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Depression and Pregnancy

Reviewed by James Brann, M.D.

Depression During and After Pregnancy

Learn about the causes, symptoms and treatment of depression in pregnancy.

Depression is just as possible during pregnancy as it is after. While most people consider pregnancy a joyful time, there are women who suffer from short bouts of depression during pregnancy. Others experience more significant symptoms of depression that may require treatment during pregnancy.

Pregnant women are often under pressure to feel glowing and cheery. This suggest however that women disregard feelings of sadness or depression that may occur during pregnancy. Depression during pregnancy however can increase a woman's risk of developing post partum depression, and can hinder a woman's ability to care for herself or her developing baby properly while pregnant. For this reason it is vital that depression during pregnancy is identified as early as possible.

Symptoms of Depression during Pregnancy

There are many symptoms of depression during pregnancy. Some commonly reported symptoms from women include:

  • Excessive sadness or feelings of guilt

  • Irritability that is persistent and aggravating

  • Persistent insomnia or fatigue that is out of the ordinary

  • Loss of interest in enjoyable or fun activities

  • Lack of desire to engage in social events or participate in activities that one might normally associate as fun or enjoyable

  • Frequent moodiness

Causes of Depression During Pregnancy

Unfortunately many of these symptoms are common during pregnancy whether or not one is depressed. If however you find that you are experiencing one or more of these symptoms more often than not, it is important that you contact your doctor to determine whether or not you may be suffering from pregnancy related depression.

Depression during pregnancy may result from fluctuating hormone levels. Rapid changes in a woman's hormone levels can influence the level of chemicals in the brain, particularly the ones that regulate mood. This commonly results in depression among pregnant women, particularly during the first and third trimesters. Some women experience more anxiety than normal during these times, while other women experience more depression.

Some women are more susceptible to depression during pregnancy than others. Some examples of high risk categories of women include:

  • Women who experience relationship problems during pregnancy, which can add to stress, depression and anxiety.

  • Women with a family history of anxiety, depression or other mood related disorders.

  • Women who have complicated or high risk pregnancy. The added stress associated with a high risk pregnancy or a pregnancy that requires bed rest can take a huge emotional toll on the mother, resulting in depression.

  • Women who undergo fertility treatments, who often feel more stress and anxiety over their baby's health than ordinary pregnant mothers.

  • Women who have experienced a previous loss during or shortly after pregnancy, which can contribute to anxiety and depression during pregnancy.

Treating Depression During Pregnancy

There are several simple steps a woman can take to reduce her chances of developing depression during pregnancy. For one it is vital that pregnant mothers get plenty of rest. Sometimes lack of sleep alone is enough to trigger short bouts of anxiety and depression. It is also important that women have time to bond with their partner during pregnancy. If you haven't already, consider some private time to nurture your relationship before your new arrival makes his appearance.

Many women also find it helpful to manage their stress through exercise and by talking things out with their partner or with a therapist or doctor. If you find that you are having difficulty despite your best efforts, you should seek the advice of your doctor. Your doctor may recommend medications to help you overcome depression during pregnancy.

For pregnant women with severe major depression, your doctor may recommend using medication. The selective serotonin reuptake inhibitors (SSRIs) are the first-line treatment medications in pregnancy, rather than other antidepressants. Sertraline (zoloft) or Citalopram (Celexa) are usually the first medications to be used.

For pregnant women that do not respond to the SSRIs, venlafaxine (Effexor) or bupropion (Wellbutrin) are recommended.

Treatment options for severely depressed, pregnant patients who do not respond to SSRIs, venlafaxine, and bupropion include tricyclic antidepressants.

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