Pregnancy Without Joy: The Facts About Perinatal Depression

Introduction

Pregnancy is seen by most as a beautiful and happy time. But, up to 1 in 7 women develops depression related to pregnancy. Perinatal depression is the most common complication during pregnancy and postpartum. Instead of this time being the happiest time of one's life, for some people, it may be the hardest and lack the anticipated joy. The good news is that many ways exist to help treat perinatal depression.

Symptoms

Perinatal depression does not feel the same for everyone. Some people may have just a few symptoms, while others may have many symptoms. Either way, it affects your daily life. How long depression lasts and how intense the symptoms are is also different for each woman. As you can see from the following list, there are many symptoms associated with perinatal depression:

• Feeling sad, anxious, or empty
• Feelings of hopelessness or negativity
• Feelings of guilt, helplessness, or worthlessness
• Frequent crying
• Sadness that persists
• Lack of energy
• Irritability or restlessness
• Problems concentrating
• Eating more or less than usual
• Sleeping more or less
• Increased anxiety
• Lack of interest in activities
• Wanting to be alone
• Not interested in your baby
• Doubting your ability to care for your newborn
• Thoughts of hurting oneself or your baby

Postpartum Depression Versus Baby Blues

Postpartum depression occurs after your baby is born. It is one form of perinatal depression. It is different from the baby blues. Baby blues is a term used to describe normal worry, tiredness, and sadness that many women experience after having a baby. The symptoms of baby blues resolve in the first two weeks after birth. Symptoms and feelings associated with postpartum depression are more intense and last longer than two weeks.

Diagnosis

Clinicians use various tools to screen for perinatal depression. One of the most common tools is the Edinburgh Postnatal Depression Screening (EPDS) tool. Experts recommend screening every pregnant woman at her initial prenatal visit and then at regular intervals throughout pregnancy. Screening should continue after delivery in the hospital and the outpatient setting. The diagnosis of depression at delivery is increasing. The diagnosis was seven times higher in 2015 than in 2000. This increase may be due to improved screening and diagnosis of perinatal depression.

Treatment

Untreated depression can harm the mother and baby, so getting help is vital. Sadly, only about 50% of women seek help. Depression is a serious mood disorder. It may last weeks or even months. If you have symptoms of perinatal depression, please speak to your doctor or midwife as soon as possible. Most women get better with treatment, which is the best thing you can do for yourself and your baby. Every woman deserves support. Having a baby is challenging even in a supportive and ideal situation.

Several treatment options are effective. Usually, a combination of the following treatments is used:

Therapy

There are no side effects from therapy; it helps you cope with feelings and behavior patterns. Therapy does take time and may not be covered by insurance.

Medications

Many safe medication options-keep symptoms under control. Side effects from medications include sleep problems, stomach problems, anxiety, and loss of sexual desire. There are also possible infant side effects. Medications take time to work.

Self-Care

There are many self-care options to improve symptoms of depression. Choose what options you think are best and make a self-care plan.

Women may use therapy and medications to treat perinatal depression, but self-care is always necessary. Options for self-care include, but are not limited to:

• Exercise
• Journaling
• Yoga
• Meditation
• Healthy diet
• Drink plenty of water
• Regular sleep
• Increase social support
• Books
• Online blogs and forums
• Aromatherapy
• Massage therapy
• Support groups

Conclusion

This is an emergency if you are thinking of hurting yourself or your baby. Please call 911 or one of the following hotlines:

• Suicide and Crisis Lifeline by just dialing 988 in the United States.
• National Mental Health Hotline for pregnant and new mothers. You can call or text 1-833-943-5746. This hotline is available in English or Spanish.

You can find joy during this life-changing time by recognizing your symptoms, self-care, and developing a plan with your healthcare provider.

---

References/Resources

Obstetric Provider Toolkit: MCPAP for Moms

Societal Costs of Untreated Perinatal Mood and Anxiety Disorders in the United States: ideas.repec.org

Interventions to Prevent Perinatal Depression: US Preventive Services Task Force Recommendation Statement: JAMA Network