My patient felt ecstatic when she saw the two dark pink lines on her pregnancy test. She wasn’t surprised when fatigue and nausea soon followed. But she began to worry when she couldn’t sleep and became engulfed in sadness that eclipsed her maternal joy.
She confided in a couple of close girlfriends.
“Everyone told me that I was hormonal and that I would begin to feel better during my second trimester,” she said.
We may be able to better catch and prevent pregnancy-related depression in the future, the New York Times reports.
For the first time, the U.S. Preventive Services Task Force, an independent panel of experts that make evidence-based recommendations on how to prevent health issues, said perinatal depression — depression that occurs during pregnancy and up to the first year after a baby’s birth and which impacts around one in seven women — might be preventable with counseling before birth.
“Effective counseling interventions can help prevent perinatal depression before it develops,” said Task Force member Karina Davidson, Ph.D., M.A.Sc in a statement. “We can help prevent one of the most common and serious complications of having a baby.”
The Task Force recommended that doctors refer pregnant women that fit certain higher-risk characteristics to counseling interventions like group or cognitive behavioral therapy. The task force did not have a recommended timing for when to start therapy or for how long to attend. But most of the studies referenced were initiated during the second trimester with a range of four to 20 counseling sessions.
Experts aren’t sure what exactly causes perinatal depression, but it’s believed that hormonal changes or the stress of new motherhood may trigger symptoms. Feeling overwhelmed, stressful schedule changes, lack of sleep, an unrealistic view of motherhood, feeling less attractive and struggling with a new sense of identity, all of which can happen after birth, may bring on symptoms.
While the task force didn’t identify a specific screening tool, it did say that women with “personal or family history of depression, history of physical or sexual abuse, an unplanned or unwanted pregnancy,” as well as women who are going through current stressful life events, are diabetic, had complications during pregnancy or lack social and financial support have an increased risk of developing perinatal depression.
But Dr. Michael O’Hara, Professor in the Psychology Department at the University of Iowa and executive committee member of the postpartum research network, The Marcé Society, tells What to Expect that though there is a slightly higher risk of depression in women with these backgrounds, it doesn’t necessarily mean they’ll all go on to develop pregnancy or postpartum depression (PPD).
If therapy before pregnancy isn’t an option, moms-to-be can do other things to help with the transition to motherhood. Eating well, maintaining exercise, finding a community (even an online one), getting out and seeing adults and getting enough sleep may reduce your chances of developing perinatal depression.
“These are things moms can do to reduce the likelihood that they’re [going to] have problems.,” said O’Hara. “This is where family and friends can be really, really helpful in a preventive sense by allowing moms to get sleep whether it’s sleeping through the night or later in the morning or catching up with naps.”
O’Hara also said that boundaries with family and visitors is critical.
“It’s an exciting time both in pregnancy and postpartum, but sometimes moms end up still in that caretaker role with other people who can really take care of themselves when they should be focusing on themselves and the baby,” he says.
He adds that moms who think they may be struggling with pregnancy-related depression should speak to their doctor. “You may turn out to be just fine, but it’s better to get some help early,” he says.
Most importantly: If you’re suffering from any kind of depression, remember that it is never (ever!) your fault.
It’s important to note that the “baby blues” (feelings of sadness and anxiety) are normal for the first three weeks or so after giving birth. However, if after that first month you find yourself feeling persistently sad, panicky, hopeless, angry, or irritable, experience insomnia or a lack of appetite, or experience memory problems and extreme fatigue, you may have postpartum depression.
Many women find antidepressants helpful, and most are considered safe to take both during pregnancy and for nursing moms, but if you would rather not take them for any reason, you have other options. Your doctor may recommend one-on-one therapy or support groups or more holistic options like light therapy and acupuncture. He or she will work with you to find a treatment plan that fits your lifestyle and preferences.
The following resources offer more information and support if you (or someone you know) may be suffering from PPD:
Postpartum Support International (800-944-4PPD) Mental Health America (800-273-TALK) National Alliance on Mental Illness (800-950-NAMI)
Reaching out for help can be scary and painful, but as they say in every single airplane safety video: You have to put your oxygen mask on first before you can help others. You don’t have to live with depression forever, and in getting treatment, you’re taking care of yourself — and taking care of yourself means you can spend more time with your brand-new baby. Your health matters — so don’t ever feel afraid or ashamed of speaking up.
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