Do I have Depression during Pregnancy? (“Emma’s* Story”)

While pregnancy is typically depicted as a happy time in a woman’s life, for some women, pregnancy itself can predispose a woman to mood disorders including depression during pregnancy.

Emma is pregnant with her first child. She has never suffered from depression. At first she attributes her feelings of sadness and lack of energy to symptoms of pregnancy. She barely has energy and is tearful daily. She has difficulty sleeping and despite not having morning sickness, has no appetite. She no longer has interest in things that used to be enjoyable to her such as reading or baking, and at times, finds herself wishing that she could just be left alone in bed. Emma’s family tries to tell her that she just needs to “snap out of it” and that if she just tries to push herself, she will feel better. She purchased multiple natural vitamins in order to improve her mood. Emma feels guilty about her symptoms, and becomes convinced that she is doing this to herself. She does not want to pursue any treatments thinking that surely she will get better on her own. After another three months of worsening symptoms, poor weight gain during the pregnancy, and having to stop working due to her symptoms, Emma agrees to initiate treatment. Once the treatment for depression during pregnancy takes effect, Emma’s energy improves, she is able to return to work, and now she feels excited and enthusiastic about the new addition to her family.

It used to be thought that depression & pregnancy were somehow incompatible, as if a pregnant woman were somehow shielded from developing mood disorders. The image of the glowing pregnant woman was the predominant icon of pregnancy. However, about 20% of women experience some symptoms of depression during pregnancy and about 10% of women develop major depression during pregnancy. Women who have experienced major depression in the past have a higher risk of suffering depression during pregnancy. Those especially at risk are women who had stopped taking antidepressant medication while trying to become pregnant. It is important to identify, and if necessary treat depression during pregnancy. Maternal depression itself may adversely affect the developing baby. Several studies have found an association between maternal depression during pregnancy and factors that predict poor neonatal outcome including preterm birth, lower birth weight, smaller head circumference, and lower Apgar scores. Untreated severe anxiety has been associated with low Apgar scores, premature labor, and low-birth-weight. In addition, increased serum cortisol and catecholamine levels that are released during periods of stress and depression may affect the pregnancy. In fact, recent research indicates that children of depressed mothers are more likely to have behavioral problems and to exhibit disruptions in cognitive and emotional development. It is important, therefore, for a woman who is suffering moderate to severe symptoms of anxiety and depression during pregnancy to seek professional help. Treatment with therapy and/or medication may be recommended. Depending on whether the woman is in her first trimester, second trimester or last trimester, treatment with medication may be indicated. Untreated symptoms during pregnancy can often be exacerbated during the postpartum period. With treatments specifically designed to respond to symptoms of depression, pregnancy can then become an enjoyable and exciting time in a woman’s life.

For a consultation with Dr. Naomi Greenblatt to discuss your case or other issues relating to depression during pregnancy, please call The Rocking Chair at (201) 308-5325 . At the initial consultation, an assessment will be made and treatment recommendations will be discussed. Risks/benefits of treatment will be presented and we will also discuss a plan for the duration of the pregnancy and the postpartum period.

* Pseudonym