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How can pre-existing mental health conditions affect a pregnancy?

There are many chronic health problems, like hypertension, diabetes, or uterine abnormalities, that can make a pregnancy more prone to certain complications. Healthcare providers are on the lookout for these conditions, but there’s another area of health that is often overlooked that can have an equally serious impact, especially during the TTC journey: mental health.

The connection between mental health and pregnancy

We hear increasingly more about postpartum depression (PPD) these days thanks to illuminating studies and portrayals of PPD in the media. This is a good thing, as society is finally shining a greater light on this common condition that affects about 1 in 7 new moms. What we should also be discussing, though, is depression and anxiety during pregnancy (known as peripartum or antepartum mood disorders) which can take an equally serious toll, and make postpartum depression more likely.

According to the March of Dimes, women who have experienced depression before are more likely to develop depression during pregnancy. Depression is generally caused by a combination of factors, including shifts in brain chemical balances and stress. Unfortunately, chemical changes and stress are both commonplace during pregnancy.

Although any woman can develop depression during pregnancy (Mayo Clinic states that between 14 and 23% of women suffer from depression), it’s clear that those with a history of depression are more likely to develop it in the peripartum and postpartum periods.

Are antidepressants safe?

First things first: if you’re currently on an antidepressant, it’s important to continue taking your medication until you have a conversation with your healthcare provider.

For ethical reasons, there aren’t randomized trials of antidepressants in pregnancy, but many women do take antidepressants in pregnancy. It’s up to patients and providers to determine whether antidepressants are the right course of treatment on an individual basis.

Although we often hear that a particular medication “has not been proven safe” during pregnancy, we must remember how difficult it is to prove that a medication is perfectly safe, especially among a pregnant population.

Your healthcare provider knows the most about your medication and your mental health history, and can help you make the right decision for you and your baby. It’s important that you tend to your mental health during pregnancy, so that you can be the best pregnant person and parent to your baby.

And for women with serious depression, it’s likely that the risks of untreated depression outweigh any possible risks of depression medication on a gestating baby.

Does a history of depression make PPD more likely?

Current estimates state that postpartum depression affects about 1 in 7 new moms, but women with a history of depression are more likely to develop it. One study published in the journal Depression and Anxiety concludes that women with a history of depression are more than 20 times more likely than those without a history of depression to develop PPD.

There are additional factors that increase one’s risk for postpartum mood disorders, but if you already know that you have a history of depression or anxiety, it’s good to open up lines of communication with your healthcare provider beforehand.

The bottom line

Mental health conditions can have a major impact on a person’s quality of life, especially during pregnancy. Screening tools like the PHQ-9 can help you better understand your risk of depression, so regularly taking these screeners, as well as speaking with your healthcare provider in advance, are both great ways to stay on top of your mental health.

  • Mayo Clinic Staff. “Antidepressants: safe during pregnancy?” Mayo Clinic. Mayo Clinic, February 28 2018. Retrieved July 9 2018. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/antidepressants/art-20046420.
  • Mayo Clinic Staff. “Depression during pregnancy: you’re not alone.” Mayo Clinic. Mayo Clinic, November 24 2016. Retrieved July 9 2018. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/depression-during-pregnancy/art-20237875.
  • M.E. Silverman, et al. “The risk factors for postpartum depression: a population-based study.” Depression and Anxiety. 34(2): 178-187. February 2017. Retrieved July 9 2018. https://www.ncbi.nlm.nih.gov/pubmed/28098957.
  • “Depression during pregnancy.” March of Dimes. March of Dimes, May 2018. Retrieved July 9 2018. https://www.marchofdimes.org/complications/depression-during-pregnancy.aspx.

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