Pregnancy is a life changing condition. Physically and mentally, there are many changes that happen with new life growing within. These changes during the perinatal and postnatal periods often put new mothers and mothers-to-be at high risk for developing anxiety and depression. Less common but worse conditions may include bipolar disorder and postpartum psychosis.
Women may develop a mental health problem during pregnancy or may have a recurrence of such a problem if she had such issue before pregnancy. Women on medication for some mental disorder may have to stop taking their prescriptions when they get pregnant. Unfortunately, they form a high risk group for recurring symptoms. Seven out of ten women who stop their antidepressant medication for instance fall back into depression or anxiety during their pregnancy.
In the U.K., about 10-15 out of 100 pregnant women become clinically depressed or anxious. The cause is not singular but it is usually a mix of factors and it can happen to anyone. These factors may depend on:
- Degree of recent or ongoing stress in one’s life such as a death of a loved one, divorce or separation, etc.
- Attitude toward pregnancy. The thought of raising a child, for instance, may put undue worry on a person especially one with a difficult childhood. Changes in weight and shape may take an emotional toll especially if the mother has an eating disorder.
- Whether one is on treatment or medication. Stopping treatment could make one fall ill again.
- Type of mental illness one has experienced
Postpartum Depression and Anxiety
As pregnancy and post pregnancy are times of great changes, depression symptoms may not be so easy to identify. Depression signals may come when there are big changes in everyday routines or habits such as short sleeping hours, increase in appetite, etc.
If you are experiencing some of these symptoms for more than two weeks, get some help:
- Feelings of hopelessness, worthlessness, emptiness, sadness, and other feelings of inadequacy
- Very low moods; extreme sadness
- Feeling numb
- Easily irritated, angry, or resentful
- Unfounded fears for the baby or of motherhood
- Loss of interest in things that were normally enjoyable
- Withdrawal from social contact
- Not taking care of self
- Poor concentration and decision making
- Harbouring thoughts of harming the baby or one’s self; thoughts of suicide
- Decreased energy; extreme lethargy
Anxiety is a common partner of depression. When experiencing these symptoms, you need to see your GP or health professional who may test your degree of depression and anxiety using the Edinburgh Postnatal Depression Scale (EPDS). The EPDS is a questionnaire which assesses your feelings if these fall outside the normal range and into the depression/anxiety scope. This test may be conducted twice during pregnancy and once after childbirth.
A pregnant woman, who has had prior history of mental illness such as schizophrenia, bipolar disorder, anorexia, or severe depression, must make a wise decision to talk to her GP. Consultation with a specialist, even if she feels very good about herself and her pregnancy at the moment, is important because there is a high enough risk for her mental illness to recur during pregnancy or after childbirth. One needs a care plan drawn up by a GP in order to head off or at least lessen the effects of the illness.
Medication During Pregnancy
Since many pregnancies are usually unplanned, some women may be under medication at the time of conception. If you are under medication but suspect a pregnancy, do not stop medication suddenly but go see your doctor immediately. He will assess whether to change or gradually take you off your medicines. Stopping medications suddenly can quickly cause a relapse of your symptoms or cause undesirable side-effects. If the doctor sees no harm to the foetus with the drugs you were prescribed with, he may insist that you continue with your medicated treatment.
While many medications are unsafe for pregnancy, selected antidepressants such as a few serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) are considered safe for pregnant women. These few have not been associated with birth defects and pass at very low levels through breast milk.
The decision of your doctor on whether to continue or not to continue medication may rest on the ff. factors:
- the likelihood that you may not be able to take care of yourself when off medication
- your tendency to turn to drugs or alcohol because you feel unwell without medication. This tendency is harmful for both you and the developing foetus.
- your tendency to develop postpartum depression which will affect your nurture and care for your baby
- you are at a high risk for a relapse. A relapse may require more medication, usually a higher dose or a supplementary drug, both situations that can be very harmful to the baby.
- if talking therapies are not enough to mitigate your mental health issues. Mental health problems like depression must be addressed because these can cause a host of problems from low birth weight to infant development.
Talking therapies or psychological treatments may be imperative treatments for pregnant women afflicted with depression or anxiety. Cognitive behavioural therapy (CBT) for one can help you cope with your feelings by changing the way you think and behave. Talking therapies help people identify the problem and ways to change their thinking and behavioural patterns so that the effects of the triggers are significantly lessened. Some people may do away with medication and get by very well with talking therapy alone.
Talking therapy may be done as a one-on-one consultation or as a group event. This type of therapy may also be conducted online as e-therapy through e-mail or video sessions.