Depression before birth

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SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.
Also visit the online treatment locator.

SAMHSA’s National Helpline, 1-800-662-HELP (4357) (also known as the Treatment Referral Routing Service), or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.

Also visit the online treatment locator, or send your zip code via text message: 435748 (HELP4U) to find help near you. Read more about the HELP4U text messaging service.

The service is open 24/7, 365 days a year.

English and Spanish are available if you select the option to speak with a national representative. Currently, the 435748 (HELP4U) text messaging service is only available in English.

In 2020, the Helpline received 833,598 calls. This is a 27 percent increase from 2019, when the Helpline received a total of 656,953 calls for the year.

The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.

The service is confidential. We will not ask you for any personal information. We may ask for your zip code or other pertinent geographic information in order to track calls being routed to other offices or to accurately identify the local resources appropriate to your needs.

No, we do not provide counseling. Trained information specialists answer calls, transfer callers to state services or other appropriate intake centers in their states, and connect them with local assistance and support.

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Last Updated: 08/30/2022

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Depression during and after pregnancy: why it occurs

Ekaterina Barskaya

GMS Clinic doctor, perinatal psychologist

When a woman makes a decision for herself that she will be a mother, changes gradually begin in the body both at the physiological and psycho-emotional levels. There is an adaptation to new sensations, roles, status. Their acceptance by a pregnant woman and her reaction to changes will depend on many factors: age, social, religious, personal characteristics and life experience. nine0006

Today we will talk about the symptoms of depression and the importance of a stable psychological state of expectant mothers with Ekaterina Sergeevna Barskaya, a GMS Clinic doctor and a perinatal psychologist with 20 years of experience.

Does prenatal depression really happen and why does it occur?

Yes, this really happens. The first pregnancy is exciting in itself. I want everything to be not only correct, but completely perfect. However, the flow of information or someone else's experience, which is often negative, causes a defensive reaction - anxiety, which in turn forms uncertainty in one's thoughts and actions. nine0006

There is such a natural fear as the instinct of self-preservation, and not a single desired pregnancy was without fear for oneself and for the child - this is natural!

Each stage of pregnancy has its own challenges and difficulties. And how sensibly the state and feelings will be accepted depends largely on the woman herself.

The first trimester is the realization and acceptance of the very fact of future parenthood. There is a reassessment and a change in lifestyle, habits, regimen, taste preferences. The body is rebuilt, new functions appear that were not previously known. Symptoms of toxicosis, irritability and drowsiness are frequent companions of the first period. Here it is important to learn to listen to your body and satisfy the need for rest. nine0021
In the second trimester there are noticeable changes in the body. Feel the movements of the child. From that moment on, attachment is formed, acceptance of another life inside your body.
The third trimester is preparation for childbirth. As practice shows, the more anxious a woman feels, the more information about childbirth she tries to find. Sometimes this leads to even more stress and anxiety.

Imagine a person decides to jump with a parachute. He ground himself with theories about the opening mechanism of the dome, about air currents, about the correct grouping, etc. But it's still scary. You can refuse to jump. But childbirth - will be! Knowing about the future is good, but emotions are sometimes stronger than rationality. Therefore, the most important thing is to believe in yourself, in your body, in your child. If you become pregnant, carried a baby, then the body knows what to do next. We must listen to him and support him. nine0006

Before childbirth, the body concentrates inward, as if accumulating strength. Therefore, expectant mothers become more passive, sleepy, sometimes aloof. This is physiologically understandable - they need a sufficient amount of the hormone oxytocin. And the adrenaline released into the blood during stress destroys it. That is why special attention is paid to the regime, sparing lifestyle and information hygiene.

Are there prerequisites for the onset of prenatal depression?

Unfortunately, the number of depressive states is growing in the modern world. Studies show that women are 3 times more likely to be affected than men. One of the reasons is a brighter psycho-emotional background. nine0006

Depression in pregnancy can be caused by a variety of factors:

heredity;
fear;
unresolved conflicts;
internal rejection of future motherhood;
unwanted pregnancy;
financial and domestic difficulties;
excessive demands on oneself, when it is necessary to do everything, control everything and be an ideal mother, wife, employee, etc. nine0021

Prenatal depression is not just a bad mood. This is a persistent, weeks-long state of anxiety, sadness, and pessimism. It can provoke not only psychosomatic diseases, but also premature birth.

Correct and timely diagnosis of the mental state can reduce the risk of developing depressive tendencies during pregnancy, and thus prevent postpartum disorders.

It is important to pay attention to the mood of the expectant mother in time. Of course, patience and care are needed from others. A more trusting and warm relationship will help to avoid difficulties. nine0006

What happens to a woman's emotional state after childbirth?

After childbirth, a woman expects a surge of emotions and tenderness. But this is not always the case. Maternal feelings do not turn on on click. The expectations of others that a young mother is happy, feels and understands the child are often not justified. A woman may experience regret and even guilt. It's okay, it happens!

Even in the maternity hospital, you can experience unpleasant sensations: the so-called "baby blues" or depressive syndrome. 85% of young mothers face it - this is due to hormonal changes in the body, it starts 3-5 days after birth and lasts from 2 days to two weeks. Usually it does not require any intervention and goes away on its own. If, over time, the psychological state of a new mother causes concern, and the process of adapting to a new role is not going as expected, pay attention to the following signs: nine0006

tearfulness and sadness for no particular reason;
reduced emotional background;
irritability;
apathy;
lack of emotional reaction to what is happening in life;
poor sleep, appetite;
absent-mindedness.

All of these are warning signs. The main burden will fall on the shoulders of the partner, because he plays the role of "first violin", providing the necessary support and attention. After the birth of a child, a crisis often occurs in family relationships, and it will take time to adapt. The passage of this period will depend on how much parents understand and support each other. nine0006

How to help a young mother?

Support and care are different:

Give mom a chance to rest and sleep.
Take charge of household and domestic duties.
Have a weekend - give a young mother the opportunity to get out of the house, go to a manicure, a beauty salon, meet her friends.
Find an opportunity to communicate. It can be a motherly chat where you can discuss all the complexities and difficulties of motherhood, see that what is happening is normal. nine0021
Don't give up on your own desires. Remind mom sometimes to do something for herself: let her choose her favorite foods for dinner, do not forget about her TV shows, books and hobbies.
Listen to the emotional state. Create an environment in which you can cry, complain, or yell into a pillow, for example. It helps to relieve tension and throw out the accumulated negative emotions.

Don't be afraid to ask your mom for help from a specialist. It can be a psychologist, neurologist, psychiatrist. They will be able to provide additional support in difficult times. nine0006

And yet: is depression a physiology or a psychology?

This question is often asked. In my opinion, this is a single system. At the biochemical level, depression looks like an imbalance in the cerebral cortex: serotonin, dopamine and norepinephrine. These are neurotransmitters that transmit impulses to our neurons and are involved in the regulation of mood and behavior. This is physiology.

But when there is a reaction, psychology comes into play. We feel → react → give feedback to what is happening. As the saying goes: "When the soul cries, the body also suffers." Everything in our body is interconnected. Both psychology and physiology. Influence can have features of the nervous and endocrine systems, heredity. nine0006

Try to always listen to yourself and do not be too self-critical. When a child is born, it is important for him to see an emotional response from his parents. Especially mothers are the information reading systems of this world. Be supportive of yourself and your child.

possible causes, symptoms and treatment

Prenatal depression is one of the causes of poor health of a pregnant woman. And it would seem that what can overshadow such a magical time for any woman? I am sure that each of the expectant mothers will find an excuse for herself, without becoming aware of the real reasons for this unpleasant phenomenon. And yet, where does depression come from during pregnancy and how does it manifest itself? nine0006

General characteristics of the condition

There is a misconception that depression in pregnant women occurs only immediately before childbirth. But it's not. She can accompany a woman throughout her pregnancy, and each stage of childbearing has its own characteristics.

Some signs of blues are associated only with hormonal changes in the body of a woman, and therefore they are considered as a temporary and passing phenomenon, while others may be of a more complex nature. Therefore, depression during pregnancy is treated differently depending on the period of gestation. nine0006

Prenatal symptom: the onset of labor is close

The mother-to-be actively and in advance prepares for the onset of labor. What she needs to know in order to...

First trimester

Psychologists refer to this period of pregnancy as the "period of denial". It is especially characteristic of women who do not have an unpleasant symptom - toxicosis. The period of denial is characterized by a woman's unwillingness to take into account her interesting position and change her daily lifestyle.

The emotional background of a woman in the first trimester of pregnancy

Mood swings, nervousness and aggressiveness are quite normal for this stage. Many men notice that their pregnant wife becomes cold towards them. Not taking into account the fact that the body of a woman in this period is experiencing tremendous stress. This can cause disagreements in the family, which, in turn, can provoke the appearance of a depressive state in a woman. nine0006

Types of depression: signs, treatment

Depression is difficult to predict. Its appearance may be connected not only with...

It is worth paying close attention to the emotional state of a pregnant woman when the general symptoms of melancholy are of a protracted nature. If a man smooths out all the critical moments in relations with his wife and sets her in a positive way, then the first trimester of pregnancy will pass without incident.

Second trimester

At this stage of pregnancy, the belly is already actively growing, so every day a woman begins to become more aware of her situation. Moreover, as a rule, this awareness is associated with thoughts about how she will have to change her usual life, what she will have to give up and what she will have to sacrifice for the sake of the child.

During this period of pregnancy, many begin to look for new hobbies and change their lifestyle. Some begin to knit, others draw, others enroll in culinary courses. In this trimester of pregnancy, the risk of falling into a depressive state is the lowest. nine0006

However, those women who are acutely experiencing physical changes in the body (growing belly, pain in the lower back, joints, etc.) may experience certain mental abnormalities. The physical and psychological state of a person are very closely related. Therefore, those women who experience certain inconveniences in connection with their new position should pay more attention to sleep and rest.

Third trimester: prenatal depression

The third trimester is the most dangerous period in terms of emotional and psychological disorders. Women in the last months of pregnancy are already fully aware of their situation and imagine their upcoming lifestyle in colors. And, as a rule, it does not seem too rosy to them. nine0006

Depression before childbirth may occur due to a woman's internal fear of becoming a housewife. Many invest in this concept eternal cooking, washing diapers, mountains of dirty dishes and all the other delights of home care.

This condition is so common that it is already "recorded" in prenatal symptoms. At the end of the term, the woman is already tired both physically and emotionally. It is hard for her to do everyday things, so she spends most of her time lying or sitting on the couch. Such fatigue affects the behavior of a woman even more, so most often she seeks to retire and consider the correctness of her decision to become a mother. Without serious support from loved ones, this condition can drag on, which is very dangerous. After all, the birth of a child awaits her ahead, and prenatal depression can prevent a woman from tuning in to the upcoming difficulties. Let us dwell in more detail on the characteristics of this state. nine0006

Causes

The first thing to understand is where prenatal depression in pregnant women comes from. The causes of occurrence can be very diverse. The fact is that during pregnancy, the hormonal background of a woman changes dramatically, so she reacts more sharply to everyday life difficulties than before. But among the most common reasons for the development of prenatal depression are the following:

Conflicts in the family. Close relatives need to clearly understand that a pregnant woman reacts very sharply to all conflict situations, especially if they are somehow related to her position. Protracted quarrels can cause the development of prenatal depression. nine0021
Financial difficulties. Before an important event in life, all women experience the so-called nesting effect. If the expectant mother, due to her financial capabilities, cannot purchase all the things that, in her opinion, are necessary for the child, then she falls into a depressive state.
Unhealthy lifestyle. It has been observed that women who lead an active lifestyle, eat regularly and fully, and observe a sleep and rest regimen, are less susceptible to such a condition as prenatal depression. nine0021
Bad habits. Nicotine, alcohol and drug addiction is a direct path to the onset of a painful condition before childbirth.
Fear of future status. Even if the appearance of a child in the family is a planned event, this does not guarantee that the woman will not begin to doubt the correctness of her decision. Especially acutely these doubts begin to torment her in the last days before the birth. Therefore, in such a situation, a man needs to understand that his pregnant wife requires special attention. nine0021
Difficult pregnancy. When the pregnancy is unfavorable and a woman periodically has to go to the hospital under the supervision of doctors, she experiences a lot of negative emotions, such as fear, despair, weakness, and so on. Ultimately, all these negative emotions can develop into prenatal depression.

Knowing the cause, it is much easier to deal with it. As a rule, cases in which it is impossible to do without the help of a qualified specialist are extremely rare. nine0006

Symptoms

Like any other disease, prenatal depression has its own symptoms. Many people take very important signs lightly and attribute them to a bad mood, but this is fundamentally wrong. It is much more difficult to deal with a neglected form of a psychological disorder than with its first manifestations.

Common symptoms of prenatal depression include:

increased irritability;
tearfulness;
long alarm condition;
absent-mindedness;
concentration loss;
constant feeling of hunger or, conversely, lack of appetite;
feeling of lethargy, fatigue, detachment;
drowsiness;
feelings of guilt, fear, hopelessness;
lack of sleep;
panic fear of childbirth;
self-doubt and self-doubt.

Many of these symptoms are considered completely normal during pregnancy. For example, a huge number of pregnant women experience a constant feeling of hunger, while not suffering from this disorder. It is worth considering that one symptom cannot be a cause for concern, but a combination of several signs of the disease can be a reason to contact a specialist. nine0006

How to cope with prenatal depression yourself

If the symptoms of a painful condition are not so pronounced and are intermittent, then you can try to cope with it yourself. Here are a few ways to help drive away a negative mood:

You can get rid of bad thoughts with the help of your favorite thing. It can be cooking, drawing, reading - anything, as long as it brings positive emotions to a woman.
Make a clear daily routine and strictly adhere to it. If you follow a clear daily routine, then a pregnant woman simply will not have time to be distracted by her own experiences.
Exercises for pregnant women can not only prepare the expectant mother for the upcoming birth, but also cheer her up.
The main enemy of a woman with symptoms of prenatal depression is loneliness. Therefore, she needs to avoid him by any means. You should spend more time with friends, family, colleagues, and not quietly wait for your husband from work within four walls. nine0021

Many pregnant women for some reason are afraid to share their experiences with their loved ones. But this is fundamentally wrong. If a woman is overwhelmed with negative emotions, she must definitely seek help and support from people close to her.

When to consult a specialist

When a woman's prenatal condition causes concern not only for herself, but also for those around her, it is worth thinking about qualified assistance. Close people of a pregnant woman should be alerted by the following signs:

panic fear of motherhood;
apathy towards everything that is happening;
forcing feelings of guilt and hopelessness;
indifference to intimate life with her husband;
sudden decrease or increase in body weight;
talking about death or suicide.

Prenatal depression is treated by family psychologists. Depending on the complexity of the psychological disorder, different methods of therapy are used, including pharmacological ones.