Pre-partum depression

It happens in 10-15% of pregnant women. And it is far less likely to be properly diagnosed or treated than post-partum depression. Know that if you’re depressed during your pregnancy, it’s normal, and that you can get help for it. Talk to a friend, to your doctor or midwife, join a group, do what you need to do to help yourself and your baby. I’ve had this affliction with the first two pregnancies and it’s kicking in early with this one. Frustrating to say the least. At least I’m at a point where I can expect it, know what to look for, and can fight back.

Pre-partum blues
Depression symptoms pose risk to mother and fetus

One in five pregnant women may be experiencing symptoms of depression, but few are getting help for it, a new University of Michigan study finds.

And those with a history of depression any time before their pregnancy – about one in every four women – are about twice as likely as other women to show signs of depression while pregnant, the study results show.

A study of 3,472 pregnant women, conducted by researchers from the U-M Depression Center in the waiting rooms of 10 Michigan obstetrics clinics, was published last year in the Journal of Women’s Health.

And recently the U-M team presented new results at the American Psychiatric Association’s annual meeting, showing that many pregnant women with depression aren’t being treated. And even if they are taking antidepressants, the doses are likely to be too low to help much.

Growing scientific evidence suggests that hormone imbalances associated with depression can affect the fetus or put a woman at higher risk of post-partum depression. Population-based evidence has also shown that babies of depressed mothers do worse at birth, and beyond, than other infants.

“A woman’s childbearing years are also her highest-risk time for depression. Doctors used to think of pregnancy as a ‘honeymoon’ away from depression risk, but this is turning out to be a myth,” says lead author Sheila Marcus, M.D., a clinical assistant professor of psychiatry at the U-M Medical School. “We now know that the hormones and brain chemistry involved in depression are known to be affected by changes in other hormones related to pregnancy. And we know this may affect the fetus.”

Studies have shown that babies born to depressed mothers have lower birth weights, higher risk of premature birth and birth complications, delayed cognitive and language development, and more behavioral problems. Scientists are beginning to speculate that these effects may be due in part to the unbalanced sea of hormones and reduced blood flow that these fetuses are exposed to in the womb. Even minor depression, Marcus notes, may affect the fetus.

Fortunately, Marcus notes, recent studies have shown that some standard depression treatments – including some antidepressant drugs – do not appear to increase the risk of birth defects. A few longer-term studies suggest that infants exposed to some antidepressants in pregnancy look very similar to their siblings who are not exposed, both in terms of IQ and learning problems, when compared at age 5. But she notes that more work is necessary in this area.

She and her colleagues hope their study will help raise awareness among pregnant women, and their doctors and midwives, about the need to recognize depression symptoms and seek treatment.

Explains Marcus, “We need to educate women about the signs of depression, and encourage them to be open about how they’re feeling during pregnancy and after delivery, rather than feeling guilty and embarrassed.”

Medications and psychotherapy can regulate the stress hormones and other brain chemistry involved in depression, helping alleviate women’s symptoms, improve their quality of life, and reduce their chances of debilitating post-partum depression, self-harming acts, and suicide.

The U-M Depression Center, has launched a website about depression designed specifically for women, www.med.umich.edu/womensguide. The site recognizes that one in four women will experience depression sometime in her life, and that hormone-related life transitions such as puberty, pregnancy and menopause are strongly associated with an increased risk.

Special note:
If you or someone you know is experiencing symptoms of depression during pregnancy or after delivering a baby, it’s important to tell a medical professional such as your doctor or nurse midwife. Treatment, including talk therapy and medications, can help lessen symptoms for the mother and reduce the impact on the baby. Click here for a list of resources that might help.

Resources:

U-M Depression Center
http://www.med.umich.edu/depression

A woman’s guide to understanding depression
http://www.med.umich.edu/womensguide

U-M Depression Center: Depression Related Resources
http://www2.med.umich.edu/psychiatry/umdc/resourcesrch.cfm

http://www.bellybelly.com.au/pregnancy/ante-natal-depression