Perinatal Depression: Treatments & Symptoms
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Learn about how pregnancy can affect depression and what can happen after delivery. Find out what the symptoms and treatments are for prenatal depression.
Written by Michael Kerr
Postpartum depression—the depression that occurs in new
mothers after the birth of a child—may be better known, but mood disorders
during the pregnancy itself are more prevalent in expectant mothers than
previously thought.
The combination of the
two types of depression (both prenatal and postpartum) is known as perinatal
depression.
Prevalence
Pregnancy can be one
of the happiest times in a woman's life, but it can also play havoc with
hormones and create plenty of unforeseen stress.
The combination of
biological and emotional factors may lead to anxiety and depression. It was
once believed that pregnancy protected a woman from emotional disorders, but
that has turned out to be a myth. This is largely due to the difficulty in
diagnosing perinatal depression.
Also, there has been
an inordinate focus on postpartum depression in recent years. It is estimated
that between 10 and 20 percent of women develop some type of pregnancy-related
mood disorder and approximately one in 20 women in the U.S.
Symptoms of
Perinatal Depression
Because
they share symptoms, signs of depression such as tiredness,insomnia, emotional changes, and weight gain are often masked
by the pregnancy itself.
Symptoms to watch for
include:
·
frequent crying or weepiness
·
trouble sleeping not related to
frequent urination
·
fatigue or low energy
·
changes in appetite
·
loss of enjoyment in once pleasurable
activities
·
increased anxiety
·
poor fetal attachment
Symptoms of the
'Baby Blues'
As many as 80 percent
of women are affected by what is known as the "baby blues."
During a woman's pregnancy her levels of estrogen and
progesterone rise dramatically (to assist in ?the expansion of the uterus and to help sustain the placenta).
However, within 48 hours of delivery, the levels of both hormones plummet
drastically.
Since these hormones
are associated with mood, many researchers believe this "postpartum
hormonal crash" causes the baby blues and may make some women more
susceptible to postpartum depression.
Symptoms of the baby
blues usually resolve within one or two weeks of delivery and may include:
·
irritability
·
anxiety
·
frustration
·
feelings of being overwhelmed
·
rapid mood changes (elation one
moment, weeping the next)
·
exhaustion
·
insomnia or hypersomnia (excessive
sleeping)
Symptoms of
Postpartum Depression
Like perinatal
depression, postpartum depression affects between 10 and 20 percent of new
mothers. It includes symptoms such as the following that occur for more than 14
days after delivery:
·
feelings of being overwhelmed
·
intense anxiety
·
frequent crying or weeping
·
irritability or anger
·
pervasive sadness
·
fatigue or low energy
·
feelings of worthlessness,
hopelessness, or guilt
·
changes in sleeping or eating habits
·
lack of concentration or
forgetfulness
·
intense worries about the baby
·
a lack of interest in the newborn or
once pleasurable activities
·
physical symptoms such as headaches, chest pains, or
hyperventilation
A more severe form of
postpartum depression is called postpartum psychosis. It is an extremely rare
condition that affects between one and two women per 1,000.
Postpartum psychosis
is usually accompanied by symptoms such as hallucinations (either auditory or
visual) and delusions. Other symptoms may include suicidal ideation or thoughts
of harming the baby.
Postpartum psychosis
is an extremely serious condition that requires immediate emergency
hospitalization for the safety of both the new mother and her baby.
Treatment
Treatments for
perinatal depression are the same as with other forms of depression and the
success rates are typically much higher—between 80 and 90 percent of women are
helped by either medications, interpersonal cognitive behavioral or
psychotherapy, or a combination of drugs and talk therapy.
Antidepressant
drugs—especially selective serotonin reuptake inhibitors (SSRIs)—are the most
common treatment for perinatal depression both during pregnancy and after the
delivery of a child.
Several studies, both
in the U.S. and the U.K.
It is understandable,
however, that new mothers are concerned about any side effects that may affect
their infants and, so, many women opt for other treatments besides antidepressants.
Interpersonal therapy
has proven very effective for perinatal depression, as have (to a lesser
extent) cognitive behavioral therapy and psychotherapy.
Additionally,
alternative treatments such as massage and especially acupuncture have shown
great promise in the treatment of perinatal forms of depression. A recent Stanford University
It is important to
note that prolonged depression may be more harmful to a mother and her child
than the side effects of any treatments or medications. A woman should talk to
her doctor about all of the options available in order to make an informed
decision before choosing a treatment—one that will be best for both her and her
baby.
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