled or compulsions. It has been noticed that many pregnant women are at an increased risk for the onset of OCD and the postpartum period. In one study it was noticed that among women who were diagnosed with OCD, 39% of the women reported that their OCD began during pregnancy. 

Treatments for OCD in pregnancy are the same as they are in nonpregnant adults. It mainly includes cognitive behavioural therapy and pharmacotherapy.

3.    Generalized anxiety disorder

There are fewer data available regarding the prevalence or course of a generalized anxiety disorder (GAD) through pregnancy. Most women will naturally worry about the health of the baby and how they will go through with labour and physical changes that happen during pregnancy. Excessive worrying is considered to be a symptom of generalised anxiety disorder or depression.

4.    Social phobia

Many women do not experience any first-onset social phobia or pre-existing social phobia during pregnancy. A very small number of women may experience tocophobia, which is an unreasonable dread of childbirth. The study shows that these women are more likely to develop postpartum depression if denied the delivery method of their choice i.e., caesarean section.

What are some signs of depression and anxiety?

Women with depression or anxiety during pregnancy may feel:

  • Extremely sad or angry
  • Foggy memory or have trouble completing tasks
  • Feeling robotic i.e., just going through motions
  • Feeling anxious around the baby
  • Feeling guilty and feeling like they are failing at motherhood
  • Feeling unusually irritable or angry 
  • Little interest in things
  • Having scary and upsetting thoughts

What are the causes of depression and anxiety during pregnancy or after birth?

Several factors make some women experience both anxiety and depression. Some are more likely than others to experience one or both of these conditions.

These causes can be:

  • A history of depression or anxiety, either in your earlier pregnancies or at other times.
  • If there is a history of family depression or anxiety
  • A difficult pregnancy procedure or birth experience
  • If you give birth to more than one baby i.e., twins or triplets.
  • Relationship problems with your partner
  • Financial problems
  • Having little or no support from family or friends for your baby
  • If it’s an unplanned pregnancy

Researchers believe depression and anxiety during pregnancy may be a result of physical, emotional, and environmental factors.

Do depression and anxiety during pregnancy affect the baby?

Yes, these mental health problems do not only affect you but can affect your baby too. Depression may inhibit the early mother-child bonding that is important for your baby's development. You may not be able to adhere to the needs of your baby. And, with older children in the home, it can be more difficult to connect to your baby or give any attention to your older children as well.

So, it is important to start treatment as early as possible as it is important for your and your baby’s health. The sooner you start the treatment you’ll start to recover quickly.

Treatments for depression or anxiety during pregnancy

Many treatments can help you feel better. Treatment for mental health issues is important as it can reduce your symptoms or make them go away completely. Your doctor will provide you with many options for depression or anxiety during pregnancy.

Your health care professional may start with a set of questions this process is called screening. They may do this to learn more about what you are feeling and find the right form of treatment. Some treatments for depression and anxiety are:

1.    Counseling

Some women might find it helpful to talk about their feelings and concerns with a mental health professional one-on-one. Your doctor can provide you with useful ways to manage your feelings and tell you what changes to make to help ease the depression or anxiety. 

2.    Medication

Several medications can also be used for treating depression and anxiety. Your doctor will give you medications that are safe for pregnant women and for breastfeeding moms and their babies. You can also research and learn about mental health drugs and their possible effects on a breastfed baby. There are some things you can do, in addition to treatment, that may help you feel better.

How you can self-treat your depression and anxiety?

  • Connect with other mothers. You can look for a mother’s support group in your community or online. These groups will help you in learning from others who are going through or have gone through something similar. And, they also encourage you to share your own feelings. 
  • Make time for yourself. The most important thing is self-care. You should do something for yourself, start with getting out of the house, or taking a long hot bath without interruption. During your self-care routine have your partner, a family member, or a babysitter watch the baby.
  • Do something you enjoy. Self-care is not the only thing you can do. Do something that relaxes you like listening to music, reading a book, or watching a favorite movie.
  • Be realistic. Do not set unrealistic goals for yourself such as having a perfect home. You don't have to do everything at the same time just do what you can and leave the rest.
  • Ask for help. Don't be afraid to ask for help from your family members and friends. It can be for taking care of your baby or doing some household chores.  
  • Rest when the baby rests. Sleep can be very effective and is just as important for you as it is for the baby. You can try to sleep when the baby sleeps, during the daytime and at night.
  • Be with others. Don’t isolate yourself and surround yourself with other adults, like family and friends who make you feel comfortable. Regularly schedule a special time for you and your partner or spend a day with your friend.

Remember this depression and anxiety that women experience during pregnancy or after the birth of their baby are not things you can cause. These are medical conditions that require proper medical and professional care.

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