Help and support for antenatal depression

Most of us know about postnatal depression; however, far fewer are aware of the sympyoms and causes of depression experienced by some mothers-to-be as a pregnancy develops.

Referred to as antenatal depression (and sometimes as perinatal or prenatal depression) depression during pregnancy is experienced by as many as one in five women and causes a range of feelings including fatigue, negativity, emotional vulnerability, guilt, numbness and isolation.

The causes of antenatal depression

There are many causes of antenatal depression and these will vary from woman to woman. However, it is safe to say that it is hardly surprising that pregnancy, with all the emotional, physical, hormonal and psychological changes should sometimes result in marked changes in mood and mental wellbeing.

The following is by no means a complete list but nonetheless lists some of the major causes of antenatal depression as well as some of the more significant risk factors:

• Unplanned pregnancy – However happy you might be about the impending arrival, an unplanned pregnancy can leave you mentally underprepared for pregnancy.
• Previous birth complications – You may feel anxious and depressed if you have previously had a difficult pregnancy or labour.
• You are unsupported – Women who lack basic support from their partners and/or families are more likely to experience antenatal depression.
• Hormonal changes – Your body has to adjust to serious hormonal upheaval during pregnancy. Sometimes this can take its toll on your mental wellbeing.
• Financial concerns – Money worries can be depressing at any time of life, but financial fears can be exacerbated during pregnancy.
• The reality of morning sickness – Some people can find morning sickness debilitating, particularly those with hyperemesis gravidarum.
• Major life events – Pregnancy itself is a major life event so if another occurs – for example a death in the family – it can be majorly disruptive and may a precipitate the onset of antenatal depression.
• Exhaustion – Some mothers-to-be may have difficulty sleeping, which can take its toll on mental health, particularly with so much else going on at the time.
• A history of depression or mental illness – If you have experienced mental health issues in the past, you are more likely to develop anxiety and depression during pregnancy.
• Drug or alcohol abuse – If you have ever had difficulties with alcohol or drug consumption, you are at greater risk of developing antenatal depression.
• Family history – If your mother experienced antenatal or postnatal depression, you are more likely to develop one or both of these yourself.

The symptoms of antenatal depression

It is important to remember that it is normal for all of us to sometimes feel low or even depressed. It is only when these feelings begin to define our moods over longer periods of time that we might become aware that there is a problem. In fact, sometimes we might feel low without even really realising or recognising it, particularly if we are feeling numb or unengaged with our own mood or mentality.

All of the following are possible antenatal depression symptoms to look out for:

• Anxiety – This is a tricky one because anxiety is a natural response to many of the concerns around pregnancy and childbirth. However, if your anxiety becomes oppressive, constant or restrictive, it may be an indicator of a problem.
• Difficulty concentrating – Again, this is tricky, because reduced concentration is, for many, a feature of pregnancy. However, if anxious or depressed thoughts are keeping you from concentrating, it may be an indicator of antenatal depression.
• Thoughts about death – Although it is normal for pregnancy to throw thoughts about mortality into sharp relief, preoccupation or anxiety regarding thoughts of death and/or suicide may indicate antenatal depression.
• Mood swings – Mood swings are a normal part of pregnancy but if you are finding your moods uncontrollable, for example, you consistently can’t keep tears or anger at bay, you may wish to discuss this with your doctor.
• Fatigue – Another tricky one. Fatigue during pregnancy is normal, but if it feels overwhelming to the point where you are reluctant to get out of bed you may wish to discuss this with your doctor.
• General apathy – Are you experiencing a lack of interest in most things? Do you feel flat and joyless? Are you neglecting yourself nutritionally and hygiene-wise. This may indicate some level of antenatal depression.
• Negative thoughts – If you find it difficult to summon any positive thoughts and/or are experiencing thoughts of self-harm or harming others, this could be a sign that you need support.
• Detachment from your baby – If you are feeling detached from the thought of your growing baby or are just generally feeling emotionally numb, this may be a sign that you are depressed, even if you are not yet aware of it yourself.

Support

If you feel that you may be experiencing antenatal depression it is important to know that there is plenty of help and support available.

From talking therapies such as Cognitive Behavioural Therapy to support groups and, when necessary, medication – the situation for mothers with antenatal depression has dramatically improved over the past two decades. For more information, speak with your doctor or midwife.

There are also numerous ways you can support yourself through periods of antenatal depression. For example, simply by attending to basic things such as getting washed and dressed everyday can help you to prevent a slump from becoming a major low.

Also, getting outdoors and exercised – even minor exercise – can help keep your spirits more buoyant.

Above all, show yourself compassion. What you are going through is very normal and is nothing to be ashamed of. Be kind to yourself in the way you might be kind to a friend or loved one going through the same thing.