What is depression?
Depression can be described as feeling sad, blue, unhappy, miserable,
or down in the dumps. Most of us feel this way at one time or another
for short periods. But true clinical depression is a mood disorder in
which feelings of sadness, loss, anger, or frustration interfere with
everyday life for an extended time. Depression can be mild, moderate,
or severe. The degree of depression, which your doctor can determine,
influences how you are treated.
How common is depression during and after pregnancy?
Depression that occurs during pregnancy or within a year after delivery
is called perinatal depression. The exact number of women with depression
during this time is unknown. But researchers believe that depression is
one of the most common complications during and after pregnancy. Often,
the depression is not recognized or treated, because some normal pregnancy
changes cause similar symptoms and are happening at the same time. Tiredness,
problems sleeping, stronger emotional reactions, and changes in body weight
may occur during pregnancy and after pregnancy. But these symptoms may
also be signs of depression.
What causes depression?
There may be a number of reasons why a woman gets depressed. Hormone changes
or a stressful life event, such as a death in the family, can cause chemical
changes in the brain that lead to depression. Depression is also an illness
that runs in some families. Other times, it’s not clear what causes
depression.
During Pregnancy
During pregnancy, these factors may increase a woman’s chance of
depression:
After Pregnancy
Depression after pregnancy is called postpartum depression or peripartum
depression. After pregnancy, hormonal changes in a woman's body may trigger
symptoms of depression. During pregnancy, the amount of two female hormones,
estrogen and progesterone, in a woman's body increases greatly. In the
first 24 hours after childbirth, the amount of these hormones rapidly
drops back down to their normal non-pregnant levels. Researchers think
the fast change in hormone levels may lead to depression, just as smaller
changes in hormones can affect a woman's moods before she gets her menstrual
period.
Occasionally, levels of thyroid hormones may also drop after giving birth. The thyroid is a small gland in the neck that helps to regulate your metabolism (how your body uses and stores energy from food). Low thyroid levels can cause symptoms of depression including depressed mood, decreased interest in things, irritability, fatigue, difficulty concentrating, sleep problems, and weight gain. A simple blood test can tell if this condition is causing a woman's depression. If so, thyroid medicine can be prescribed by a doctor.
Other factors that may contribute to postpartum depression include:
What are symptoms of depression?
Any of these symptoms during and after pregnancy that last longer than
two weeks are signs of depression:
After pregnancy, signs of depression may also include being afraid of hurting the baby or oneself and not having any interest in the baby.
What is the difference between “baby blues,”postpartum
depression, and postpartum psychosis?
The baby blues can happen in the days right after childbirth and normally
go away within a few days to a week. A new mother can have sudden mood
swings, sadness, crying spells, loss of appetite, sleeping problems, and
feel irritable, restless, anxious, and lonely. Symptoms are not severe
and treatment isn’t needed. But there are things you can do to feel
better. Nap when the baby does. Ask for help from your spouse, family
members, and friends. Join a support group of new moms or talk with other
moms.
Postpartum depression can happen anytime within the first year after childbirth. A woman may have a number of symptoms such as sadness, lack of energy, trouble concentrating, anxiety, and feelings of guilt and worthlessness. The difference between postpartum depression and the baby blues is that postpartum depression often affects a woman’s well-being and keeps her from functioning well for a longer period of time. Postpartum depression needs to be treated by a doctor. Counseling, support groups, and medicines are things that can help.
Postpartum psychosis is rare. It occurs in 1 or 2 out of every 1000 births and usually begins in the first 6 weeks postpartum. Women who have bipolar disorder or another psychiatric problem called schizoaffective disorder have a higher risk for developing postpartum psychosis. Symptoms may include delusions, hallucinations, sleep disturbances, and obsessive thoughts about the baby. A woman may have rapid mood swings, from depression to irritability to euphoria.
What steps can I take if I have symptoms of depression during
pregnancy or after childbirth?
Some women don’t tell anyone about their symptoms because they feel
embarrassed, ashamed, or guilty about feeling depressed when they are
supposed to be happy. They worry that they will be viewed as unfit parents.
Perinatal depression can happen to any woman. It does not mean you are
a bad or “not together” mom. You and your baby don’t
have to suffer. There is help.
There are different types of individual and group “talk therapies” that can help a woman with perinatal depression feel better and do better as a mom and as a person. Limited research suggests that many women with perinatal depression improve when treated with anti-depressant medicine. Your doctor can help you learn more about these options and decide which approach is best for you and your baby. The next section contains more detailed information about available treatments.
Speak to your doctor or midwife if you are having symptoms of depression while you are pregnant or after you deliver your baby. Your doctor or midwife can give you a questionnaire to test for depression and can also refer you to a mental health professional who specializes in treating depression.
Here are some other helpful tips:
How is depression treated?
There are two common types of treatment for depression.
Women who are pregnant or breastfeeding should talk with their doctors about the advantages and risks of taking antidepressant medicines. Some women are concerned that taking these medicines may harm the baby. A mother’s depression can affect her baby’s development, so getting treatment is important for both mother and baby. The risks of taking medicine have to be weighed against the risks of depression. It is a decision that women need to discuss carefully with their doctors. Women who decide to take antidepressant medicines should talk to their doctors about which antidepressant medicines are safer to take while pregnant or breastfeeding.
What effects can untreated depression have?
Depression not only hurts the mother, but also affects her family. Some
researchers have found that depression during pregnancy can raise the
risk of delivering an underweight baby or a premature infant. Some women
with depression have difficulty caring for themselves during pregnancy.
They may have trouble eating and won’t gain enough weight during
the pregnancy; have trouble sleeping; may miss prenatal visits; may not
follow medical instructions; have a poor diet; or may use harmful substances,
like tobacco, alcohol, or illegal drugs.
Postpartum depression can affect a mother’s ability to parent. She may lack energy, have trouble concentrating, be irritable, and not be able to meet her child’s needs for love and affection. As a result, she may feel guilty and lose confidence in herself as a mother, which can worsen the depression. Researchers believe that postpartum depression can affect the infant by causing delays in language development, problems with emotional bonding to others, behavioral problems, lower activity levels, sleep problems, and distress. It helps if the father or another caregiver can assist in meeting the needs of the baby and other children in the family while mom is depressed.
All children deserve the chance to have a healthy mom. All moms deserve the chance to enjoy their life and their children. Don’t suffer alone. If you are experiencing symptoms of depression during pregnancy or after having a baby, please tell a loved one and call you doctor or midwife right away.
For More Information
You can find out more about depression during and after pregnancy by contacting
the National Women's Health Information Center (NWHIC) at 1-800-994-9662
or the following organizations.
National Institute of Mental Health, NIH, HHS
Phone: (301) 496-9576
Internet Address: http://www.nimh.nih.gov
National Mental Health Information Center, SAMHSA,
HHS
Phone: (800) 789-2647
Internet Address: http://www.mentalhealth.org
American Psychological Association
Phone: (800) 374-2721
Internet Address: http://www.apa.org
National Mental Health Association
Phone: (800) 969-NMHA
Internet Address: http://www.nmha.org
Postpartum Education for Parents
Phone: (805) 564-3888
Internet Address: http://www.sbpep.org
Postpartum Support International
Phone: (805) 967-7636
Internet Address: http://www.postpartum.net
The depression during and after pregnancy FAQ has been reviewed by Catherine Roca, Chief, Women’s Programs, National Institute of Mental Health, National Institutes of Health (NIH).
