Depression in Pregnancy: Why it matters and what you can do

It’s supposed to be a pivotal experience in a woman’s life and one that is filled with joy and anticipation, but worldwide around ten per cent of women experience depression in pregnancy. Antenatal depression as it is clinically known, is not often discussed. Despite advances raising awareness of postnatal depression, the fact of becoming depressed during pregnancy is often overlooked. The problem is even more pronounced in developing countries where around 15.6 per cent of women suffer from depression during pregnancy. These are significant stats that shouldn’t be ignored.

But what can cause depression during pregnancy and importantly, how can you overcome it or manage it, while still doing the best you can for your unborn baby?

Guilt, shame and stigma

The public perception of pregnancy can be at odds with the reality. Bumps, baby showers, shopping for tiny outfits and making the nursery furniture often make up the media image of the perfect happy pregnancy, which can make it even harder for women who are suffering from depression in pregnancy to admit to it. With friends and family overjoyed at your news, or work colleagues excited for your new arrival, there’s a lot of pressure to feel or behave a certain way and depression doesn’t usually come into it.

In fact, one reason why depression isn’t more widely reported during pregnancy is the stigma that still surrounds mental health and the idea that women who are expecting a baby ‘shouldn’t’ be feeling depressed. It’s a big ask, especially when pregnancy is a time of life that is filled with complex changes on every level – emotional, hormonal, physical, mental, practical. I strongly believe that women should feel able to share their inner realities instead of pressure to present a brave face to the world, especially if they’re struggling to cope with depression in pregnancy. As a midwife, I never underestimate the importance of having a good support network and the power of speech to move things forward.

Women who are suffering from depression in their pregnancy can feel racked with guilt about their behaviour or even experience feelings of shame, which goes much deeper, and focuses on the self. This societal pressure and these internal negative feelings can then compound depression.

Why antenatal depression can take hold

Antenatal depression is another form of clinical depression and as with any type of clinical depression it is linked to various symptoms and triggers. There is no one reason why some women experience antenatal depression. For example it can be associated with hormonal changes to adjusting to weight gain and changes in your physical appearance, to coping with a lack of control about your pregnancy. Lots of factors can contribute. Other issues such as a personal or family history of depression, a history of physical abuse, a previous baby loss or fertility challenges, trauma or being in a new house or country – they can all be triggers too.

What are the signs of antenatal depression?

Typically depression in pregnancy presents if you relate to some of the following symptoms:

1. Having a low mood most of the time

2. Lacking in energy or motivation to do things

3. Unable to concentrate or decision make

4. Not getting enjoyment from life

5. Feeling tearful for no specific reason

6. Not enjoying other people’s company

7. Feeling agitated and restless

8. Loss of self-confidence

9. Feelings of guilt or worthlessness

10. Thoughts about self-harm or suicide

These symptoms may present gradually over the course of your pregnancy or may arrive more suddenly. But there are things you can do to deal with depression in pregnancy.

Strengthen your circle

The first and most important thing to do when you discover you are pregnant, is to strengthen your inner circle. I’m always telling my clients to upgrade their inner circle of contacts, friends and people. It’s vital to surround yourself with people who give you energy, positivity, love and support. So do away with people who drain you and those that you don’t feel able to be yourself around. This is especially important if you are feeling depressed. Take stock of the people in your life who enrich it and if you feel able to – share your feelings with them. They will understand and will do what they can to help.

Start with self-care

Antenatal depression can make an already stressful time even more challenging, so prioritising self-care is fundamental. I truly believe that looking after yourself in the best possible way during pregnancy, is helpful in overcoming any challenge. My four selfcare pillars are simple. Knowledge, nutrition, mindfulness and movement. Knowledge is important to feel more comfortable about the changes ahead, but it’s equally important to be able to drown out the ‘noise’ of information overload that isn’t helpful. Ultimately, good knowledge helps you to feel more comfortable and confident.

Nourish your body with the right foods and practice mindfulness in all areas of your life, from what you’re eating, to how you’re feeling, how you spend your time and what is required for your wellbeing.

Finally, movement is especially helpful for depression in pregnancy as it stirs up the happy hormone oxytocin which is great for increasing feelings of positivity. Moving every day will help – whether you do a gentle gym workout, a pregnancy yoga practice or simply go for a walk, movement helps to strengthen your body and give your mind clarity.

Seek support

One of the worst things about depression in pregnancy is how isolating it can be. Women who are expecting but are suffering from antenatal depression can feel incredibly alone and unable to talk about their feelings. Finding someone you love to communicate with will instantly lift a weight from your shoulders and speaking to a health professional is a great option to feel supported and helped through this process. It’s worth remembering that antenatal depression is not rare. It happens a lot more than you might think and medical professionals have encountered it regularly.

Whether you decide to share your feelings with your midwife, GP or another health care professional, they’ll be able to provide you with the help and support you need.

In terms of the treatments available for antenatal depression, there are several main routes which include Cognitive Behavioral Therapy which tackles ways to reprogramme your thinking, Interpersonal Psychotherapy which can help you to resolve issues that may have contributed to your antenatal depression, and antidepressants. You and your chosen medical professional can discuss which route could be right for you.

Finally, remember that it’s ok to need help. No one is judging anyone for depression in pregnancy. Just as some women experience pelvic girdle pain, terrible morning sickness and some don’t suffer at all, some women suffer from depression during pregnancy, so don’t feel that you’re “not allowed”. The most important thing is to seek support when or if you need it because taking care of yourself, is taking care of your baby.

Pregnant? Sign up to Urban Hatch’s online antenatal course, HATCH™  to learn how to approach pregnancy and parenthood with comfort and confidence.