Pregnant

Antenatal depression: When your bump brings the blues

“When my pregnancy was confirmed at 12 weeks, my partner was over the moon, but I was more nervous than excited. I thought it would just take some time for the news to sink in, but I couldn’t seem to work up any real enthusiasm. In fact, my overwhelming feelings at the time were irritation and exhaustion.

"And to make it worse, every time someone congratulated me, I felt guilty. If I couldn’t get excited about the pregnancy, what kind of mother was I going to be?”

Abi Zondi’s recollection of her early pregnancy may seem at odds with the usual rosy glow that’s supposed to accompany the happy news of a new baby, but it’s actually quite common.

Although it was thought for years that pregnancy hormones protected women against the onset of depression and anxiety (at least until the baby was born), it’s now known that about 2 in 10 women experience bouts of depression during their pregnancy, and some of them require medication.

“I read everything I could get my hands on when I first found out that I was pregnant,” Abi says. “So, I was aware that the rapid increase in my hormone levels were making me moody. I tried not to worry too much, because I thought my negative feelings were temporary, and that they would go away as the pregnancy went on.”

Clinical psychologist Thandazile Mtetwa, who practises at Ngezwi Psychological Services in Gauteng, says, “It may be difficult to know when the person is experiencing depression, as most of the depression symptoms tend to be associated with the normal changes that occur in any healthy pregnant woman. But, when these symptoms are interfering with your daily functioning, and there’s a combination of at least three of them over a continuous period of two to three weeks, you need to seek medical help.”

Symptoms of possible depression during pregnancy

  • Feeling of sadness or emptiness
  • Feeling like something bad is about to happen
  • Sleeping too much or battling to sleep
  • Increased irritability, agitation and excessive crying, OR, feelings of numbness (not getting upset by things that used to upset you)
  • Loss of enjoyment in things that used to be enjoyable
  • Always feeling tired
  • Wanting to eat all the time, or not wanting to eat at all
  • Feelings of excessive or unwarranted guilt
  • Thoughts of self-harm (suicide or self-mutilation)

What causes depression?

There are many factors that contribute to depression: personality, brain chemistry, lifestyle, and, even the weather. And although anyone can fall prey to depression at any time, there are some specific factors that could trigger depression during pregnancy, a major one being a personal history of depression.

Importantly, if you’re taking medication for depression and then find out you’re pregnant, don’t stop taking it or taper it down. “This can cause you to relapse, which could prove harmful to your baby,” says Thanda. “You need to speak to your psychiatrist, who knows your history and will know what will work best for you.”

Other triggers for depression during pregnancy include:

  • A family history of depression
  • Hormone imbalances, sometimes as a result of fertility treatment
  • Previous difficult pregnancies, or miscarriage
  • A difficult pregnancy, such as one that requires lots of bed rest
  • Unplanned parenthood, particularly if you’re very young and/or single and without a support system, or are in a dysfunctional relationship
  • Stressful life events, such as a big move, losing a job, or a death in the family

How can you deal with depression in pregnancy?

Knowing what the possible triggers are for depression in pregnancy, and if you’re prone to any of them, is your first step. The next one is to take very good care of yourself, in order to give yourself the best chance of remaining emotionally and physically healthy throughout your pregnancy

“Exercise, healthy eating, sleep and positive thinking raise serotonin levels,” says Thandazile. Serotonin is a chemical neurotransmitter that’s manufactured in the brain, and influences brain cells related to mood, appetite, sleep, memory and learning, and some social behaviour – many of the things that make us happy or unhappy.

That said, it’s very important to understand that depression and anxiety aren’t conditions a person ‘brings on herself’ or a state of mind she can ‘snap out of’; they’re biochemical conditions that may require counselling or medication. 

“For mild to moderate depression, counselling alone may be enough,” says Thandazile, “while for severe depression, a consultation should be made with a mental health care worker like a psychiatrist or psychiatric nurse, so that they can prescribe suitable medication in addition to counselling.”

When it comes to antidepressants, don’t try to treat yourself by taking St John’s wort or other ‘natural’ remedies – the safety of these during pregnancy is unknown, and they’re not a substitute for professional help.

In fact, the long-term effects for even prescribed antidepressants during pregnancy haven’t been fully researched, although short-term studies indicate that they pose very little risk to the growing baby. “The safest thing to do if you suspect that you’re depressed is to consult your healthcare provider, because situations and risks for each person differ,” says Thandazile.

Abi, now the proud mom of a healthy, happy 5-month-old, says that getting professional help during her pregnancy made all the difference. “I had to get my mind around the fact that seeing a therapist wasn’t a sign of weakness, but a positive and necessary step to keep myself and my baby healthy.”

Ups and downs…

These conditions, on either side of depression, can also affect a pregnant woman.

Bipolar disorder

This is a serious condition characterised by cycles of depression, alternating with periods of abnormally high spirits that include increased activity, little need to sleep or eat, racing thoughts, inappropriate social behaviour or poor judgment. It requires immediate medical attention.

Anxiety

Sometimes a precursor to full-blown depression, feelings of anxiety can include very intense worry about your or your baby’s health, or panic attacks that come on without warning and sometimes make you feel as if you’re having a heart attack.

Can your diet help ward off depression?

A recent study by Chinese researchers, which collated information from 26 individual studies conducted since 2001, showed a definite link between the consumption of fish and a reduction in the risk of depression. One possible explanation is that the Omega-3 fatty acids found in fish may be key in the activity of serotonin and dopamine (another signalling chemical in the brain involved in depression); another is that people who eat a lot of fish may have a healthier diet in general, which in turn could help their mental health.

By contrast, another study, this one conducted by UK researchers, showed that people with a diet high in processed food had a 58% higher risk of depression than those who ate very few processed foods, while those who ate the most whole foods had a 26% lower risk of future depression.

Unfortunately, sometimes people use food as a means to cope with depression, or just to feel better. And, often, the foods they turn to – those high in saturated fat, sugars and heavily processed ingredients – have the opposite effect.

Whatever the cause and effect, the message is clear: a diet high in whole foods (including fish), vegetables (including dark leafy greens like spinach and kale), nuts and seeds, and fruits (especially berries) is far preferable to one swimming in sugar and fats.

Keep moving

Exercise during pregnancy doesn’t only help ward off feelings of anxiety and depression. It also improves sleep, reduces aches and pains, strengthens muscles, builds endurance, and makes it easier to get back in shape after your baby is born.

Walking, swimming, low-impact aerobics and dancing (that doesn’t involve leaps, jumps or twirls) are all excellent exercises for pregnant women. Yoga, stretching and weight training (all under proper, professional supervision) are also great for maintaining muscle tone, keeping limber and boosting your mood.

Need help?

  • SA Depression & Anxiety Group (SADAG) 0800 20 50 26, www.sadag.org
  • Families South Africa (Famsa) 011 975 7106/7 (phone for an office near you), www.famsaorg.mzansiitsolutions.co.za
  • Mental Health Information/Suicide Crisis 0800 567 567 or SMS 31393
  • The SA Federation for Mental Health 011 781 1852 or email info@safmh.org

Are you struggling with depression during your pregnancy? Tell us by emailing to chatback@parent24.com and we could publish your story. Do let us know if you'd like to stay anonymous.  

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