depression during & after pregnancy

By Mary Polce-Lynch, Ph.D., June 2011

Postpartum depression (extreme sadness after your pregnancy) can be a common occurrence. What is not as widely publicized are symptoms and signs that occur during pregnancy as well, known as ante depression.

Normal mood fluctuations will occur before and after your baby is born, However, if any of the following symptoms are present to a marked degree for two weeks or more,

Q. What is antepartum depression? What is postpartum depression?

A. Depression symptoms that occur in pregnant women are referred to as antedepression ("ante" is Latin for "before"). Postpartum depression refers to depression symptoms that occur after a baby is born.

Q. What are the symptoms of ante/postpartum depression?

A. Normal mood fluctuations occur during and after pregnancy. If any of the following symptoms are present to a marked degree for two weeks or more, during pregnancy or after a baby is born, a woman should let her provider know so she can be evaluated for depression:

  • Significant hopelessness
  • Excessive feeling of guilt or worthlessness
  • Significant appetite changes (loss or increase)
  • Excessive sadness and crying
  • Suicidal thoughts
  • Excessive irritability and anger/aggression
  • Agitation or inability to relax
  • Lack of motivation or pleasure
  • Lack of concentration or focus
  • Change in sleep patterns (sleeping much more or much less)
  • Excessive fatigue
  • Excessive anxiety or worry, especially about the baby (Note: this may be related to an anxiety disorder rather than depression)
  • More serious symptoms of postpartum depression include thoughts of hurting yourself or the baby, fear of being left alone with the baby or not wanting to care for the baby

 

Q. What is the best treatment for ante/postpartum depression?

A. Many studies indicate that counseling should be the first line of treatment for ante/postpartum depression. Studies also indicate that social support, exercise, meditation and yoga are effective in reducing depression symptoms. Medication is also effective and should be combined with counseling.

Q. Is ante/postpartum depression dangerous?

A. The severity of depression symptoms is what determines whether or not depression is considered dangerous. Mild to moderate depression is not considered dangerous; however, severe depression that is accompanied by psychosis, where a woman loses contact with reality and wants to hurt herself or her baby, is considered dangerous. Postpartum psychosis is very rare and is treatable with medication and/or hospitalization.

Q. Why do women get ante/postpartum depression?

A. There is no way to predict who will or will not have depression during or after pregnancy. In addition, there is no single cause that can explain ante/postpartum depression for all women. Multiple risk factors are associated with both forms of depression, some of which include a previous history of a mood disorder in self or family, significant stress, poor relationship with partner or father of baby, lack of social support, hormone changes, genetic factors and cultural factors. With regard to postpartum depression, recent research is examining how the baby's temperament and interactions with the mother may also affect the mother's mood.

Q. Will medication hurt the baby during pregnancy or while nursing?

A. Any decision about medication should be discussed with your physician prior to treatment. The health of the mother is a very important factor when considering any medication during pregnancy or while nursing.

Q. How common is postpartum depression?

A. It is estimated that as many as one in five mothers have postpartum depression symptoms, a reassuring fact for women who experience it. However, it is often not discussed because of the cultural expectation for pregnancy and birth to be purely a joyful time. The truth is that many women experience physical and emotional distress while pregnant and after a baby is born. Knowing this can help reassure women that they are "normal" and allow them to talk about their distress so they can get support. Social support is a very important factor when recovering from postpartum depression.

Q. What is the difference between "baby blues" and postpartum depression?

A. The terms "baby blues" and postpartum depression refer to the same cluster of symptoms and are often used interchangeably. It was once believed that "baby blues" only occurred within the first few weeks after the baby is born. However, more recent research and case studies suggest depression and anxiety symptoms can emerge within the first year after the baby is born.

Reference

Phillips, M.L. (2011). Treating postpartum depression. Monitor on Psychology, 42(2), 46-48.

Additional resources