Depression during pregnancy

The awareness of impending motherhood in most cases brings joy, but sometimes the period of waiting for a baby can become a real test for the female psyche. According to medical data, depression during pregnancy occurs in particularly sensitive, stress-unresistant natures, who had a tendency to despondency even before conception.

Instability of the emotional background can lead to addiction to alcohol and psychotropic substances. The state of depression is very harmful for the expectant mother, therefore it requires immediate referral to a specialist.

Depression is a mental disorder characterized by marked mood swings, loss of joy, and a predominance of pessimistic and negative attitudes toward life. The characteristic signs of depression are: low self-esteem, lack of interest in reality, irritability, anxiety, and worry.

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Causes of Depression During Pregnancy

Nature has created all the conditions for a successful pregnancy, but the human brain has predetermined a lot of problems and obstacles. The frantic pace of everyday life has made its own "adjustments" to the physiological process of bearing a child in the form of social norms and foundations, the status of a woman and moral and ethical aspects. Despite the strongest pressure from the outside, a pregnant woman in a new role becomes a hostage, first of all, of her own experiences. How could it be otherwise? After the birth of the baby, you can forget about your previous life, a person will be born who is completely dependent on you. Cardinal changes require moral readiness, tolerance, and the ability to adapt to a new role from a young mother.

There are many factors that influence mental disorders. Support and help from the spouse and family members will be important here. The main causes of depression during pregnancy are:

• conception was unplanned and entails colossal changes for which the woman is not prepared;
• everyday and housing problems;
• lack of material resources (for example, the expectant mother does not have a permanent job);
• negative attitude of relatives and husband towards the “addition to the family”;
• debilitating toxicosis;
• circumstances of a physiological and psychosocial nature;
• experiences associated with the loss of a loved one, job, etc.;
• lack of dopamine, serotonin, norepinephrine;
• endogenous factors (internal changes in the body);
• long-term use of medications (sedatives, sleeping pills, etc.);
• drug overdose;
• hormonal changes;
• failures in the past when trying to have children (miscarriage, abortion, frozen pregnancy, etc.);
• increased fatigue and weakness.

Depressive states can be inherited, provoked by emotional, physical or sexual abuse. Each depression during pregnancy is individual, but, despite this, it can be treated. Doctors explain the spread of the negative phenomenon among pregnant women by the close connection between the neuroendocrine system and the emotional background, which is especially pronounced under the influence of hormonal changes.

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Symptoms of Depression During Pregnancy

Signs of depression during pregnancy include anxiety about physical condition and the upcoming birth. Mood swings and excessive tearfulness lead to sleep disturbances and the inability to wake up in the morning. As a result, serious problems with the well-being of the expectant mother appear.

The following symptoms of depression during pregnancy are distinguished:

• irritability;
• rapid fatigue, feeling of constant tiredness;
• increased feeling of hunger or lack of appetite;
• chronic sadness;
• lack of joy and pleasure in life;
• no desire to communicate with anyone;
• fear of going outside (agoraphobia);
• low self-esteem;
• feelings of guilt and lack of self-confidence;
• apathy;
• persistent drowsiness;
• suspiciousness and anxiety about anything;
• heightened sensitivity and tearfulness.

Some pregnant women are constantly in a bad mood, others feel an acute sense of helplessness and uselessness, sometimes leading to suicidal thoughts.

If you are unable to spend every day in the awareness of the uniqueness of the moment, receiving joy and pleasure, if depression during pregnancy comes to the fore, you should consult a psychologist.

Depression in early pregnancy

Psychologists call the first trimester the "period of denial." A new life has already begun, but the woman keeps forgetting about it, of course, if there is no toxicosis or other problems. For example, the expectant mother seriously discusses a hiking trip to the mountains with friends or thinks over plans for a business trip that coincides with the 36th week of gestation. And this is absolutely normal, because the belly and the baby's first movements are not yet there.

The beginning of pregnancy is probably the most difficult period for every woman. The body is rebuilt and gets used to “working in a new way”, all body systems, including the nervous system, undergo changes. Stress, fears for any reason (childbirth, baby’s health, financial stability, etc.) – all this surrounds the expectant mother. Often, depression at the beginning of pregnancy is associated with family troubles, the inability to do favorite things (for example, attend sports classes due to medical contraindications), refusal of usual things (for example, smoking).

However, frequent mood swings and increased sensitivity should not be confused with depression. Many women notice instability of the emotional background after conception. Oddly enough, such behavior is considered in medicine as one of the indirect signs of pregnancy. The reason for such changes is hormonal changes. Mood swings, drowsiness, fatigue are physiological norms. But problems of a protracted (two or more weeks) nature with a pessimistic attitude, thoughts that everything is terrible and will be even worse, talk of death and constant anxiety indicate true depression.

No doctor can predict the consequences of depression during pregnancy. Researchers from Canada have found that children born in conditions of psychoemotional instability may have low weight, slow development, and sleep disorders after birth. The expectant mother should see a specialist if she experiences persistent anxiety.

Depression in early pregnancy

In the second trimester of pregnancy, a woman realizes that she is pregnant and then thoughts appear that with the birth of the child, her own life will go topsy-turvy. Psychologists have called this stage "the search for the lost object." The object is understood as a favorite job, a certain rhythm and habitual way of life, friends and colleagues, entertainment, etc. The most interesting thing is that it is during this period that many women "find themselves new." Some go to language courses, others discover a talent for singing, drawing. In general, according to psychologists, this is the most beneficial and active period in the life of an expectant mother. But pregnant women who are prone to pessimistic thoughts and have a history of depression have to experience real emotional storms.

According to medical data, depression during pregnancy is much more common than in the postpartum period. Both phenomena are not related to each other, that is, the presence of prenatal depression does not mean its appearance after the birth of the baby.

Back pain, weight gain, breast engorgement, frequent urge to urinate and other body features cause negative thoughts during pregnancy. The more difficult the pregnancy is physically, the more difficult it is for the woman psychologically.

Depression in early pregnancy is a combination of several negative factors. Hormones that prepare the body for pregnancy play a significant role in mood swings. Insomnia leaves no chance for a good rest. Financial, social problems, misunderstandings in the family can become a kind of catalyst for the unstable psyche of the expectant mother. If you add the anxiety of the pregnant woman to all of the above, the level of stress will go off the charts.

A woman who has learned about the life that is emerging inside her should protect herself from negative information from the outside. Carefully choose films and programs to watch, it would be a good idea to get carried away with knitting or embroidery. Create a cozy, positive and calm atmosphere around you, where there will be no place for despondency and worries. Remember that stressful situations and negative thoughts have a bad effect on your baby and can even lead to a miscarriage.

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Depression in late pregnancy

In psychology, the third trimester has a clear name - depression. Here, panic often appears in the most balanced natures. Women picture a colorful future with pots, diapers and pots. From time to time, loneliness, despondency and hopelessness settle in the soul. Some pregnant women during this period are angry at their husbands, whose lives are not falling apart, at their mothers-in-law, who pester with their advice. The most important thing is to allow yourself to sometimes be in a bad mood and respect yourself "like this".

The last months of pregnancy are characterized by: a large belly and the associated difficulties in moving, maximum load on the spine and ligaments, a feeling of helplessness, uselessness and dependence on others. Some women believe that they are no longer interesting to their spouses, and this in turn is fraught with increased tearfulness, irritation and resentment.

Depression at the end of pregnancy can be caused by fear of the upcoming birth, physical and mental fatigue, external factors. Excess weight and the loss of former sexual attractiveness, in the woman's opinion, can aggravate the depressive mood. Dissatisfaction with oneself and anger are reflected in the closest people who "do not understand anything and do not support."

Pregnant women in late pregnancy sometimes behave strangely: they seek solitude, taking long walks in nature, or they plunge headlong into sewing and preparing a dowry. In fact, it is very important to listen to yourself, your body, and then depression during pregnancy will not bother you. Spend precious time before the baby is born on yourself, after the baby is born you will no longer have such luxury.

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Depression in the last weeks of pregnancy

Depression during pregnancy is often detected in the last weeks of gestation. The belly reaches its maximum size, which prevents proper rest, fatigue also reaches its peak and the woman longs for a quick resolution of the pregnancy. Often, irritation is fueled by questions from others: about who is expected, when to give birth, etc.

Scientists claim that depression in the last weeks of pregnancy does not cause much harm to the expectant mother, but it has a negative impact on the child's subsequent life. The stress felt by the baby during intrauterine development forms a certain attitude and the ability to cope with difficult situations independently after birth. There is evidence that such children adapt to difficulties more difficultly, do not know how to cope with life's troubles, develop worse and lag behind their peers.

Women on the eve of labor should remember that labor and the adaptation period are easier and faster, the calmer, more balanced, physically and mentally prepared the expectant mother is. Therefore, do not waste your strength and energy by negatively emotionalizing, but do something that truly brings you pleasure, because the long-awaited meeting is not long away.

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Depression in the 9th month of pregnancy

Pregnancy is not a continuous euphoria and a sense of celebration stretching over nine months, but also a time when new, often unpleasant thoughts and emotions arise. Psychologists recommend going on maternity leave on time, rather than working until contractions begin. Of course, a familiar way of life helps a woman delay the realization of grandiose life changes. Favorite work, colleagues, a feeling of being needed and important only temporarily protect from encountering depression during pregnancy. All the troubles after the birth of the baby will still fall on your shoulders, it will be better to mentally prepare yourself in advance, avoiding the snowball effect.

Depression in the 9th month of pregnancy can develop into hysteria if you do not cope with it in time. The nervousness increases due to a heavy belly, your own clumsiness, it becomes impossible to get enough sleep (suffocation torments) and eat (heartburn appears). The expectant mother is worried about any little thing, and her head is filled with anxious thoughts about childbirth, her health and the baby. Of course, it is difficult to be prepared for all the changes during this period. You need to know that worrying is normal. Almost every pregnant woman in the ninth month notes how slowly and painfully time drags on. Special courses for pregnant women, walks, photo sessions, etc. help to cope with the wait.

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Depression after a frozen pregnancy

A frozen pregnancy is a tragedy that affects the physical and mental state of a woman. After conception, the body has launched the necessary physiological mechanisms to prepare the woman for bearing and giving birth to a baby. Due to various circumstances, the development of the embryo stops and it is removed surgically, which leads to a "program failure". The loss of a child turns into a real catastrophe, for which the woman blames herself. Dark thoughts, pain, misunderstanding, anger, despair and detachment drive one crazy and can lead to suicide attempts.

Depression after a frozen pregnancy in a woman requires mandatory attention from loved ones, and sometimes psychological help. First, you should stop blaming yourself. You are not able to influence the development of the baby in the womb. Second, do not hold back your emotions. If tears come, cry. Third, you need time to recover mentally, energetically and physically. On average, rehabilitation takes from 3 to 12 months. Fourth, undergo additional examinations. This will increase your confidence in a favorable outcome in the future.

Depression during pregnancy ending in a frozen pregnancy is characterized by a loss of interest in life, when nothing makes a woman happy anymore, and the pain and melancholy increase with each passing day. In this case, you should not postpone a visit to a psychologist. The specialist will prescribe a relaxation program, hypnosis, recommend yoga therapy courses or acupuncture.

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Diagnosis of depression during pregnancy

Depression during pregnancy is diagnosed based on symptoms. To confirm the diagnosis, two main conditions are necessary:

• pessimistic moods or a depressed state continue throughout the day for at least two weeks, almost every day;
• lack of interest or pleasure in daily activities for a similar duration.

Additional conditions are:

• sleep disorders;
• decrease or increase in appetite;
• energy depletion or chronic fatigue;
• a state of psychomotor agitation or inhibition;
• an inflated sense of guilt or worthlessness;
• decreased level of concentration, inability to make decisions, or to comprehend what is happening around;
• suicidal tendencies, thoughts of death.

Diagnosis of depression during pregnancy includes various tests, surveys and instrumental methods. During the initial consultation, the psychologist determines the nature of depression (moderate/severe) using assessment scales - Hamilton, Beck, Hospital Anxiety Scale. A full examination involves a blood test to identify genetic markers of predisposition to depression and specific triggers that provoke the launch of the pathological mechanism. Scientists are confident that genetic screening will allow identifying the disease in the early stages in pregnant women.

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Treatment of depression during pregnancy

Depression during pregnancy requires mandatory consultation with a psychologist or psychotherapist, who determines the complexity of the disease and prescribes the necessary therapy. Mild and moderate stages can be treated with hypnosis or an individual/group psychosocial approach, i.e. working through fears and doubts under the guidance of a competent specialist. Psychotherapy is divided into cognitive-behavioral and interpersonal, during which pregnant women get rid of emotional disorders without the use of medications by mastering the skills of rational-positive thinking.

Among the newest methods, treatment of depression during pregnancy is practiced with bright morning light and parallel intake of Omega-3 fatty acids. A number of studies provide data on the effectiveness and safety of such therapy. There are even special devices for light therapy that imitate sunlight.

Regarding the use of pharmacological drugs in the treatment of mental disorders in expectant mothers, antidepressants are prescribed in the following cases:

• the woman suffered from severe depression before conception and after pregnancy the picture worsened;
• the disease occurs with frequent relapses;
• it is difficult to achieve stable remission;
• Depression is asymptomatic.

Of course, it is better to get rid of the signs of depression long before conception, since all modern psychotropic drugs have the property of penetrating the placental barrier into the amniotic fluid. The leading drugs in the fight against prenatal depression are serotonin and norepinephrine reuptake inhibitors - "venlafaxine", "sertraline", "paroxetine", "fluoxetine", "citalopram". The risk of taking drugs is associated with the possibility of developing a heart defect, umbilical hernia and craniosynostosis in the child, so these substances are prescribed in situations where the benefit to the mother is undeniably higher than the risk to the fetus. In mothers who took antidepressants during pregnancy, babies are born with such problems as: diarrhea, decreased activity of the stomach function, tremors, increased heart rate, breathing problems, etc.

The dosage of medications is selected individually and may be:

• "sertraline" - a single daily dose of 50 to 200 mg. The course is 2-3 weeks;
• "venlafaxine" - the minimum dose is 75 mg twice a day. If the therapeutic effect is not achieved within a few weeks, the amount of the substance is increased to 150-375 mg per day;
• "paroxetine" - depending on the severity of the disease, the recommended dose may be from 10 to 60 mg per day. The duration of treatment varies from 2 to 3 weeks with a possible increase in the initial dosage;
• "fluoxetine" - initially 20 mg per day (maximum dose - 80 mg) for 3-4 weeks;
• "Citalopram" - from 10 to 60 mg per day. The course of treatment is up to 6 months.

Pharmacological drugs for depression during pregnancy have an impressive list of side effects, including:

• digestive dysfunction (constipation, flatulence, nausea, hepatitis, etc.);
• dysfunction of the central nervous system (hallucinations, drowsiness, panic attacks, convulsions, etc.);
• allergic reactions;
• problems with the respiratory system (runny nose, shortness of breath, cough, etc.);
• cardiovascular disorders (for example, tachycardia, pressure surges);
• frequent urination.

Special instructions for the use of pharmacological agents apply to patients with liver failure, heart disease and kidney disease. The drug is prescribed and its effect is monitored by a doctor, taking into account the possibility of suicide attempts, the likelihood of which may increase with the use of medications. The increase and decrease of the dosage is carried out smoothly, and also strictly in agreement with the attending doctor.

Treatment of severe depression during pregnancy at any stage is possible by electroconvulsive therapy. The method is based on the suppression of stress hormones by inducing convulsions. Acupuncture, which is characterized by a minimum of side effects, is also used as an alternative to drug treatment. Work on acupuncture points to combat mental disorders takes from 4 to 8 weeks.

Good results are achieved by treating depression during pregnancy with physical exercises. The intensity of the training depends on the severity of the disease and individual instructions of the gynecologist. Moreover, the maximum effect is observed when visiting the gym, and not when independently working out the complex at home. A woman can choose the most suitable type of physical activity for herself, among the recommended ones are yoga, swimming, aerobics, Pilates.

It turns out that depression during pregnancy is treated with herbal antidepressants. The most popular and effective remedy in the treatment of mild or moderate disorders is St. John's wort. The plant does not cause harm if the woman does not have an individual intolerance. The intake of herbal raw materials should be agreed with a gynecologist and psychotherapist. Expectant mothers should be careful, since St. John's wort is incompatible with pharmacological antidepressants, cyclosporines and other drugs. The question of choosing a high-quality and environmentally friendly product remains open, so buy St. John's wort from trusted herbalists or in herbal pharmacies. The recommended dosage is 300 mg of infusion up to three times a day. To prepare the decoction, you will need a glass of boiling water and 2 tablespoons of dry raw materials, which are kept for half an hour in a water bath.

Prevention of depression during pregnancy

The state of pregnancy requires, first of all, emotional support from relatives and a loving spouse. Experts have proven that depression during pregnancy develops in those women who are often criticized in the family and face a wall of misunderstanding. It is important for the expectant mother to have her fears and experiences listened to by the closest people who will help her feel positive emotions and return the joy of life.

Prevention of depression during pregnancy consists of:

• full rest;
• healthy sleep;
• proper, balanced nutrition, enriched with vitamins and plant fiber;
• exciting, useful activity that brings maximum happiness and satisfaction to the expectant mother;
• daily walks;
• moderate physical activity;
• mandatory care of one's appearance;
• the ability to focus on positive thoughts and create your own harmonious reality, the ability to quickly switch to an optimistic attitude;
• the need to go on maternity leave in time;
• communication with like-minded people (for example, attending childbirth preparation courses);
• timely referral to a psychologist/psychotherapist.

Fatty polyunsaturated acids help prevent depression: docosahexaenoic (DHA), eicosapentaenoic (EPA) and Omega-3, which are found in fatty fish. Moreover, DHA is of plant origin, and EPA is of animal origin. In addition to reducing stress, the acids have a beneficial effect on cardiovascular activity, preventing a number of heart diseases.

It is important for the expectant mother to realize that depression during pregnancy is a common problem. It is important to accept your depressed state, give up the feeling of guilt and, if necessary, seek specialized help in a timely manner.