Did you know it is estimated that up to 20% of women experience symptoms of depression in pregnancy? Some of these women are already being treated for depression when they become pregnant. Others develop depression during the pregnancy.
What may surprise you is that many women who are suffering from depression don’t recognize what is happening. Some symptoms, like loss of energy, changes in appetite, and poor sleep can happen in a normal pregnancy, but can also be signs of depression.
Symptoms of depression
Let’s talk about symptoms of depression, then discuss risks and benefits of treating this condition during your pregnancy.
- Feeling sad or down
- Inability to concentrate
- Loss of libido
- Changes in appetite
- Mood swings, from high to low
- Feelings of anxiety, guilt, or fear
- Fatigue or inability to stay asleep
- Suicidal thoughts
Depression is treatable, through therapy and/or medications. The choice of treatment may depend on your preferences and the severity of depression.
Conventional or traditional treatment
Mild to moderate symptoms may respond well to psychotherapy. For more severe symptoms, or if you prefer medication, or if therapists are not available to you, medication may be a good choice.
If medication is needed to treat your depression, and you have not previously taken an antidepressant medication, an SSRI (selective serotonin reuptake inhibitor) is usually chosen.
In general, these are considered safe for pregnant and breastfeeding women. There are other classes of antidepressant medications that may also be used. If you have been taking a particular medication that is working well for you, we usually continue this, as there is a risk of relapse if your medication is changed. Your provider will discuss different options with you.
For all these medications, we try to use the lowest dose needed to control your symptoms. Most of the antidepressants used in pregnancy are also safe for breastfeeding and should be continued during the postpartum period to reduce the risk of postpartum depression.
Alternative or complementary treatments
There are alternative treatments for depression that have also been shown to help mood and overall health. As with medication, I always encourage you to be your #1 health advocate. Make research and learning a part of your health plan for yourself.
Research trials have shown that a course of acupuncture may improve symptoms of depression in pregnancy.
Bright light therapy
This can be effective for treating Seasonal Affective Disorder (SAD), as well as other types of depressive disorders. One hour daily of bright white light (7000 lux) was compared with placebo (70 lux light) in a group of pregnant patients with depression. The bright light group showed greater improvement.
Folic acid helps prevent birth defects, so it is recommended in pregnancy. But folic acid has also been shown to improve depression when given in addition to antidepressant medications. And women with depression tend to have lower levels of folic acid.
Regular exercise, pregnant or not, has been shown to improve mood and increase energy. Movement and exercise studied in groups of pregnant women did tend to improve symptoms of depression.
Pregnant moms treated with twice weekly massage therapy had greater improvement in their symptoms than those treated with standard therapies. And as a bonus, their babies tended to function better and have a lower risk of prematurity and low birth weight.
Many women with symptoms of depression are reluctant to seek treatment because of barriers like the cost of medication, the stigma of being labeled “mentally ill,” fear of taking medication that may hurt their baby or lack of availability of counseling or mental health care in their area.
In fact, only about half of women with depression undergo treatment.
If you are experiencing symptoms of depression, talk to your OB or primary care provider. When depression goes unaddressed, women are more likely to have poor nutrition, smoking and substance abuse, suicidal thoughts, fewer prenatal visits, postpartum depression, and poor bonding with their baby. You don’t have to suffer alone. Help is available and can be tailored to your needs and preferences.
The bottom line is: say something. You have the right to feel well and balanced during one of the most special times of your life.