What do I need to know about depression symptoms that start during pregnancy?

For a long time, there was a misconception about depression during pregnancy – an idea that depression during pregnancy wasn’t possible. This idea was based in a misunderstanding of the impact hormonal changes can have during pregnancy, as well as the cultural assumption that pregnancy should be a happy time. Unfortunately, the reality of depression doesn’t care much about this particular idea of “should,” and while having an increased risk of developing depression during pregnancy certainly isn’t a guarantee that one will become depressed, it’s important to keep an eye out for signs of depression before, during, and after pregnancy.

Recognizing unexpected depression symptoms during pregnancy

During pregnancy, many people experiencing the symptoms of depression don’t seek help because these symptoms can feel like a part of pregnancy symptoms, rather than depression. However, depression during pregnancy can be differentiated by severity and duration – symptoms that last up to two weeks or longer, and symptoms that have an impact on a pregnant person’s wellbeing and ability for self-care may be signs of depression. And like depression at any other point in life, depression during pregnancy that’s treated can be less severe, and women can start to feel much better a lot sooner than without treatment.

One thing to know on the way into a pregnancy is that, as a general rule of thumb, during pregnancy, if you start to experience symptoms that can have a negative impact on your pregnancy and your health, it’s a good idea to check in with a healthcare provider about those symptoms. Even if they don’t end up being a problem, it’s a safer bet to get those symptoms checked out.

One of the signs of depression is symptoms that last for two weeks or longer, while another is a feeling of disconnect from the fetus, or feelings of ambivalence about being pregnant, but thoughts or impulses of violence or self-harm should be treated as an emergency. People experiencing these symptoms should seek immediate help from a medical or mental health professional.

Treating depression during pregnancy

Moderate depression can sometimes be effectively treated with talk therapy, and maybe accompanied by diet, exercise, and sleep changes. For severe depression, medication is generally the most effective treatment, and medication can be an important part of treatment for more moderate depression, as well, depending on the person. However, both healthcare providers and new parents can be hesitant about medication for depression during pregnancy.

For ethical reasons, there haven’t been randomized trials of antidepressants during pregnancy, but we have increasing amounts of information from registries and other types of studies. However, some antidepressants have been studied more than others. Research suggests that SSRIs (eg. Prozac, Zoloft, Celexa) may be some of the safest depression medications to take during pregnancy, since they don’t cause birth defects. Finding a healthcare professional who is comfortable discussing the pros and the risks of different types of depression medication during pregnancy can be a key part of finding the right treatment plan for a healthy pregnancy.

A personal history of depression

If you have a personal history of depression, you may already have a sense of what kind of symptoms to keep an eye out for, and what kinds of treatment work best for you. If you’re TTC, this is a great time to talk to your medical team about the way your treatment might interact with pregnancy. Some moms-to-be assume that they should stop taking antidepressants if they find out they’ve become pregnant, but in most cases, this is not true.

If you have a personal history of depression, but aren’t currently being treated for it, it’s still a great time to check in about what your options might be for treatment if you do experience depression symptoms during pregnancy. A history of depression makes depression during pregnancy more likely, even for people who aren’t currently depressed while TTC.

Read more
  • “Depression during pregnancy.” March of Dimes. March of Dimes, May 2018. Retrieved July 3 2018. https://www.marchofdimes.org/complications/depression-during-pregnancy.aspx.
  • “Depression during pregnancy.” canada.ca. Government of Canada, May 26 2016. Retrieved July 3 2018. https://www.canada.ca/en/public-health/services/pregnancy/depression-during-pregnancy.html.
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