Prenatal Depression – It’s Time We Talk About It

Does Prenatal Depression Exist?

Did you know that in about 50% of the cases the depression started in pregnancy? So why are women not sharing about their prenatal depression more?

To be honest, the answer is complicated. Up until the last revision of the DSM (the holy grail of psychological diagnosis), depression during pregnancy (prenatal depression) or the postpartum period wasn’t even a diagnosis. But the new DSM revision now includes a diagnosis of Depression with a Peripartum Onset. Peripartum Onset means that at least one episode of depression occurred during pregnancy and during the first 4 weeks after delivery.

Now at least, the psychological community acknowledges that depression occurs during pregnancy and deserves a diagnostic code. But it’s still hard to diagnose depression in pregnancy. It doesn’t help that most OBs won’t use screening tests for depression despite ACOG recommendations.

And we can’t forget about PPD

By now you have no doubt heard about Post-Partum Depression (PPD). It’s a condition affecting a whopping 1 out of 7 mothers in the United States. But it’s only been getting a widespread acknowledgement in the recent years. Even though PPD has been studied since the 1980s, there are still many medical practitioners who will dismiss a mother’s complaints as “that’s just motherhood”. PPD still comes with so much shame and stigma attached, that many women don’t feel comfortable sharing their experiences. And thus they suffer in silence.

My Story with Prenatal Depression

If you’ve been following my blog, you know that I suffered from PPD after the birth of my first child. But what I haven’t shared is that the depression started during pregnancy. However, I chose to ignore my symptoms. After-all, I am the queen of “I don’t need any help” and master excuse maker as to why I don’t have time to get treatment. Plus it’s easy to blame things on “pregnancy hormones”.

I also didn’t meet the risk factors for depression. My pregnancy was wanted, there was no abuse or neglect in my living situation, I gained proper amount of weight, went to all my prenatal appointments and had no suicidal ideations. The one red flag was the fact that as my pregnancy progressed, I felt less and less excited about it. And I’m not saying that you have to be excited every minute of your pregnancy. But having a pregnancy not accompanied by depression, I can tell you that it just felt different.

I often felt sad, cried and was not excited about baby related things. I lost interest in becoming a mother. It was a strange feeling. I didn’t expect the excitement to go away after a few months. These feelings were not normal.  

I didn’t share my feelings with any of my loved ones and my doctors did not screen for depression either. My midwives asked about my nutrition, my overall mood and spent a full 30-45 minutes talking to me. But there was never a formal test administered. I clearly managed to lie and say that I felt perfectly fine. After all, just like any woman, I grew up hearing about “pregnancy hormones” and thought that any sort of moodiness could just be attributed to that. But that’s what makes prenatal depression so tricky to diagnose. You can’t take the hormonal aspects out of it because pregnancy hormones do play tricks on you and make you weepy, irritable, angry but they don’t typically make you hopeless or disinterested in motherhood.

Risk Factors and Symptoms of Prenatal Depression

Here are some risk factors and symptoms that can help you identify if you are suffering from prenatal depression:

You may be at risk for depression if:

1. You suffer from anxiety
2. Living in an unsafe situation
3. The pregnancy was accidental
4. You have a lot of life stressors
5. Living with a violent partner
6. You lack support

You may exhibit these symptoms as well as other depression symptoms:

1. Poor diet and weight gain
2. Not going to prenatal appointments
3. Fears of being an inadequate mother
4. Anxiety about baby (i.e. worrying that baby may die, baby is not healthy (without having substantive reasons to think so))
5. Feelings of hopelessness and lack of enjoyment in everyday activities

If you feel like any of the above apply to you, talk to your OB about this. Many of them may still not bring anything up about depression or administer a formal screen test but if you mention your symptoms, they will have to take you seriously and refer you to a therapist. And if for some reason your OB still ignores you, you can look for a therapist here (Resource Library). Also, switch to a different OB because if they don’t take your concerns seriously during pregnancy, they won’t take them seriously postpartum either.

Don’t Suffer Alone

I hope that if you are suffering from prenatal depression and come across my article, you realize that you are not alone. Your suffering is real and deserves treatment. The best treatment can only be determined by medical professionals. Any sort of pharmacological approach can come with serious contraindications. But the good news is that therapy and community support can be enough to help.

I’m here for you if you want to talk. Feel free to write in the comment section and I will be happy to talk with you.

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