If you have a personal or family history of depression, the hormone fluctuation that goes along with pregnancy can be the kind of uncertainty that makes you nervous. Many people who have, or have had, depression, report that they’ve never felt better in their lives than during pregnancy, but others report intense or deepening depression, during a time that is often culturally described as the happiest of their lives.
In recent years, postpartum depression has, rightly, received more of the attention it deserves than it has had in the past. But depression that happens during pregnancy – also called antenatal or prenatal depression – is still often overlooked, though it is thought to affect up to 15% of pregnant women.
Talking to your doctor about depression during pregnancy
Really, the best time to get in touch with your healthcare provider, or with a medical professional you trust, to ask about support for depression during pregnancy is any time you feel you need that support. If you think you may be experiencing depression, many providers like to start with talk therapy, either as a treatment in itself or as a vehicle for evaluating how their patients are doing, and what other support they might need, so starting to look at treatment options can be fairly low-impact.
An exception to this may be women who already have a history of treated depression, and an idea of what works best for them in terms of treatment. If you have an idea about a course of antidepressants that might work best for you, and you reach out to a healthcare provider who is familiar with your history, they may be quicker to put you on the path to the treatment plan that has worked well for you in the past.
What does depression during pregnancy look like?
In general, prenatal or antenatal depression looks a lot like depression at any other time. This doesn’t mean that if you have a personal history of depression, that depression during pregnancy will necessarily feel exactly the same. Instead, it means that a lot of the signs of depression during pregnancy are versions of signs of depression at any other time. These signs include:
- Feeling sad without any break from it (all downs, no ups)
- Having trouble enjoying the things you usually like to do
- Frequent crying
- Severe mood fluctuations
- Excessive sleeping or trouble sleeping
- Avoiding conversations about feelings
- Low self-esteem about motherhood, or feeling especially unprepared for parenthood
- Excessive anxiety about the baby
- Not responding well or feeling comforted when the people in your life try to reassure you
- Having trouble sticking to a healthy prenatal care routine
- Using smoking, drinking, or illicit drugs as a means to cope with emotions
- Low weight gain for your pregnancy’s trajectory due to decreased appetite or diet
- A sense of hopelessness
- Thoughts of suicide or hurting yourself
- Thoughts of hurting someone else, including the baby.
Some of these symptoms are just a part of the process of pregnancy, of course, which is why diagnosing depression during this time can feel like a gray area. A good rule of thumb is that if these symptoms are getting in the way of your ability to live your life, and take care of yourself to the best of your ability, they may be signs of depression. Not all depression is as obvious and extreme as feeling suicidal so even milder symptoms, if they are persistent, should be evaluated by a professional.
Advocating for your own care
Some symptoms of depression are similar to the symptoms of pregnancy – for example, aches and pains, exhaustion, and an increased feeling of worry are all parts of many healthy pregnancies that aren’t affected by depression. The difference between the normal increase in stress both on the body, which is going through so many changes, and a pregnant woman’s emotional state, has more to do with the intensity of these symptoms than it does with the type of symptom.
This means that depression during pregnancy often isn’t diagnosed. Because of this, it isn’t just important to talk to your doctor, but to remember that while your doctor may have a more extensive medical education than you do, you have a more extensive relationship with your body and your brain. If you think something is wrong, and it feels like more than “just pregnancy,” don’t be afraid to advocate for yourself. It’s better to get more help than you need than it is to get less, and this is especially true during pregnancy.
If you speak up about how you’re feeling with your doctor, and you feel your concerns haven’t been heard, consider looking into mental health services on your own. Whether you end up talking to a mental health provider on a regular basis, or just having one check-in, having the chance to talk through what you’re feeling with a mental health provider can help you take back control of your health.
If you are experiencing symptoms that you think may be signs of depression, it is important to call your healthcare provider to get the help you need. This includes symptoms that are extreme, or ones that are mild and persistent. If you are feeling like you are in urgent danger of hurting yourself or someone else, you should call 911 or the toll-free 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255); TTY: 1-800-799-4TTY (4889).
- Julie A. Lamppa. “Talking about postpartum depression.” MayoClinic. Mayo Foundation for Medical Education and Research, Aug 11 2015. Web.
- “How do I talk to my healthcare provider?” PostpartumStress. The Postpartum Stress Center, LLC., 2017. Web.
- “Postpartum depression facts.” NIMH. NIH Publication No. 13-8000 from National Institute of Mental Health, NIH, HHS, Jun 2016. Web.