Depression and pregnancy

What is antenatal depression?

Pregnancy can be an emotional time. You might feel excited and elated one moment and stressed and unsure the next. This is completely normal. As your body goes through physical changes, it's common for your mood to go up and down.

However, if your low moods or negative thoughts persist and interrupt your daily life, you may be developing antenatal depression.

You might hear the terms antenatal, postnatal and perinatal depression and wonder what the difference is between them:

• Antenatal depression is depression that starts before your baby’s birth.
• Postnatal depression is depression that develops between one month to a year after birth.
• Perinatal depression is depression that starts before, during or after pregnancy and childbirth.

What are the signs of antenatal depression?

The signs of depression during pregnancy are the same as those when depression happens at any other time in your life.

However, it can be harder to recognise the signs of depression when you’re pregnant. This is because some of the challenges of becoming a parent overlap with depression. These are changes in your:

• sleep patterns
• appetite
• thinking and behaviour

Look for help if you've been experiencing signs of depression for 2 weeks or more. You may have symptoms such as:

• feeling low, numb or 'feeling nothing at all'
• feeling helpless, hopeless or worthless
• feeling teary and emotional, angry or resentful towards others
• experiencing unexpected changes in your sleep or appetite
• having a lack of interest or lacking energy to do things
• having thoughts of harming yourself, your baby or other children

What causes antenatal depression?

There are many reasons why people experience depression. You may be struggling with the changes in your life that come with pregnancy and thoughts of the future.

While depression can affect any pregnant person, it may be more likely if you:

• have experienced difficult life events
• have a history of physical, emotional or sexual abuse
• have experienced pregnancy or childbirth-related trauma before
• have a history of depression or other mental health conditions such as anxiety
• have a family history of depression

If you develop depression during pregnancy, it's likely to persist after your baby is born. So it's a good idea to get help now.

There are some tests available that can help you:

• understand whether you’re experiencing symptoms that are common with depression and anxiety
• recognise when to get support

It’s best to do these questions with a doctor. They can give you advice and suggest treatment.

The Edinburgh Postnatal Depression Scale

The Edinburgh Postnatal Depression Scale is a simple checklist that asks about your mental health.

You can find out more about the Edinburgh Postnatal Depression Scale from Beyond Blue.

The Antenatal Risk Questionnaire

The Antenatal Risk Questionnaire is a set of questions. They can help identify aspects of your life that may place you at higher risk of antenatal depression.

Find out more about the Antenatal Risk Questionnaire from the Centre of Perinatal Excellence.

Depression and anxiety in pregnancy

Anxiety and depression often happen together. Up to 1 in 2 people have symptoms of both anxiety and depression at the same time.

People who have depression or anxiety during pregnancy are also more likely to have postnatal depression.

It's common during your pregnancy to worry about:

• your baby's health
• what your birth experience will be like
• weight gain or body shape

As many as 3 in 10 females experience some level of anxiety during pregnancy. Some may have more severe symptoms that need extra support.

Get help if you have the following:

• stress or feeling on edge much of the time
• muscle tension that doesn’t go away
• difficulty staying calm
• recurring worrying thoughts
• feelings of panic or helplessness

How is depression during pregnancy treated?

Antenatal depression is temporary and treatable. If you're experiencing depression, emotional and practical support from loved ones can help you manage. If you need further help, there are effective psychological and/or medical treatments available.

Therapy

Psychological therapy or counselling can help you through perinatal depression. Therapy aims to give you support, education and information on how to understand and cope with depression.

Therapies that have been proven to be very effective in managing depression include:

• cognitive behavioural therapy
• interpersonal therapy

Cognitive behavioural therapy can help you identify negative, unrealistic thoughts about pregnancy and parenting. It then encourages you to challenge those thoughts by approaching your thinking in a different way.

Interpersonal therapy can help you resolve things that may be contributing to your antenatal depression, such as past losses or conflicts.

Medicines

In some cases, your doctor may prescribe antidepressants to help manage symptoms of perinatal depression. Two common types of antidepressants that are used in pregnancy are:

• selective serotonin reuptake inhibitors
• tricyclic antidepressants

Remember to check with your doctor or pharmacist before taking any medicine while you are pregnant or breastfeeding. This includes over-the-counter medicine and supplements. They will be able to tell you what medicines are safe for you and your baby.

Lifestyle changes

If you are experiencing depression during your pregnancy, there are some other things you can do, such as:

• exercising
• eating healthily
• journaling
• getting enough sleep
• spending time with loved ones for fun and support
• practising mindfulness and meditation

Some types of exercise are not recommended during pregnancy. If you’re not sure, talk to your doctor. Be sure to avoid high intensity sports.

Resources and support

If you or someone you know is showing signs of perinatal depression, see your doctor. It’s important to seek help early.

You can also contact any of the following organisations for help:

• PANDA — phone 1300 726 306
• Beyond Blue — phone 1300 22 4636
• Head to Health — phone 1800 595 212

Need to talk to someone?

The Pregnancy, Birth and Baby helpline offers free non-judgmental emotional support during pregnancy and parenting for when you’re feeling anxious or overwhelmed.