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Addressing Pre-Natal Depression

August 29, 2011

 Discovering that one is pregnant brings exclamations of, “Congratulations!”, and “How joyful!” from friends and families.  As 1 in 4 women experience depression sometime during their lives, it shouldn’t be surprising that 15- 20% of pregnant women experience depression during pregnancy.  But all too often, depression is not diagnosed properly during pregnancy because people think it is just another type of hormonal imbalance. This assumption can be dangerous for the mother and the unborn baby.

Most of us have heard of post-partum depression, but what is depression during pregnancy?  Pre-natal or ante-partum depression, is a mood disorder just like clinical depression. During pregnancy, hormone changes can affect brain chemicals, which are directly related to depression and anxiety. These can be exacerbated by difficult life situations, which can result in depression during pregnancy.  Pregnancy naturally brings on life changes:  moving to a larger home, changes in work schedules, financial pressures, changes in social supports, relationship stresses, fertility issues and others.

As in other life stages, women with depression usually experience some of the following symptoms for 2 weeks or more:

  • Persistent sadness
  • Difficulty concentrating
  • Sleeping too little or too much
  • Loss of interest in activities that you usually enjoy
  • Recurring thoughts of death, suicide, or hopelessness
  • Anxiety
  • Feelings of guilt or worthlessness
  • Change in eating habits

But pregnant women are more likely to under-report their symptoms of depression. They may worry about being judged or labeled as mentally ill,  or they may simply ignore their symptoms because they are expecting to be happy during this “joyful” period.

“I simply feel detached,” reports one depressed mom-to-be. “We planned this pregnancy and I’m so confused, I expected to be happy. But it’s this awful cycle of depression. I feel depressed because I’m depressed.”

Depression that isn’t treated during pregnancy is dangerous to both mother and child. Untreated depression can lead to poor nutrition, poor sleep, lack of exercise, and other unhealthy and/or unsafe behaviors, which can then cause premature birth, low birth weight, and developmental issues in her baby. A woman who is depressed often does not have the strength or desire to adequately care for herself or her developing baby. Babies born to mothers who are depressed may then also be less active, show less attention and are more irritable and agitated than babies born to moms who are not depressed.

If you are pregnant and depressed, please let your health provider know!  She or he can best advise you on the proper care and interventions. 

SmartCare Integrated Behavioral Health, serving rural communities, frequently receives referrals of pregnant women, both very young as well as more mature mothers, who show signs of depression.  They may at times have the additional burden of being isolated in these rural communities.  We have the benefit of partnering with Nurse Practitioners, Nurse Midwives and other health providers to provide a network of integrated care to pregnant and parenting women.  It is our goal, through our Wellness Activities, to provide education and support to these women.  If we can increase their support networks by assisting them in surrounding themselves by caring individuals, as well as connecting them with each other, we hope to see the additional outcome of decreased post-partum depression as well.

Please contact us if you, or someone you know, would like to participate in a support network for pregnant women in Ramona, Campo or Pauma Valley.

Here is a link for a screening tool for Post Partum Depression, also found to be valuable for pregnant women: Edinburgh Post-natal Depression Scale

Some of our patients also qualify for San Diego County’s Nurse-Family Partnership.

As always, we love to hear your ideas for Wellness Activities.  And please take a moment to “like” us on Facebook, so that we reach as many of our community members and partners as possible!

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