If you're pregnant, chances are you've heard about postpartum depression. But did you know that many women also experience depression during pregnancy? Here's what you need to know about pregnancy and depression.
How common is depression during pregnancy?
Research suggests that about 14 to 23 percent of all pregnant women experience depression during pregnancy.
Depression, a mood disorder that causes a persistent feeling of sadness and loss of interest, is the most common mood disorder in the general population. The condition occurs twice as often in women as in men, and the initial onset of depression peaks during a woman's reproductive years.
Why does depression during pregnancy often go unrecognized?
Some symptoms of depression, including changes in sleep, energy level, appetite and libido, are similar to symptoms of pregnancy. As a result, your health care provider might attribute these symptoms to your pregnancy, rather than depression.
Women might also be reluctant to talk to their health care providers about changes in moods during pregnancy.
What are the risk factors for depression during pregnancy?
Some risk factors for depression during pregnancy include:
- Life stress
- History of depression
- Poor social support
- Unintended pregnancy
- Intimate partner violence
What are the signs and symptoms of depression during pregnancy?
The signs and symptoms of depression during pregnancy are the same as those that occur with depression in the general population. However, additional clues that might indicate depression during pregnancy include:
- Excessive anxiety about your baby
- Low self-esteem, such as feelings of inadequacy about motherhood
- The inability to experience pleasure from activities usually found enjoyable
- Poor response to reassurance
- Poor adherence to prenatal care
- Smoking, drinking alcohol or using illicit drugs
- Poor weight gain due to a decreased or inadequate diet
- Thoughts of suicide
Why is treatment for depression during pregnancy important?
Antidepressants: Safe during pregnancy?
If you have untreated depression, you might not seek optimal prenatal care, eat the healthy foods your baby needs or have the energy to care for yourself. You are also at increased risk of postpartum depression and having difficulty bonding with your baby.
Depending on the severity of your depression, treatment options might include psychotherapy or antidepressants.
What are the recommendations for screening for depression during pregnancy?
The American College of Obstetricians and Gynecologists recommends that health care providers screen for depression and anxiety using a standardized tool at least once during pregnancy.
During a screening your health care provider will likely ask questions from the Edinburgh Postnatal Depression Scale or another standardized screening questionnaire, which consists of questions about mood and anxiety. Your answers are scored and your total score can be used to identify whether you have depression. Alternatively, your health care provider might ask you if, in the past month, you have been bothered by feeling down, depressed or hopeless or by having little interest in doing things.
There is limited evidence that screening to identify and treat depression during pregnancy improves outcomes. This might be due to variations in access to resources and appropriate treatment once depression has been diagnosed. However, screening for depression during pregnancy also appears to pose no adverse effects. Currently, screening for depression during pregnancy is recommended as a part of your standard prenatal care.
If you think you might have depression during pregnancy, don't wait for a screening. Talk to your health care provider about how you're feeling and work with him or her to determine the next steps.
Nov. 24, 2016
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- American College of Obstetricians and Gynecologists Committee on Obstetric Practice. Committee Opinion No. 630: Screening for perinatal depression. Obstetrics & Gynecology. 2015;125:1268.
- O'Connor E, et al. Primary care screening for and treatment of depression in pregnant and postpartum women. Journal of the American Medical Association. 2016;315:388.
- Grigoriadias S. Mild to moderate antenatal unipolar depression. http://www.uptodate.com/home. Accessed Oct. 17, 2016.
- Grigoriadias S. Unipolar major depression during pregnancy. http://www.uptodate.com/home. Accessed Oct. 17, 2016.
- Yonkers KA, et al. The management of depression during pregnancy: A report from the American Psychiatric Association and the American College of Obstetricians and Gynecologists. Obstetrics & Gynecology. 2009;114:703.