Perinatal Depression: Symptoms and Treatment

If there's one thing we can always do better as a society, it's taking the mental health of new and expectant mothers more seriously.

Mental illness in women during pregnancy is a serious issue. According to the CDC, it’s estimated that between 10 to 20 percent of women experience some version of maternal depression either ahead of giving birth or during the postpartum period — collectively, during what is called the perinatal period.

Let’s put that relatively high incidence of depression into context. In a room of 10 people, one or two of their mothers experienced prenatal depression or postnatal depression around the time of their birth. 

And pregnant women have it tough enough. If you're here because you or a loved one are showing signs of maternal depression, it's important to understand the risk factors for mental disorders in pregnant women so you can take care of not just yourself or a loved one, but of the adorable little infant entering this world. 

Supporting pregnant and postpartum women is important for us all. Read on to learn more about perinatal depression, and what you can do about it.

According to the National Institute of Mental Health, perinatal depression is a mood disorder that can affect women during or after pregnancy. It is characterized by feelings of sadness, anxiety and fatigue that can make it difficult to care for one’s self or others, and these feelings are often extreme.

As such, the major concern with perinatal depression is that it can affect a new mother’s ability to care for herself and her children.

Perinatal depression is always a result of pregnancy, though it can come before or after giving birth. It is a type of depressive disorder that lasts two weeks or more (meaning it can show up in both a pregnant woman and a postpartum woman), and requires treatment to recover from. 

It can be helpful to understand that perinatal depression in common language is actually a name for two subtypes of depression: prenatal depression (which occurs before giving birth) and postpartum depression (which occurs after giving birth).

With perinatal depression (which, when it occurs during the first two weeks after birth is sometimes referred to as the “baby blues”) a woman is typically faced with feelings of extreme sadness, fatigue and anxiety as a result of or in anticipation of their pregnancy, and these feelings can make it difficult to carry out daily tasks. 

Perinatal depression can be a serious problem as both prenatal and postpartum depression, and can make it tough for a new mother called on to nurse and change diapers, for example, as well as an expectant mother who needs to care for herself and give attention to her health, nutrition and hygiene.

The problem with diagnosing or identifying risk of perinatal depression is that it can be difficult to predict. What causes perinatal depression is not one thing, or even a short list of things, but rather a variety of factors having to do with relationships, mental health history and expectations of new motherhood or of supporting partners and family members.

A person may experience an increased risk of perinatal depression due to a personal or family history of depression. They may be at increased risk of perinatal depression due to hormonal changes, or the demands of motherhood and other life responsibilities and the daunting prospect of trying to “do everything” while in a vulnerable position.

Histories of bipolar disorder, anxiety, depressive illness or other mood disorders can be a key indicator of increased perinatal depression risks.

Perinatal depression in women can be caused by far less obvious things than stressful life events, too. A mother is at an increased risk for perinatal depression if she lacks social support from her friends and family during or after her pregnancy, and she may see an increase in risk if the pregnancy was unplanned or is complicated.

One of the biggest issues facing new and expectant mothers is that, in some cases, people may not give this real condition the consideration it deserves.

Calling perinatal depression “baby blues” or “maternal blues” diminishes the severity of this form of depression and the potential consequences of this depressive disorder if left untreated. 

And that’s a major problem, especially if people don’t feel that the condition is serious enough to look for these signals.

There are important symptoms to watch for to catch perinatal depression early. Screening for depression can sometimes be difficult, so be on the lookout for the following perinatal depression symptoms:

• Feelings of guilt and inadequacy

• Feelings of sadness

• Being overwhelmed or anxious

• Excessive worry about the health and safety of the baby (some worry is normal)

• Intense or extreme mood swings

• Trouble sleeping or insomnia

• A lack of joy or excitement, especially about things that normally bring joy

• Changes in eating habits

• Thoughts of harming yourself or the baby

• Hallucinations, in rare cases

If you’re experiencing any of these symptoms, or if a loved one is experiencing them right in front of you, there are some important keys to remember and understand. 

It’s important to know that a new or expecting mother is no more responsible for these feelings than she is for tomorrow’s weather. 

Your medical history, stress levels, body and habits can’t necessarily prevent or predict symptoms of depression. What can most certainly help, though, is support from friends and family.

Because perinatal depression is a form of depression, a health care provider will likely treat this depressive disorder with many of the same tools available for the treatment of major depression and other types of depression. 

One of the first questions many people have about depression treatment for pregnant and nursing women is whether or not antidepressants are safe to use, and the answer is that for the most part they are considered safe and effective.

A healthcare professional will tell you more about the low risks of birth defects and other complications before starting you on a course of medication, but that’s a question to be brought up with your provider individually, rather than to be answered in a blanket statement. 

Antidepressants might not necessarily be the best option for you in the opinion of your individual healthcare professional, for example.

If they are, you’ll most likely be prescribed a form of antidepressant called selective serotonin reuptake inhibitors (SSRIs), which help you deal with the symptoms of depression by giving you the tools needed to regulate serotonin levels in your brain. 

You can utilize online mental health services before starting a course of antidepressant medication to avoid potential side effects.

A mental health professional might also recommend therapeutic practices including cognitive behavioral therapy (CBT) to help you self-manage those intrusive negative thoughts of hopelessness and worry. 

Practices like meditation have also been shown to help minimize symptoms of depression. 

And finally, a healthcare provider might also direct you to certain lifestyle changes including safe diet and exercise modifications to promote better mental and physical health. 

Meditation and exercise are considered equally effective treatments for depression according to some experts, and so this might be a great option if you’re wary of prescriptions. 

Dealing with perinatal depression is no easy task, and whether it's yourself or a loved one who’s struggling, there are things you can do to help. 

Whether you or your loved one are suffering in the postpartum period or already showing some signs of depression during pregnancy, the time to help is now, before symptoms worsen and depressive symptoms begin to affect the early days of a new child's life. 

Major depression, minor depression and any other form of unaddressed depression are best managed with a tailored course of treatment, and that's something that only a healthcare provider can safely and effectively design. 

If you or a loved one are dealing with life stress, the adverse effects of pregnancy, or if you're seeing symptoms of depression, have that conversation today. Consider options like online therapy for fast and accessible support.