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Depression and anxiety during pregnancy

depression; anxiety; antenatal; ante; natal; ante-natal;

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Pregnancy, birth and early parenthood are times of great change. Having a baby can be the biggest life change that you will ever have. 

Depression and anxiety can occur at any time in your life, and can often come to the surface with major events like pregnancy or having a baby. The risk is higher if you have been depressed in the past.

  • Around 12 per cent of pregnant women in Australia experience antenatal depression – depression during pregnancy. 
  • Postnatal depression (PND) is depression that a woman experiences in the months after the birth of her baby. Postnatal depression affects almost 1 in 6 women in Australia (15%).

If you are concerned that you, or someone you know, have symptoms of depression talk with a doctor or health professional. It is important to seek help – the sooner the better.

Support and treatment are important. Various treatments are available, and a good understanding of the risks of not treating depression and anxiety, as well as the risks of treating the is very important.  If antidepressant medication is needed, there are medications which are believed to be reasonably safe and effective even for women who are pregnant.

Many fathers also feel depressed during pregnancy, or more often after the birth, but often they do not seek help. Have a look at the topic 'Fathers and depression after the birth of their baby'.

Signs and symptoms of depression

Antenatal depression has the same signs and symptoms as depression experienced by women who are not pregnant and by men, although thinking may focus on the baby inside.

Common symptoms of antenatal depression include

  • Crying a lot, or crying about small upsets
  • Feeling very uncertain of your skills
  • Sleeping poorly
  • Being very frightened of being alone
  • Feeling that you will be a bad mother
  • Irritability with other people around you such as your partner, other children or other family members
  • Perhaps hating yourself
  • Not feeling any sex-drive (libido)
  • Just feeling you can't cope with anything, for example, housework
  • Feeling very anxious and uncertain about a whole range of things – such as going out shopping or seeing friends.
  • An increase in wanting things in order or the complete opposite - not caring at all about how things look.
  • Noticing breathlessness, feelings of panic and anxiety, tightening in the chest and heart palpitations (irregular heat beats).
  • Obsessional thoughts which are sometimes about harming yourself - this may include thinking about suicide.

This can be a time of great tension between partners.

What can you do about it?

With any condition, recognising that it is there, and accepting that you need to do something about it is the first gigantic step. For many women, this will be the first time they have had to seek help about their feelings.

If you were expecting everything to go smoothly you might feel very ashamed at admitting that all is not well.

You may have to decide whether this is a problem you and your family can sort out, or whether you need to get professional help. If you have a partner, talking it over might help you to make that decision. But some women don't have partners or might think that their partner is not really into feelings and might not understand. In that case, you could talk it over with your mother or a friend.

Some women may have a professional person to whom they can turn, and may choose to do this instead, or perhaps will do so if she and her partner have discussed it, and think this is a good pathway.

People you could ask include:

  • Family doctor (GP)
  • Psychologist
  • Social worker
  • Community mental health nurse

There are quite a lot of places you can get specialised help.

Treatment

You and your health worker must work out together which is the best pathway for you.

  • It is a good idea to have someone else with you when you talk these things over, to help you make a decision and to discuss it all as time goes on.
  • Ask them to explain anything you don't understand or don't feel happy about.
  • Sometimes, your health worker may suggest referring you to a doctor, psychiatrist or psychologist, and this can be very helpful.

Various kinds of treatment may be suggested. These include learning about relaxation, meditation or yoga, regular exercise, good sleep patterns (sleep 'hygiene'), talking with a counsellor, learning more abut negative ways of thinking (cognitive-behaviour therapy) and medications.

Your doctor may suggest you try some medication. This is most likely to be an antidepressant if your symptoms are severe.

  • You and your doctor need to weigh up the risks of your unborn baby getting some of the drug against the risks of you staying depressed and unable to manage.
  • Some medications are believed to be reasonably safe when women are pregnant.

In addition to professional help, it is good to speak to other women who may have had similar problems. In South Australia the staff at Helen Mayo House (telephone 7087 1047) may be able to put you in touch with community groups.

Why is treatment and positive action so important?

There can be several problems if depression is not treated.

  • A woman may have unnecessary on-going suffering, and worst of all, there is the possibility of self-harm (even suicide).
  • Depression often causes big strains on a relationship, which can lead to break-up.
  • Anxiety and perhaps depression as well may start to set patterns in unborn babies about how they deal with stress through their lives. Although science has not worked all of this out yet, it is almost certainly good for your baby if you learn, during your pregnancy, how to deal with stress better.
  • The depression may persist after the birth of your baby (postnatal depression). Many studies also show that there may be effects of a mother's depression on her baby. So it is good to start your baby's life feeling as positive as possible.

So, finally, do remember …

  • Antenatal depression is common, and there are things which can help.
  • It is not the fault of the woman, and has not happened because she can't "pull herself together".
  • Everyone tries the best they can but depression and anxiety may stop them doing so.

Helping other people with antenatal depression

Perhaps you know someone who is pregnant and doesn't seem to be quite herself, or is obviously very unhappy. What can you do about it?

  • If she is someone you know well and you think she would be able to cope with you bringing up her unhappiness in conversation, this may be helpful.
  • Sometimes, though, being there for her is what she really needs.

There is more information about how to support someone with depression on the websites that are listed in the topic 'Post natal depression' 

Information in other languages

There is information in many languages on the website of the NSW Multicultural Health Communication Service. 
http://www.mhcs.health.nsw.gov.au


 

References

Black Dog Institute 'Depression during pregnancy and the postnatal period'
http://www.blackdoginstitute.org.au/docs/Depression...  

Beyondblue 'Depression'
http://www.beyondblue.org.au/index.aspx?link_id=89

Beyondblue 'Pregnancy and early parenthood"
http://www.beyondblue.org.au/index.aspx?link_id=94

Children of parents with a mental illness (COPMI)
http://www.copmi.net.au

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The information on this site should not be used as an alternative to professional care. If you have a particular problem, see your doctor or midwife.

 

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