| Antenatal depression
Depression during pregnancy is more common than we think. Jane Bartlett investigates this lesser-known aspect of pregnancy and says that women needn't suffer in silence We've all heard of post-natal depression, but few people are aware that women can become depressed during pregnancy too. New research published in the British Medical Journal suggests that antenatal depression may be even more common than depression after the baby is born. The study looked at 9,000 pregnant women and used a clinically approved scale for measuring depression. It was revealed that nearly 12 per cent of women were depressed at 18 weeks, rising to 13.5 per cent at 32-weeks. After delivery the women seemed to get happier. Depression rates dropped to 9.1 per cent at eight weeks after birth, and 8.1 per cent at eight months. That elusive bloom A commonly held view is that women bloom during pregnancy, but it's not always the case, according to Dr Jonathan Evans from the University of Bristol, who led the study. GPs. Health visitors and midwives are all trained to look out for post-natal depression, which is thought to affect one in 10 women to varying degrees. In contrast research into depression during pregnancy has been minimal because their condition was thought to protect women against despondency. Dr Evans believes that more research is now urgently needed to investigate possible treatment. The research is not unique - a handful of other studies, some dating as far back as the 1960s, have suggested that pregnant women may be vulnerable to depression. So why haven't we heard more about it? Women may accept their raging emotions as part of the excitement of being pregnant, suggests Heather Welford, author of The Book of Post-natal Depression (National Childbirth Trust, #5.99). Mothers may not recognise the nature of their feelings or may explain it to themselves as being anxious, tired or lonely. Why do women get depressed during pregnancy? Hormonal changes are one possibility, but there's not enough research to say conclusively that this is a factor. It is known that you can become depressed when you feel ill, so health problems during pregnancy can have an impact. 'Trying to find out why women become depressed when pregnant is problematic,' says Welford. 'If you take any group of women at any time in their lives, there's going to be a substantial number who are depressed. Pregnancy is another major life change associated with depression. If someone close to them dies, if their marriage breaks up or they have financial difficulties, they are at risk of depression. It shouldn't be surprising that some women are depressed when pregnant.' Who is at risk? Those who have unplanned pregnancies might feel unhappy about their situation. If you feel lonely and unsupported during your pregnancy, you are at risk of becoming depressed. Relationship and financial problems will all add to your emotional load. If motherhood made your own mother depressed, you may have very ambivalent feelings about becoming a mother yourself. If you feel that you have to make a lot of sacrifices for your child, like giving up a career you love, then there is bound to be some sadness. Research shows that women who have a previous history of mental health problems are more likely to suffer from antenatal depression. Antenatal depression also makes you more at risk of post-natal depression - 23 per cent of those who have post-natal depression first become depressed during pregnancy. How does it affect the baby? The possible adverse affects of post-natal depression on a baby are well documented, and can include neglect and emotional and behavioural problems. It is less clear what impact depression before delivery day might have on a growing foetus, if any. One study has shown that distress in late pregnancy may be associated with preterm delivery. Psychiatrists have noted that stress and anxiety felt by a mother do have an impact on an unborn baby's heart rate patterns. There is however not enough research to know whether there are any significant consequences for the growing child. 'I don't think people should feel worried about the impact it might have on the baby, as this could only make their depression worse', reassures Heather Welford. 'I haven't come across any research which shows there's going to be an effect'. Treatment If you are feeling depressed, you needn't feel helpless. Although taking drugs isn't desirable, there are some antidepressants that doctors can safely prescribe. 'The benefits may outweigh the risks for women with severe depression', says Dr Evans.Counselling is a very safe option, or simply talking through how you feel with friends and family. Cutting yourself off from the world is not an option, however tempting; it'll make you feel worse. Make the effort to reach out to others and get the help you need. Symptoms The symptoms are very similar to any other depression. Mental health charity Mind suggests this checklist:
If you feel that you are slipping into depression, get help fast. Your GP is the first point of call, and he or she will refer you to a specialist or counsellor if appropriate. |