KIRA STEIN, MD, APC

ADULT PSYCHIATRY - BOARD CERTIFIED ABPN


DEPRESSED AND PREGNANT

DEPRESSED AND PREGNANT

 
4 November, 2011

Depressed and Pregnant? There’s Likely a Medical Reason

Pregnancy is often regarded as one of the happiest times in a woman’s life. In fact, many years ago it was believed that the hormones associated with pregnancy actually protected a woman from the effects of depression.

It is now known that pregnancy is not protective against depression.  Studies estimate that up to 20 percent of pregnant women will experience some depressive symptoms during their pregnancies, while about 10 percent develop clinical depression requiring medical intervention.

Possible complications of  being depressed and pregnant

One of the most anxiety-inducing aspects of being depressed and pregnant is that it not only causes the mother to suffer, but can also pose health risks to the baby. Women who are depressed and pregnant often lack the energy or motivation to seek proper treatment or maintain regular prenatal care. Also, depressed and pregnant mothers are more at risk of turning to alcohol, cigarettes or drug use, all of which have been linked to negative effects on the developing fetus.  They are more likely to experience preterm birth.

The greater the severity of depressive symptoms, the greater the likelihood of early delivery. It is also important to keep in mind that the biggest risk factor for prenatal depression is a previous history of depression. Above all, we must remember that depression is a medical condition, and is not a normal condition of pregnancy.

Causes, risk factors and treatments for being depressed and pregnant

Depression is linked to a change in the activity of various areas of the brain, as well as the levels of certain chemicals in the brain called neurotransmitters, which control your mood.

In addition to these physiological roots of depression in pregnancy, other factors that increase the risk for depression in pregnancy include:

  • Personal or family history of depression
  • A high degree of pregnancy stress
  • Age at the time of pregnancy (teenage mothers are at a higher risk)
  • Pregnancy complications, including a previous miscarriage or pregnancy loss
  • Relationship difficulties with family members
  • History of emotional, physical or sexual abuse

For mothers who are depressed and pregnant, it is critically important to know that there is hope. It may come down to simple lifestyle changes, including reducing stress, eating well, drinking enough of water, getting quality sleep and exercising. Guidelines published by the Department of Health and Human Services recommend at least 150 minutes of moderate activity per week for both pregnant women and those who have recently delivered.Nevertheless, pregnant women should be careful not to overheat, as it can be problematic for the fetus.

Treatment options for depression during pregnancy include: psychotherapy (particularly,  cognitive behavioral therapy and  in some cases couples therapy), antidepressant medications, and in severe cases electroconvulsive therapy (ECT). Although antidepressants pose some risks to fetal well-being, these risks should be weighed against worsening of maternal depression which also poses a risk to fetal well-being.

The most important thing to remember is that an expectant mother need not feel guilty about getting psychiatric help for depression.  Depression is a behavioral manifestation of a very real medical condition, and not a character weakness.
 

  • Article content, © Kira Stein, MD, APC. | West Coast Life Center

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