New motherhood comes with a wide variety of new experiences, from pregnancy acne and hair loss (yes, you can experience hair loss during pregnancy) to mental health conditions.
Pregnancy and giving birth can affect many women's mental health, causing various conditions from anxiety disorders to different types of depressive disorders. If you’re expecting, you may have even heard the term “maternal depression.”
Many new or expecting mothers who want to ensure they’re doing everything to keep their babies healthy may wonder what maternal depression is and if they’re dealing with this condition. This guide will define what maternal depression is in addition to its causes, symptoms and treatment options.
Maternal depression describes the various mood disorders that affect women throughout pregnancy as well as one year after giving birth.
Depression (or major depressive disorder) isn’t just feeling down or sad periodically —it’s a common and serious mood disorder that typically lasts for months and interferes with everyday life and makes daily tasks more difficult.
Depression is also different from a condition known as the “baby blues”. Baby blues are the mild changes in mood women experience after giving birth. 70 percent to 80 percent of all new mothers experience a change in mood after giving birth.
The symptoms of baby blues — which differ from major depression — are feelings of anxiety, worry or unhappiness typically experienced in the first few weeks or even days after delivery. Maternal depression lasts longer and feels more intense.
There are different types of depressive disorders as well as different types of maternal depression, which we’ll cover below.
Perinatal depression — also referred to as peripartum depression — is depression that occurs during or after pregnancy.
Perinatal depression includes two subtypes of depression: prenatal depression (which occurs before giving birth) and postpartum depression (which occurs after giving birth). Perinatal depression occurs while pregnant or within four weeks after giving birth, according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5).
Postpartum depression is depression that occurs in a mother after the birth of a child, even up to a year after giving birth (also known as the postpartum period). Similar to other depressive disorders, postpartum depression can interfere with your day-to-day life, including caring for your newborn.
The Centers for Disease Control and Prevention (CDC) has said that around one in eight women experiences symptoms of postpartum depression. Mothers can also experience anxiety disorders while pregnant or after delivery.
A rare but extremely severe form of maternal depression, postpartum psychosis affects about four out of 1,000 new mothers in the postpartum period.
Postpartum psychosis typically develops within days or up to six weeks after delivery. Although rare, this depressive disorder is a serious psychiatric emergency and requires immediate medical attention from healthcare providers.
Maternal depression, like other depressive disorders, can be brought on by a number of factors, from hormones to past trauma and more. However, nothing the mother does brings on maternal depression.
Hormone levels go through drastic changes during pregnancy and birth, potentially causing maternal depression.
The female hormones estrogen and progesterone are at their highest levels ever when you’re pregnant. After delivery, hormone levels quickly drop back to pre-pregnancy levels. This drastic change could lead to postpartum depression.
While a lot is unknown about the exact cause, genetics could play a role in whether a new mother develops maternal depression.
Serotonin, dopamine and norepinephrine are thought to regulate mood and happiness. Genes that affect the production of these neurotransmitters — in particular, the 5-HTTLPR gene — may impact their activity, leading to an increased risk of developing depression.
Past mental health conditions could also affect whether you develop maternal depression. Past depression, previously experienced postpartum depression, premenstrual dysphoric disorder (PMDD) or bipolar disorder all put women at a higher risk for depression.
Those with bipolar disorder or a history of other psychiatric disorders are more at risk of developing postpartum psychosis.
Certain lifestyle or health conditions can also put pregnant women at risk of depression. Complicated pregnancies such as a difficult delivery or premature birth can increase the risk as well as having a baby with special needs.
People may experience depressive symptoms differently, depending on what type of depressive disorder they have. Many symptoms of maternal depression are similar to symptoms of depression, however.
Symptoms of depression can include:
Constant sad or empty mood
Loss of interest in normal activities
Fatigue or decreased energy
Trouble focusing or concentrating
Thoughts of death or suicide
Symptoms of postpartum depression may also include:
Crying more often
Isolating from loved ones
Feeling like you’re not connecting with your baby
Feeling overly anxious
Thinking about hurting yourself or the baby
Or if you’re experiencing peripartum depression, you may also have changes in your appetite or experience anxiety.
Postpartum psychosis can cause extreme confusion, rapid mood swings, paranoia, hallucinations, restlessness, trying to hurt yourself or the baby and more.
Maternal depression, whether you’re experiencing perinatal depression or symptoms of postpartum depression, can be overwhelming. Fortunately, there are ways to find help and relief.
While experiencing a negative change in mood after giving birth is typical, if a low or depressed mood lasts for more than two weeks, talk to your healthcare provider. They can provide a maternal depression screening to determine whether you’re dealing with postpartum depression or another disorder.
One of the most common maternal depression screening tests is the Edinburgh Postnatal Depression Scale (EPDS), which helps identify postpartum mood disorders. Tests like the EPDS have been able to help correctly diagnose more women with maternal depression, which can lead to them finding the right treatment plan.
Once healthcare providers determine if you’re dealing with maternal depression, they can offer a treatment plan that’s best for you and your symptoms.
Psychotherapy or talk therapy is a common and effective treatment for postpartum depression and other mood disorders.
Cognitive behavioral therapy is one type of therapy that can help new or expecting mothers identify how negative thought patterns affect their well-being and instead learn healthier thought patterns. Interpersonal therapy is another option that helps mothers deal with all the changes motherhood brings, improve communication and strengthen social support.
Therapy can also be a good first choice of maternal depression treatment for breastfeeding mothers worried about the effects of medication.
Since maternal depression encompasses multiple types of depression, medication — typically in the form of antidepressant medications — is another treatment option.
Antidepressant medications are thought to help improve mood and decrease depression symptoms by increasing levels of neurotransmitters in the brain.
Two popularly prescribed antidepressant medications for PPD are selective serotonin reuptake inhibitors (SSRIs) like citalopram (Celexa®), and serotonin-norepinephrine reuptake inhibitors (SNRIs) such as duloxetine (Cymbalta®).
However, as with all medication, there can be possible risks. The research on the risks versus benefits of taking antidepressant medication while pregnant or breastfeeding is limited so you should discuss your symptoms with your healthcare provider first.
The body goes through drastic changes when preparing to give birth as well as after delivery. One of the many side effects of pregnancy and childbirth may be maternal depression.
Having worries or doubts when you’re a new mother is normal. But when those feelings of worry, fear or sadness are persistent and extreme, you may be experiencing maternal depression.
Maternal depression — a term to encompass different types of depression a new mother might experience — can take a toll on a mother’s well-being as well as her child’s. More than just a low mood after giving birth, new mothers might deal with perinatal depression, postpartum depression or even postpartum psychosis. Maternal depression can occur while pregnant or after giving birth.
Depression during and after pregnancy is very treatable though. If you think you’re dealing with maternal depression, contact healthcare providers for help as soon as possible. From there, they can help figure out the best course of action for treating your depression.
Kate Hagerty is a board-certified Family Nurse Practitioner with over a decade of healthcare experience. She has worked in critical care, community health, and as a retail health provider.
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