Depression During Pregnancy

Signs, Symptoms, and Treatment

Pregnancy is supposed to be one of the happiest times of a woman’s life, but for many women, this is a time of confusion, fear, stress, and even depression. According to The American Congress of Obstetricians and Gynecologists (ACOG), between 14-23% of women will struggle with some symptoms of depression during pregnancy.
Depression is a mood disorder that affects 1 in 4 women at some point during their lifetime, so it should be no surprise that this illness can also touch women who are pregnant. But all too often, depression is not diagnosed properly during pregnancy because people think it is just another type of hormonal imbalance.
This assumption can be dangerous for the mother and the unborn baby. Depression in pregnancy is an illness that can be treated and managed; however, it is important to seek out help and support first.

What is depression in pregnancy?

Depression during pregnancy, or antepartum depression, is a mood disorder just like clinical depression. Mood disorders are biological illnesses that involve changes in brain chemistry.
During pregnancy, hormone changes can affect the chemicals in your brain, which are directly related to depression and anxiety.  These can be exacerbated by difficult life situations, which can result in depression during pregnancy.

What are the signs of depression during pregnancy?

Women with depression usually experience some of the following symptoms for 2 weeks or more:

  • Persistent sadness
  • Difficulty concentrating
  • Sleeping too little or too much
  • Loss of interest in activities that you usually enjoy
  • Recurring thoughts of death, suicide, or hopelessness
  • Anxiety
  • Feelings of guilt or worthlessness
  • Change in eating habits

What are the possible triggers of depression during pregnancy?

Can depression during pregnancy cause harm to my baby?

Depression that is not treated can have potential dangerous risks to the mother and baby. Untreated depression can lead to poor nutrition, drinking, smoking, and suicidal behavior, which can then cause premature birth, low birth weight, and developmental problems. A woman who is depressed often does not have the strength or desire to adequately care for herself or her developing baby.
Babies born to mothers who are depressed may be less active, show less attention and be more agitated than babies born to moms who are not depressed. This is why getting the right help is important for both mom and baby.

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The Pregnant Woman’s Companion: Nine Strategies That Work to Keep Your Peace of Mind Through Pregnancy and Into Parenthood
Christine D’Amico

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What is the treatment for depression during pregnancy?

If you feel you may be struggling with depression, the most important step is to seek help. Talk with your health care provider about your symptoms and struggles. Your health care provider wants the best for you and your baby and may discuss options with you for treatment.
Treatment options for women who are pregnant can include:

  • Support groups
  • Private psychotherapy
  • Medication
  • Light therapy

Are there any safe medications to treat depression during pregnancy?
There is a lot of debate over the safety and long-term effects of antidepressant medications taken during pregnancy. Some research now shows that certain medications used to treat depression may be linked to problems in newborns such as physical malformations, heart problems, pulmonary hypertension and low birth weight.
A woman with mild to moderate depression may be able to manage her symptoms with support groups, psychotherapy, and light therapy. But if a pregnant woman is dealing with severe depression, a combination of psychotherapy and medication is usually recommended.
Women need to know that all medications will cross the placenta and reach their babies. There is not enough information about which drugs are entirely safe and which ones pose risks.
But when treating major depression, the risks and benefits need to be examined closely. The medication that can offer the most help, with the smallest risk to baby, should be considered carefully.
If medication seems like the best treatment for your depression, forming a collaborative treatment team is the best course of action. This would include your prenatal care provider and your mental health provider.
Ask both health care professions about what treatments will be best for you and your baby. Find out if you have options for medications and do research on them.
What long term effects do they have? Is your baby likely to deal with withdrawal symptoms after birth? Is this medication linked to health problems in the newborn or developmental delays in the future? Also, always remember that you need to weigh the possibilities of problems in the future versus the problems that can occur right now if your depression is not treated appropriately.

Are there any natural treatments?

With the controversy regarding the use of some antidepressants during pregnancy, many women are interested in other ways to help treat depression. As mentioned above, support groups, psychotherapy, and light therapy are alternatives to using medication when treating mild to moderate depression.
In addition to these, you may want to talk with your health care providers about some of the other natural ways to help relieve the symptoms of depression.

  • Exercise – Exercise naturally increases serotonin levels and decreases cortisol levels.
  • Get adequate rest – Lack of sleep greatly affects the body and mind’s ability to handle stress and day to day challenges. Work on establishing a routine sleep schedule that has you going to sleep and getting up at the same time.
  • Diet and Nutrition – Many foods have been linked to mood changes, the ability to handle stress and mental clarity. Diets high in caffeine, sugar, processed carbohydrates, artificial additives, and low protein can all lead to issues regarding your mental and physical health.  Make a conscious decision to start fueling your body with the foods that can help you feel better.
  • Acupuncture – New studies report acupuncture to be a viable option in treating depression in pregnant women.
  • Omega-3 fatty acids – For years it’s been known that omega-3 can help with a number of health issues, but the newest studies are showing that taking a daily supplement of omega-3/fish oils can decrease symptoms of depression. Pregnant women would want to make sure to take a mercury-free version of fish oil and check with their care provider or nutritionist on a recommended amount.
  • Herbal remedies – There are a number of herbal and vitamin supplements known to affect moods and the hormone serotonin. Talk with your health care provider and nutritionist/herbalist about whether to use St John’s Wort, SAM-e, 5-HTP, magnesium, vitamin B6 and flower remedies. Many of these can not be used in conjunction with antidepressants and should be evaluated on the dosage for pregnant women.

If you do not feel comfortable talking with your health care provider about your feelings of depression, find someone else to talk with. It is important that someone knows what you are dealing with and can try to help you. Never try to face depression alone. Your baby needs you to seek help and get treatment.

Want to Know More?

Compiled using information from the following sources:
U.S. Department of Health and Human Services, https://www.womenshealth.gov/
March of Dimes,
The American Congress of Obstetricians and Gynecologist (ACOG), https://www.acog.org
MGH Center for Women’s Mental Health, https://www.womensmentalhealth.org
Acupuncture for depression during pregnancy:a randomized control study. Obstet Gynecol, 2010 Mar;115(3):511-20.PMID:20177281