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Depression in the Prenatal Period

Updated: Apr 25, 2021

Depression is a mental health disorder characterized by persistently depressed mood or loss of interest in activities, causing significant impairment in daily life. Depression can lead to a range of other behavioral and physical symptoms such as: changes in sleep, appetite, energy level, concentration, daily behavior, or self-esteem. Depression can also be associated with thoughts of suicide. Approximately 14-23% of women will experience depressive symptoms during their pregnancy.


Signs & Symptoms of depression

  • Feeling isolation, despair, worthlessness

  • Fatigue prior to pregnancy

  • Insomnia (inability to sleep)

  • Multiple somatic complaints/symptoms

  • Weight changes (often loss) unrelated to pregnancy

  • Limited eye contact

  • Flat general affect

  • Suicide ideation


Untreated depression in pregnancy can lead to decreased prenatal care, inadequate weight gain, poor nutrition, substance abuse, self-harm, preterm birth, preeclampsia, suicide ideation & suicide, postpartum depression, fetal growth restriction, low birth weight, fetal developmental problems, increased mental health problems for baby and other behavioral complications.

Early detection of depression during pregnancy is critical to help prevent the outcomes list above. Pregnant women should be screened for depression at the first prenatal visit, second and third trimester throughout their pregnancy. This is usually done by gathering data about signs and symptoms of depression or by formalized depression inventories. If you feel you have severe depression or have thought of ways to harm yourself or others, please contact your healthcare provider right away.


Management of Depression in Pregnancy


A variety of non-pharmaceutical methods can be effective against depression. These can be used alone or in combination with pharmacological interventions. Some of these methods include:

  • Cognitive-behavioral therapy (CBT) (a form of psychotherapy and is essential part of a successful depression treatment)

  • Light therapy (sitting in front of a special light box for about 30 min. Every day can alleviate symptoms of depression)

  • Interpersonal therapy

  • Supportive therapy/ Support groups

  • Mind-body modalities

  • Massage therapy (shown to improve the mood, reduce anxiety, and improve perinatal outcomes)

  • Yoga/exercise (improve depression symptoms)

  • Supplementation (Omega 3 fish oil up to 3,000mg daily; folate 400 mcg a day; 2000 IU daily of vitamin D; 300mg of elemental Magnesium ones a day; Probiotics, such as Lactobacillus and Bifidobacterium have all been found to aid in preventing depression/anxiety)

  • Nutrition (Eat healthy fats, coconut oil; high-protein diet, avoid caffeine/stimulants; Avoid skipping meals)


Some Pharmacological Methods include:

Selective serotonin reuptake inhibitors (SSRIs) antidepressants are an option during pregnancy including citalopram (Celexa) and sertraline (Zoloft). The benefits and risks of medication should be discussed with your care provider. Starting at a low dose and slowly razing it until remission is achieved is usually the recommended approach.


Want More Information?

Sources for Light Boxes

Cognitive Therapy

Interpersonal Psychotherapy

References

Center for Disease Control and Prevention. (2020). Depression during and after pregnancy. Retrieved from https://www.cdc.gov/reproductivehealth/features/maternal-depression/index.html


Jordan, R., Farley, C., & Grace, K.T. (2019). Prenatal and postnatal care: A woman-centered approach (2nd ed.). Hoboken, NJ: Wiley.


Mayo Clinic. (2019). Depression during pregnancy: You’re not alone. Retrieved from https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/depression-during-pregnancy/art-202


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