Depression During Pregnancy: Know Your Risks
Awareness of postpartum depression is on the rise, and for good reason, one in nine women experience it after giving birth. But depression while pregnancy is often still overlooked, although it occurs as frequently as the postpartum variety.
One of the main reasons for this is that many of the physical symptoms of pregnancy and depression are the same, such as change in appetite, trouble concentrating, feeling tired, insomnia, and even body aches. says Veerle Bergink, MD, PhD, professor in the departments of Psychiatry and Obstetrics, Gynecology and Reproductive Sciences at Icahn School of Medicine in Mount Sinai in New York City.
“What’s complicated about depression during pregnancy is that your body is already changing so much,” she says. “You already feel atypical.”
Another complicating factor is that while some practitioners may make a point of asking questions about your mood, screening for depression is not part of routine prenatal care. “There has been a lot more attention to postpartum depression,” says Bergink. “It’s much more common to screen for this than for prenatal depression, although it would actually make more sense to start screening when women first walk into the office during pregnancy.”
Your medical history may increase the likelihood that you will develop depression during pregnancy, so knowing your risk can help you be on high alert. The biggie? Previous series of depression or anxiety. “The number one risk factor for depression during and after pregnancy is women who have already had a mood episode,” says Bergink.
Thyroid disorders can increase your chances, as can disease, preeclampsia, or finding abnormalities on an ultrasound. Non-physical risk factors include financial problems, a history of trauma or sexual abuse, an unstable relationship, or an unwanted pregnancy.
While realizing that you have depression can be a barrier, Bergink says that once you do, it’s very treatable. “Because all drugs pass through the placenta, we prefer to research non-drug options first, like exercise and behavioral changes through psychotherapy,” she says. But for more severe episodes, medications like antidepressants may be safe options.
Recognizing and dealing with depression is also essential: being open and honest about how you are feeling. “So many women feel guilty, especially during pregnancy, because they think they should feel happy,” says Bergink.
But, she says, depression isn’t something you choose to have, and you can’t blame yourself. The more women share their difficulties, the less hidden prenatal depression will be.
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