ANTENATAL DEPRESSION

Planned or unplanned, pregnancy is an emotional time. Find out what antenatal depression is, how it is treated and how to recognize if how you’re feeling is more serious than the lows that can accompany being pregnant.

What is antenatal depression?

Depression during pregnancy is called antenatal or prenatal depression. Postnatal depression—depression after the birth of your baby—may be the term more people are familiar with, but what is less commonly recognized is that expectant mums can experience depression during pregnancy too.

Like depression at other times, depression during pregnancy is an illness—one that can be treated with the right support and care. It’s more serious than feeling a bit low, worried or unhappy for a few days, with negative emotions and depressive symptoms that can last for weeks or months.

What are the symptoms of antenatal depression?

Symptoms can start at any time during pregnancy, may vary from mild to severe and can affect everyone differently. Typical symptoms include:

• Feeling sad and low most of the time
• Loss of interest in things you usually enjoy, or in other people
• Difficulty concentrating or making decisions
• Tearfulness
• Anxiety
• Feelings of hopelessness and helplessness
• Difficulty sleeping or sleeping too much
• Low self-esteem, lack of confidence, feeling guilty, or blaming yourself for your problems
• Irritation at others, getting angry easily, and reclusive behaviour
• Thoughts about harming yourself or suicide
• Not wanting to eat or eating more than normal
• Negative thoughts.

Working out whether a low mood may just be the delights of pregnancy (rollercoaster hormones, disturbed sleep, worries about the birth, feeling sick and numerous other pregnancy ailments that can get you down) or something more serious that you need support to manage, can be difficult. Trust your instincts. If you’re worried that how you’re feeling isn’t normal for you and has been persistent for more than two weeks, talk to your midwife or doctor.

What causes antenatal depression?

Risk factors for antenatal depression include:

• Depression or other mental health issues in the past
• Current anxiety
• Recent stressful life events, such as a relationship ending or bereavement
• Lack of support from family and friends
• How you feel about your pregnancy, particularly if it was unplanned
• Experience of domestic violence or abuse.

However, none of these things may be familiar to you—antenatal depression can happen to anyone.

How common is antenatal depression?

Antenatal depression is common. During pregnancy, depression and anxiety are the most common mental health conditions experienced by mums-to-be. About 10–15 out of every 100 pregnant women will be affected.

What if I’ve had depression before getting pregnant?

Tell your midwife or doctor if you’ve had depression or any other problems with your mental health before, as you may be at greater risk of becoming unwell again during this pregnancy or after the birth. If you’ve had severe depression or severe postnatal depression before, your doctor should refer you to a mental health service to get specialist advice and support.

What should I do and when should I get help?

If at any time before or during pregnancy you’re worried about your mental health, talk to your doctor or midwife and they can offer support, advice and treatment options.

It’s the old cliché but talking really can help. Talk to your partner, family or close friends so that they are aware of how you feel and can also help and support you

What treatment is available?

Treatment for antenatal depression depends on how severe your illness is. It can include self-help, psychological “talking” therapies such as counselling or cognitive behavioural therapy, and medication (antidepressants)—individually or in combination.

Any discussion with your doctor about medication should cover the benefits and any potential risks to you and your baby of treating or not treating your illness. Mums often worry about the effect on their unborn baby of taking a medicine in pregnancy but if your depression is not treated, this may be more harmful for your baby than any effect of medication. Your doctor can offer advice based on what is known about the safety of antidepressants in pregnancy and your individual circumstances to help you make decisions about what treatment is best for you.

If you have mild to moderate antenatal depression and you’ve no history of depression, guided self-help programmes may be considered the first option. Treatment for moderate or severe antenatal depression may include psychological treatment or an antidepressant, or a combination if neither has been successful individually.

It’s likely that you’ll also be referred to a perinatal mental health professional so that you can be closely monitored and supported during pregnancy and after the birth.

How can I help myself?

Getting advice from a doctor or other healthcare professional is the best way to treat antenatal depression. That said, there are things you can do to maintain your mental wellbeing or help recovery if you’ve been diagnosed or aid recovery if you’ve been diagnosed:

• Look for positive things in your life, however small or difficult it may seem
• Confide in and involve your partner or someone you are close to in your pregnancy so that you don’t feel isolated
• Don’t bottle up your feelings or be afraid to share how you feel
• Accept help or ask for it (sharing the load can be a great help)
• Eat a healthy and balanced diet
• Keep to a regular bedtime and ‘getting up’ time and avoid excess caffeine which can disrupt sleep
• Avoid alcohol and smoking
• Exercise for 150 minutes each week- walking, swimming, or pregnancy- exercise classes are all good
• Make time to do things that you enjoy or that help you relax
• Relaxation, meditation and mindfulness can be helpful
• Avoid your known triggers or stressful situations
• Don’t be hard on yourself—the illness is not your fault.

What to do if my depression is worsening

If you feel that life is not worth living or you feel suicidal, don’t delay- this is an emergency and you need to speak to your health professional at once. Help and treatment is available 24/7 and with the correct treatment and support you will recover.

Further information

More information on antenatal depression is available from dedicated organizations and charities. Their websites provide information, support networks, helplines and links to blogs and forums sharing stories from mums who’ve experienced it—reading other women’s stories may help you understand that you are not alone and that you can rebalance.

PANDAS (Pre and Postnatal Depression Advice and Support)

http://www.pandasfoundation.org.uk/

Helpline: 0808 1961 776 (open 11am – 10pm 7 days a week)

MIND

https://www.mind.org.uk/

Infoline: 0300 123 3393

National Childbirth Trust

https://www.nct.org.uk/

Support line: 0300 330 0700

Tommy’s

https://www.tommys.org/

Pregnancy line: 0800 0147 800 (open 9am – 5pm Monday to Friday)