Depression During Pregnancy: Know Your Risks

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Postpartum depression awareness is on the rise, and with good reason — one in nine women deal with it after giving birth. But depression during pregnancy is often still overlooked, even though it happens just as frequently as the postpartum variety.

One of the biggest reasons for this, is that many of the physical symptoms of pregnancy and depression are the same, such as change in appetite, problems concentrating, feeling tired, insomnia, even aches and pains, says Veerle Bergink, MD, PhD, professor in the departments of psychiatry and obstetrics, gynecology and reproductive Science at Icahn School of Medicine at Mount Sinai in New York.

“The complicated thing about depression during pregnancy is that your body is changing so much already,” she says. “You’re already feeling atypical.”

Another complicating factor is that though some practitioners may make a point to ask questions about your mood, depression screening isn’t a routine part of prenatal care. “There has been much more attention to postpartum depression,” Bergink says. “It’s much more common to screen for that than prenatal depression, even though it would actually it be more logical to start screening when women first come into the office during pregnancy.”

Your health history can increase the likelihood you’ll develop depression during pregnancy, so knowing your risk going in can help you be on high alert. The biggie? Previous rounds of depression or anxiety. “The number one risk factor for both depression during and after pregnancy is women who have had a mood episode before,” Bergink says.

Thyroid disorders can up your chances, as can illness, preeclampsia, or finding out about abnormalities on an ultrasound. Nonphysical risk factors include financial problems, history of trauma or sexual abuse, an unstable relationship, or an unwanted pregnancy.

Though realizing you’re dealing with depression can be a hurdle, Bergink says once you do, it’s very treatable. “Because all medication passes through the placenta, we prefer to look for nonmedication options first, such as exercise, and behavioral changes through psychotherapy,” she says. But for more serious bouts, medications like antidepressants can be safe options.

Also key to both recognizing and working through depression: being open and honest about how you’re feeling. “So many women feel guilty, especially during pregnancy, because they think they should be feeling happy,” Bergink says.

But, she says, depression isn’t something you choose to have, and you can’t blame yourself for having it. The more women share their struggles, the less hidden prenatal depression will be.

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