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Depression during pregnancy

 
, medical expert
Last reviewed: 11.04.2020
 
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Awareness of the upcoming motherhood in most cases brings joy, but sometimes the waiting period of the baby can be a real test for the female psyche. According to medical data, depression during pregnancy occurs in particularly sensitive, stress-resistant natures, who before the conception had a tendency to despondency.

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

Depression is a mental disorder with marked mood swings, loss of joy, a predominance of pessimistic and negative attitudes towards life. For the state of depression, characteristic signs are: low self-esteem, lack of interest in reality, irritability, anxiety and anxiety.

trusted-source[1], [2], [3], [4], [5]

Causes of depression during pregnancy

Nature has created all the conditions for a successful course of pregnancy, but the human brain predetermined a lot of problems and obstacles. The rabid rhythm of everyday life introduced its "adjustments" to the physiological process of bearing in the form of social norms and principles, the status of women and moral and moral aspects. Despite the strongest pressure from the outside, a pregnant woman in a new role becomes a hostage, first of all, her own experiences. How else? After the birth of the baby, one can forget about the old life, a person will appear who is totally dependent on you. Fundamental changes require a young mother to be morally ready, tolerant, able to adapt to a new role.

Factors that affect mental disorders, mass. Support will be important here, as well as assistance from the spouse and family members. Identify the main causes of depression during pregnancy: 

  • conception was unplanned and entails colossal changes, to which the woman is not ready; 
  • household and housing problems; 
  • lack of material basis (for example, the future mother does not have a permanent place of work); 
  • negative attitude of relatives and husband to "adding to the family"; 
  • debilitating toxicosis; 
  • circumstances of a physiological and psychosocial nature; 
  • experiences related to the loss of a loved one, work, etc .; 
  • lack of dopamine, serotonin, noradrenaline; 
  • endogenous factors (internal changes in the body); 
  • long-term use of medicines (sedatives, hypnotics, etc.); 
  • drug overdose; 
  • hormonal changes; 
  • failures in the past when attempting to give birth to children (miscarriage, abortion, frozen pregnancy, etc.); 
  • increased fatigue and weakness.

Depressive state can be inherited, be provoked by emotional, physical or sexual violence. Each depression during pregnancy is individual, but, in spite of this, it is amenable to therapy. The spread of the negative phenomenon among pregnant women is explained by the close connection between the neuroendocrine system and the emotional background, which is especially pronounced under the influence of hormonal changes.

trusted-source[6], [7]

Symptoms of depression during pregnancy

Signals of depression during the carrying of the baby are considered anxiety about the physical condition and the upcoming birth. Mood swings and excessive tearfulness lead to sleep disturbance, the inability to wake up in the morning. As a result, there are serious problems with the well-being of the future mother.

The following symptoms of depression during pregnancy: 

  • irritability; 
  • rapid fatigue, a feeling of constant fatigue; 
  • a heightened sense of hunger or lack of appetite; 
  • chronic sadness; 
  • lack of joy and pleasure from life; 
  • not a desire to communicate with anyone; 
  • fear of going out (agoraphobia); 
  • low self-esteem; 
  • feelings of guilt and lack of self-confidence; 
  • apathy; 
  • not passing drowsiness; 
  • suspiciousness and anxiety for any reason; 
  • heightened sensitivity and tearfulness.

Some women in the situation are constantly in a bad mood, others acutely feel helpless and useless, sometimes leading themselves to thoughts of suicide.

If you can not spend every day in the awareness of the uniqueness of the moment, getting joy and enjoyment, if depression is in the forefront during pregnancy, you should consult a psychologist.

Depression in early pregnancy

Psychologists refer to the first trimester "period of negation." A new life has already arisen, and a woman always forgets about it, of course, if there are no toxemia and other problems. For example, the future mother seriously discusses hiking to the mountains with friends or pondering plans for a business trip coinciding with the 36th week of gestation. And this is absolutely normal, because the abdomen and the first movements of the baby are not there yet.

The beginning of gestation is probably the most difficult period for every woman. The body is reconstructed and gets used to "work in a new way", all systems of the organism, including the nervous one, undergo changes. Stresses, fears about anything (childbirth, baby's health, financial stability, etc.) - all this surrounds the future mother. Often, depression at the beginning of pregnancy is associated with family troubles, the inability to engage in favorite activities (for example, attending sports classes on medical contraindications), the abandonment of the usual things (for example, smoking).

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

No doctor predicts what consequences depression causes during pregnancy. Researchers from Canada found that children, who were put out in conditions of psychoemotional instability, after birth may have a small weight, delayed development and sleep disturbances. A future mother should be seen by a specialist in case of an unbearable anxiety condition.

Depression in early pregnancy

In the second trimester of wearing, a woman realizes that she is pregnant and then there are thoughts that with the birth of a child, her own life will fly somersault. This stage psychologists called "the search for the lost object." Under the object is understood - a favorite work, a certain rhythm and habitual way, friends and colleagues, entertainment, etc. The most interesting thing is that just during this period many women "find themselves new". Someone goes to language courses, others discover the talent of singing, drawing. In general, according to psychologists - this is the most fertile and active period in the life of the future mother. But pregnant women, predisposed to pessimistic thoughts, who have a history of depression, you 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 connected in any way, that is, the presence of prenatal depression does not at all mean the appearance of it after the birth of the baby.

Pain syndrome in the back, weight gain, breast engorgement, frequent urination and other features of the body cause negative thoughts in the process of gestation. The harder the pregnancy in physical terms, the more difficult it is for a woman psychologically.

Depression in the early stages of pregnancy is a combination of several negative factors. Hormones that prepare the body for gestation play an important role in changing moods. The appearance of insomnia does not leave a chance for a proper rest. Financial, social problems, misunderstandings in the family can become a kind of catalyst for the unstable psyche of the future mother. If all of the above added to the alarms of the most pregnant, then the level of stress will go off scale.

A woman who has learned about the life that is emerging within her should protect herself from negative information from outside. Carefully you need to choose films and programs for viewing, it's good to get carried away by knitting or embroidering. Create around you a cozy, positive and quiet atmosphere, where there will be no place for dejection and emotions. Remember that stressful situations and negative thoughts are bad for your baby and can even lead to a miscarriage.

trusted-source[8], [9], [10], [11]

Depression in late pregnancy

In psychology, the third trimester has a clear name - depression. Here often there is a panic among the most balanced natures. Women paint themselves a colorful future with pots, nappies and pots. In the soul from time to time loneliness, discouragement and hopelessness settle. Some pregnant women during this period are angry with husbands, whose life does not crumble, on the mother-in-law, who climb with their advice. The most important thing to resolve yourself sometimes is in a bad mood and respectfully to yourself "like that".

The last months of gestation are inherent: a large abdomen and associated difficulties in movement, a maximum load on the spine and ligament apparatus, a sense of own 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 forthcoming births, physical and mental fatigue, external factors. To exacerbate the depressed mood are able to overweight and loss in the opinion of a woman of former sexual attraction. Dissatisfaction with themselves, anger is reflected in the closest people who "do not understand anything and do not support."

Pregnant women in late life sometimes behave strangely: they want to retire, make long walks in nature, or head off to sew and prepare dowry. In fact, it is very important to listen to yourself, your body and then depression during pregnancy will not disturb you. Spend precious time before the birth of the baby on yourself, after the appearance of the baby in the world you will no longer have such luxury.

trusted-source[12], [13], [14], [15]

Depression in the last weeks of pregnancy

Often, depression during pregnancy is revealed in the last weeks of gestation. The abdomen reaches its maximum size, which prevents full rest, fatigue also reaches its apogee and the woman craves the speedy resolution of pregnancy. Often irritation is spurred by questions from the side: about who is expected, when to give birth, etc.

Scientists argue that depression in the last weeks of pregnancy does not cause much harm to the future mother, but adversely affects the child's subsequent life. Stress, felt by the baby in the process of intrauterine development, forms a certain attitude and ability to cope with complex situations independently after the birth. There is evidence that such children are more difficult to adapt to difficulties, do not know how to cope with life's troubles, develop worse and lag behind peers.

Women on the eve of labor should remember that childbirth and the period of adaptation are easier and faster, the calmer, more balanced, physically and morally prepared future mother. Therefore, do not waste energy and energy negatively emotionally, and engage in something really bringing pleasure to you, because the long-awaited meeting left to wait very briefly.

trusted-source[16], [17], [18]

Depression at 9 months of pregnancy

Pregnancy is not a continuous euphoria and a sense of celebration, stretching for nine months, but also the time in which new, often unpleasant thoughts and emotions arise. Psychologists recommend to go on maternity leave in a timely manner, and not work until the beginning of the bouts. Of course, the habitual way helps a woman to delay the realization of grandiose life changes. Favorite work, colleagues, a sense of need and importance only for a time protect from meeting with depression during pregnancy. All the efforts after the birth of the baby will still fall on your shoulders, it will be better to prepare yourself morally in advance, avoiding the effect of a snowball.

Depression at 9 months of pregnancy is able to develop into hysteria, if at the time with it can not cope. Nervoz is strengthened because of a heavy stomach, its own awkwardness, it becomes impossible to sleep (suffers from suffocation) and eat (there is heartburn). Anxiety in the future mother is caused by any small thing, and her head is filled with anxious thoughts about childbirth, her health and the baby. Of course, it is difficult to be ready for all the changes in this period. You need to know that worry is normal. Almost every pregnant woman on the ninth month notes how slowly and painfully the time drags on. Cope with waiting help special courses for pregnant women, walks, photoshoots and stuff.

trusted-source[19], [20], [21], [22]

Depression after a stiff pregnancy

Frozen pregnancy is a tragedy that affects the physical and mental state of a woman. After conception, the body launched the necessary physiological mechanisms to prepare a woman for bearing and giving birth to the baby. Due to various circumstances, embryo development ceases, and it is deleted by an operative route, which leads to a "program malfunction". The loss of a child turns into a real catastrophe, in which a woman blames herself. Gloomy thoughts, pain, misunderstanding, anger, despair and detachment are crazy, capable of leading to suicide attempts.

Depression after a woman's frozen pregnancy requires obligatory attention from close, and sometimes psychological, help. First, you should stop blaming yourself. You can not affect the development of the baby in the womb. Secondly, do not hold back emotions. If tears run down, cry. Thirdly, you need time to recover mentally, energetically and physically. On average, rehabilitation takes from 3 to 12 months. Fourth, go for additional examinations. This will increase your confidence in a favorable outcome in the future.

Depression during pregnancy, ending with the fading of the fetus, is characterized by loss of interest in life, when a woman is no longer happy, and pain and anguish is increasing every day. In this case, you need not postpone the visit to a psychologist. The specialist will prescribe a relaxing program, hypnosis, recommend courses of yoga therapy or acupuncture.

trusted-source[23], [24], [25], [26]

Diagnosis of depression during pregnancy

Depression during pregnancy is diagnosed on the basis of symptoms. To confirm the diagnosis, two basic conditions are necessary: 

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

Additional conditions are: 

  • sleep disorders; 
  • decrease or increase in appetite; 
  • energy exhaustion or chronic fatigue; 
  • a state of psychomotor agitation or inhibition; 
  • overestimated sense of guilt or own uselessness; 
  • a lower level of concentration, the inability to make decisions, the ability to comprehend what is happening around; 
  • propensity to suicide, thoughts of death.

Diagnosis of depression during pregnancy includes conducting various tests, interviews and instrumental methods. During the initial consultation, the psychologist determines the nature of the depression (moderate / severe form) by means of scoring scales - Hamilton, Beck, Hospital anxiety scale. A complete examination involves conducting a blood test to identify genetic markers of predisposition to depression and specific triggers that trigger a pathological mechanism. Scientists are confident that genetic screening will allow to determine the disease in the early stages of pregnancy.

trusted-source[27], [28], [29], [30]

Treatment of depression during pregnancy

Depression during pregnancy requires mandatory treatment to a psychologist or psychotherapist, who determines the complexity of the disease and prescribes the necessary therapy. The mild and moderate stages can be treated with hypnosis or an individual / group psychosocial approach, i.e. Working out fears, 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 using medicines by mastering the skills of rationally-positive thinking.

Among the newest techniques, the treatment of depression in pregnancy with bright morning light with a parallel intake of omega-3 fatty acids. A number of studies provide data on the efficacy and safety of such therapy. There are even special devices for light therapy that simulate sunlight.

With regard to 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 depression in severe form until conception and after the onset of pregnancy the picture worsened; 
  • the disease occurs with frequent relapses; 
  • it is difficult to achieve a stable remission; 
  • Depression is asymptomatic.

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

The dosage of medicines is selected individually and can be: 

  • "Sertraline" - a one-day daily intake of 50 to 200 mg. The course is 2-3 weeks; 
  • "Venlafaxine" - the minimum dose of 75 mg twice a day. If the therapeutic effect is not achieved in a few weeks, then the amount of substance increases to 150-375 mg per day; 
  • "Paroxetine" - depending on the severity of the disease recommended for admission can be from 10 to 60mg per day. Duration of treatment varies from 2 to 3 weeks with 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 reaches 6 months.

Pharmacological drugs from depression during pregnancy have an impressive list of side effects, among which: 

  • a violation of the digestive function (constipation, flatulence, nausea, hepatitis, etc.); 
  • dysfunction of the central nervous system (hallucinations, drowsiness, panic attacks, seizures, etc.); 
  • allergic manifestations; 
  • problems on the part of the respiratory system (runny nose, shortness of breath, cough, etc.); 
  • violation of cardiovascular activity (for example, tachycardia, pressure jumps); 
  • frequent urination.

Special instructions on the use of pharmacological agents concern patients with hepatic insufficiency, heart disease and kidneys. It is prescribed by the doctor and controlled by the doctor, taking into account the possibility of suicide attempts, the probability of which with the use of medications can increase. Increase and decrease in dosage is carried out smoothly, as well as strictly in agreement with the treating doctor.

Treatment of depression during pregnancy of severe course at any time is possible by electroconvulsive therapy. The method is based on suppressing stress hormones by triggering seizures. As an alternative to drug treatment, acupuncture is also used, characterized by a minimum of side effects. The work on acupuncture points for fighting a mental disorder takes 4 to 8 weeks.

Good results are provided by treatment of depression during pregnancy by physical exercises. The intensity of training depends on the severity of the disease and the individual prescriptions of the gynecologist. And the maximum effect is observed when you visit the gym, rather than independently working out the complex of the house. A woman can choose the most suitable type of physical activity, among the recommended ones - yoga, swimming, aerobics, pilates.

It turns out that depression during pregnancy is treated with plant antidepressants. The most popular and effective remedy for the treatment of mild or moderate disorders is St. John's Wort. The plant does not harm if the woman does not have an individual intolerance. Acceptance of plant raw materials should be coordinated with a gynecologist and psychotherapist. Future mothers should be careful, since St. John's wort is not compatible with pharmacological antidepressants, cyclosporins and other medications. The question of choosing a quality and environmentally friendly product remains open, so buy St. John's wort from proven herbalists or in phyto-pharmacies. The recommended dosage is 300 mg of infusion up to three times a day. To prepare the broth you need a glass of boiling water and 2 tablespoons of dry raw materials, which stand for half an hour in a water bath.

Preventing depression during pregnancy

The condition of pregnancy requires, above all, emotional support from relatives and a loving spouse. Experts have proved that depression during pregnancy develops in women who are often criticized in the family and face a wall of misunderstanding. The future mother is important that her fears and experiences are listened to by the closest people who will help to feel positive emotions and bring back the joy of life.

Preventing depression during pregnancy consists of: 

  • high-grade rest; 
  • healthy sleep; 
  • correct, rational nutrition, enriched with vitamins and vegetable fiber; 
  • fascinating, useful activities, bringing a maximum of happiness and satisfaction to the future mother; 
  • daily walks; 
  • moderate physical activity; 
  • compulsory care for their appearance; 
  • the ability to focus on positive thoughts and form their harmonious reality, the ability to quickly switch to an optimistic mood; 
  • the need to go on maternity leave; 
  • communication with like-minded people (for example, attending training courses for childbirth); 
  • timely appeal to a psychologist / psychotherapist.

To prevent depression, fatty polyunsaturated acids are used: docosahexaenone (DHA / DHA), eicosapentaenoic (EPA / EPA) and omega-3, which are found in oily fish. Moreover, DGA is of plant origin, and EPA is an animal. In addition to reducing stress, acids have a beneficial effect on cardiovascular activity, preventing a number of heart diseases.

The future mother is important to realize that depression during pregnancy is a common problem. It is important to accept your depressed state, to give up the sense of guilt and, if necessary, to seek specialized help in due time.

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