Depression during pregnancy

Having a baby can be one of the most exciting times of your life, but it can also be stressful. You are experiencing a lot of change, and there may be times when you worry about the future.

If you are struggling with stress and anxiety, there are things you can do to support your emotional health. If you are overwhelmed, do not be afraid to ask for help if you need it.

If you are concerned about depression, talk to your health care provider as soon as you can. Read the list of symptoms of depression below to help guide you.

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Supporting your health

It is normal to experience a lot of different emotions during pregnancy. When you are pregnant, your body produces many hormones that affect your feelings. As your hormones change, you might notice you feel more irritable, weepy, anxious, angry and agitated. Usually, these mood swings happen from the sixth to 10th week and again in the third trimester.

Strategies for self-care

If you are feeling overwhelmed, try these strategies to care for your emotional health:

  • Exercise and eat well to help keep your moods in check.
    Make sure you are eating enough, and do not skip meals. Drink plenty of water. Keep active with a walk outside or go swimming to make you feel refreshed.
  • Stay away from stress.
    If certain people or types of situations make you upset, stay away from them as much as you can. Do not take on additional responsibilities at work or in your community. Learn to say "no"--if you have too much to do, it can be stressful.
  • Find time to relax and rest when you need it.
    Put your feet up, take a nap or just slow down. Let yourself rest when you are tired.
  • Accept offers of help from family and friends.
    It is OK to let people help, and it is OK to ask for help with your work and daily tasks. The most important thing is for you to rest and take care of your body and your stress levels.
  • Share your thoughts and feelings with others.
    If you are worried, upset, sad or anxious, talking about it can help. Confide in your partner, a trusted friend or a family member. It is important to talk to your health care provider about your thoughts and feelings.

Recognizing depression

Sometimes it is hard to recognize what you are struggling with. Is it depression? Are you experiencing a change in hormones or mood swings? If you are feeling sad, negative, angry and anxious, you might find it hard to talk about it. Maybe you feel that nobody could understand, and that others will judge you.

Do you feel worried or ashamed about the thoughts and feelings you are having? Do not let embarrassment or fear stop you from telling your health care provider about how you really feel. Your health care provider can only diagnose your health if you discuss your symptoms. Without getting help, you may feel worse.

By the second trimester, most women feel better because their bodies adjust to their hormones. They are less likely to have mood swings. If you still struggle with emotions, thoughts or physical symptoms at this point, see your health care provider. You may be able to be diagnosed more quickly at this stage.

Signs and symptoms

If you think you might be depressed, talk to your health care provider as soon as you can. Some symptoms of depression can show up as early as two weeks into the pregnancy. These symptoms include:

  • crying spells
  • not sleeping
  • loss of interest in life
  • panic attacks

Below you will find a detailed list of symptoms of depression. If any of these symptoms last for at least two weeks or cause you to worry, see your health care provider.

  • Depressed mood or extreme sadness
  • Crying spells for no apparent reason
  • Guilty thoughts or feelings of worthlessness or hopelessness
  • Restlessness, lack of control or lack of energy
  • Difficulty concentrating or disorganized thoughts
  • Feelings of guilt or inadequacy as a mother-to-be
  • Changes in sleep or appetite (for example, sleeping or eating too little or too much)
  • Withdrawing from your partner, family, friends, co-workers

Do you have thoughts of suicide or of hurting yourself or others? Seek help from your health care provider immediately.

Causes and triggers

There are many different reasons why you might be likely to develop depression during pregnancy. You may be more physically vulnerable to depression, or you might be in a stressful situation that can trigger depression.

You might be vulnerable to depression if:

  • you have a family history of depression, especially postpartum depression
  • you were depressed during your teens or in your young adult years
  • you were depressed after the birth of a previous baby
  • you are experiencing an unwanted pregnancy
  • you were previously infertile and had hormone treatments when trying to get pregnant

You might be in a situation that can trigger depression if:

  • you are in a relationship that feels unsupportive
  • you feel isolated without social support
  • you have a history of experiencing abuse or violence
  • you have a drug and/or alcohol dependency
  • you have had recent stressful life events (like the death of a loved one, moving or changing jobs)

For some women, the stresses of becoming a mother, new responsibilities and financial stresses are enough to trigger anxiety and depression.

Getting help for depression

If you feel depressed when you are pregnant, it may prevent you from being able to take care of your health. You might avoid prenatal medical care, and you may not sleep or eat well because of how you are feeling. Getting help for depression is important for your health and your baby's health.

Reasons to get help

Treatment for depression during pregnancy can protect you from depression after the birth of your baby.

Untreated depression after the birth can lead to:

  • more negative face-to-face interactions with the baby
  • less eye contact during feeding
  • less playfulness with the baby
  • more withdrawal from the baby

Infants of untreated depressed mothers tend to:

  • look away from their mother
  • react with more crying, sadness and fussiness
  • have more trouble sleeping

If you are treated for depression early, you can reduce the effects of your depression on your baby. Also, if you are treated for depression during pregnancy, you can lower your risk of developing postpartum depression.

Feeling emotional in the early days and weeks after the birth of your baby is normal. These feelings are often known as having the "baby blues" and should get better with time, rest and support. If you feel your symptoms are getting worse, or if you having trouble coping, talk to your health care provider.

Talking to your health care provider

Sometimes it is hard to know if you are struggling with depression or if you are feeling the symptoms of pregnancy. The symptoms can be similar and confusing. Talk to your health care provider often about how you are feeling.

Make sure to talk about:

  • how strong your emotions are (for example, how sad you feel)
  • how often you have these emotions (for example, how often you cry)
  • how your emotions are affecting:
    • your life
    • your ability to take care of yourself
    • your home or work
    • your interactions with your partner, family and friends
  • how much you are sleeping or eating--not enough or too much
  • if you have had any feelings of hopelessness and suicidal thoughts

Remember, your health care provider cannot read your thoughts. He or she does not know what happens to you in a regular day. You need to tell him or her everything about what you do, how you feel and what you think. Especially if your thoughts and actions scare you, share them with your health care provider.

If your health care provider is not around, go to the closest emergency medical centre to talk to someone.

Treatment options

If you are depressed, you may need counselling and/or medication. If counselling does not help, your health care provider may prescribe medication.

The latest research shows there are types of antidepressant and antianxiety medication that are safe to use during pregnancy. Medication is usually used in the second trimester to make sure it is safe for the fetus.

It can take four to six weeks to know if the medication is working. Do not stop your medication until you talk to your health care provider. If you stop medication suddenly, you might experience severe symptoms of withdrawal, depression and thoughts of suicide.

Getting medical help is the most important thing you can do for your recovery.

Your partner, family or friends can help to support you as well.  Some ways they can assist you and show you they care can include:

  • going with you to medical appointments
  • helping with daily chores around the house like cooking and cleaning
  • offering to babysit if you have other children
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