Dealing with depression and anxiety during pregnancy is a challenge that can affect any expecting parent. It’s important to recognize the symptoms, risk factors, and treatments for these common mental health disorders while also exploring coping strategies for anxiety and depression during pregnancy. This knowledge will empower you to better manage your emotional well-being throughout this significant phase of life.
According to research, roughly 16 percent or more of pregnant women develop clinical anxiety or depression at some point. According to Healy Smith, M.D., a reproductive psychiatrist at the Women’s Mental Health Clinic at New York-Presbyterian Hospital in New York City, research indicates that fewer than 20% of them seek therapy and that treatment is frequently ineffective.
Dr. Smith argues that the misconception that pregnant women must be joyful is still pervasive. “As a result, therapy providers may be less likely to inquire about a woman’s mental health, and she may feel embarrassed to bring it up.” This suggests that a significant number of expecting parents may be coping with anxiety and/or depression without receiving the necessary support and assistance.
To protect the health of the infant, the American Academy of Pediatrics (AAP) issued a policy statement in December 2018 indicating that clinicians should screen for depression during pregnancy. “When we are able to assist a mother with her mental health, we are effectively helping the entire family,” explains author Dr. Marian Earls. The declaration also states that pregnant women should be evaluated for depression at 1, 2, 4, and 6 months after the birth of their child.
If your screening reveals that you are experiencing anxiety or depression during pregnancy, there are safe treatments available.
Depression Symptoms During Pregnancy
Dr. Smith explains that diagnosing mood disorders during pregnancy can be difficult since “several of the symptoms coincide with pregnant symptoms, such as changes in appetite, energy levels, attention, and sleep.” It is also reasonable to worry about the health of the pregnancy to some degree. But, you should seek assistance if you develop chronic symptoms of depression and/or anxiety, particularly if you cannot function normally.
Signs of pregnancy-related depression include:
- A feeling of valuelessness.
- During at least two weeks, experiencing a predominant depressive mood. You may feel unhappy, forlorn, “empty,” and generally discontented.
- alterations in appetite
- Reduced interest in the surrounding environment.
- Feelin guilty.
- Sleeping too much or too little.
- Poor vitality.
- No longer enjoying the activities, you formerly enjoyed.
- Negative concentration.
- Suicide-related thoughts
Anxiety Symptoms During Pregnancy
Symptoms of anxiety during pregnancy vary depending on the type of disorder, which may include generalized anxiety disorder, obsessive-compulsive disorder, and panic disorder.
Signs of Generalized Anxiety Disorder
- Disrupted sleep patterns.
- Difficult-to-control excessive anxiety
- Feeling restless inside.
- Negative concentration.
- Tension/muscle pains.
Signs of Obsessive-Compulsive Disorder
- Compulsions alleviate these ideas by repeating thoughts or acts.
- Repetitive, pervasive, and intrusive thoughts.
Panic Disorder Manifestations
- Constant worry about experiencing a manic episode.
- Repetitive panic attacks
Prenatal Risk Factors for Anxiety and Depression
Once, physicians believed that the hormones coursing through a pregnant woman’s body would protect her from depression. We now know that the opposite is true for some expecting parents. However, although specialists believe that hormones play a role in depression, the precise mechanisms remain unknown.
According to Sheila Marcus, M.D., head of the Women’s Depression Program at the University of Michigan Depression Center in the department of psychiatry, “it may be caused by any number of physiologic or life stressors.” “Hormone fluctuations may be one of these stressors among women with a genetic susceptibility to depression,” Dr. Marcus explains.
Anxiety and depression during pregnancy can affect anyone, but those with the following risk factors are especially susceptible:
- An individual or familial history of a mood condition, such as anxiety or depression.
- A premenstrual dysphoric disorder history (PMDD).
- Being a young parent (under the age of 20).
- Being separated, divorced, or widowed.
- Suffering interpersonal or marital conflict.
- Feeling ambivalent about being pregnant.
- Having a meager income.
- Having experienced traumatic or stressful situations within the preceding 12 months.
- Having inadequate social support.
- Having four or more children.
- Living alone
- Pregnancy complications
Potential Consequences of Untreated Depression and Anxiety
Because anxiety and depression can lead to difficulties, it is crucial to seek therapy for them. Dr. Smith states, “There are well-documented but sometimes disregarded repercussions of untreated anxiety and depression during pregnancy for both the fetus and the mother.”
Risks for developing infants whose mothers have untreated prenatal mental health conditions include:
- Low APGAR score (which measures the health of an infant after birth).
- Low weight at birth.
- Inadequate adaption to life outside the womb, including respiratory discomfort and agitation.
- premature delivery (before 37 weeks).
Hazards for an expectant mother include:
- Having a cesarean section.
- Poor bonding with the infant.
- They are neglecting their physical health.
- Postpartum anxiety or sadness.
- Abortion during a pregnancy
- Preterm labor.
- Usage of alcoholic beverages or illicit narcotics.
Anxiety and Depression Therapy During Pregnancy
According to experts, depression and anxiety necessitate medical treatment. Yet, selecting how to manage them during pregnancy is difficult, especially in more severe situations. Your medical providers will devise the optimal strategy for your care. We have described various pharmaceutical and non-pharmaceutical therapeutic options here.
The following treatments have been demonstrated to be beneficial for pregnant women with mild to moderate depression.
- Psychotherapy, such as cognitive behavioral therapy (CBT), in which a trained therapist teaches new ways to manage thoughts and emotions.
- Omega-3 essential fatty acids, found in foods like oily fish and walnuts, can function as a natural mood enhancer.
- Light therapy is a treatment for depression in which patients are exposed to artificial sunshine at specified periods of the day.
- Acupuncture, a Chinese practice (in this context) involving the insertion of very fine needles into parts of the body believed to affect mood.
Medication for Antidepressants and Antianxiety
Typically, medication is the most effective treatment for anxiety and depression. Gideon Koren, M.D., the former director of the Motherisk program at the Hospital for Sick Children in Toronto, notes that many physicians and expectant mothers fear the drugs. Most medications have never been tested on pregnant women, so doctors are uncertain of their effects on unborn children.
Wellbutrin and selective serotonin reuptake inhibitors (SSRIs) like as Zoloft, Prozac, Lexapro, and Celexa are the most often recommended choices. Several studies indicate possible correlations between preterm birth and low birth weight (comparable to rates among pregnant women with untreated depression), neurodevelopment (and maybe autism spectrum disorder), and short-term consequences such as fussiness and poor feedings. You and your physician must consider the benefits and hazards of antidepressants.
Before discontinuing medicine for depression or anxiety, you should visit a psychiatrist. Dr. Stephanie Ho, a reproductive psychiatrist in private practice in New York City, cites a study that found “women who discontinued an antidepressant around conception had a 68 percent chance of recurrence of depression during pregnancy, compared to 26 percent for those women who continued their medication.” The majority of relapsed patients had to resume treatment during pregnancy.
Moreover, according to a study published in February 2019, the prenatal supplement EnBrace HR may successfully prevent depression during pregnancy. The findings, which were published in Annals of Clinical Psychiatry, revealed that pregnant women who took EnBrace HR had a 40% reduced rate of depression than those who did not take their antidepressants.
According to the article, EnBrace HR was evaluated for depressive relapse prevention and acute treatment of major depressive disorder (MDD) in women considering or undergoing pregnancy. “The efficacy seen in this trial demonstrates that Rx EnBrace HR, an all-natural, nutritional prenatal and postnatal vitamin containing methylfolate, is an effective, safe, and well-tolerated choice for treating and avoiding depression during pregnancy.” EnBrace HR has no adverse side effects and protects against diseases such as spina bifida, congenital abnormalities, neural tube defects, and miscarriage.
Omega-3 fatty acids, vitamin D, SAMe, and methylfolate are the nutraceuticals with the most proven effects, according to a 2021 review study of the potential benefits of taking various nutritional supplements or consuming certain foods (often called nutraceuticals) for depression treatment and prevention. Nonetheless, the authors of the study state, “Nutraceuticals could be a viable support and adjunctive therapy for people with MDD, but they should always be paired with recognized medicines, as the benefits may be larger when this is done.”
Finding Assistance and Experts
If you are pregnant and experiencing signs of depression or anxiety, consult your OB-GYN or midwife. They should be able to either treat you directly or refer you to the right mental health professional. Some groups can also provide assistance with confidence:
Postpartum Support International
Postpartum Support International can put you in touch with a local coordinator who can help you locate local resources, offer support, and provide you with advice on how to manage mood and anxiety issues during and after pregnancy (www.postpartum.net).
The MGH Center for the Mental Health of Women
The MGH Center for Women’s Mental Health provides accurate information on the hazards associated with untreated depression during pregnancy and evaluation and treatment alternatives (www.womensmentalhealth.org).
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