Pregnancy brings about significant changes, especially in a vulnerable moment. Discover what perinatal depression is and how to treat it.
Motherhood is associated with deep happiness, but it is also filled with challenges and changes that can lead to perinatal depression. This condition is quite common, affecting about 11% of women during pregnancy and 13% in the first trimester after childbirth. Currently, it is estimated that about 50% of perinatal depressions go undiagnosed. Learn what perinatal depression is, what symptoms to watch out for, and how to treat it.
What is Perinatal Depression?
Perinatal depression is a form of depression that affects some women during pregnancy or after childbirth. The perinatal period begins during pregnancy and extends up to 12 months after childbirth. It is characterized by a unique combination of neuro-hormonal and psychosocial effects. Therefore, there is a greater tendency for irritability, exhaustion, sadness, and depression, which can significantly interfere with the mother's ability to take care of herself and her baby.
It is important to emphasize that perinatal depression, like any form of depression, is not the mother's fault or the fault of anyone experiencing it. It is also not a sign of weakness or lack of love for the baby but rather a mental health condition that can affect anyone, regardless of age, history, or life circumstances. It is a complex response to a combination of biological, genetic, hormonal, psychological, social, and environmental factors that are not under the mother's control in this case.
Types of Perinatal Depression
Perinatal depression can manifest at different times.
Prenatal Depression
Prenatal depression occurs during pregnancy before the baby is born. It can develop at any time during pregnancy, from the first to the third trimester. If left untreated, it can affect the pregnancy itself, fetal development, and the mother-baby bond. It can also increase the risk of premature birth and low birth weight and, later in childhood, be associated with cognitive and learning difficulties, emotional regulation issues, and an increased risk of various psychiatric disorders.
Postpartum Depression
Postpartum depression occurs, as the name suggests, after childbirth, usually in the first few months, but it can develop up to a year after the baby's birth. If left untreated, it can compromise the baby's emotional and social development.
What are the main causes of Perinatal Depression?
There is no single definitive cause of perinatal depression. It can originate from a combination of various biological, psychological, social, and hormonal factors. The main risk factors include:
Hormonal Changes
Significant hormonal changes occur during pregnancy and after childbirth, especially in estrogen and progesterone levels. These changes can affect the brain's chemical balance, contributing to the development of perinatal depression.
History of Depression
Having a previous depression, whether associated with previous pregnancies or not, increases the risk of experiencing this condition again. Additionally, having first-degree relatives with a history of depression or bipolar disorder can also increase the risk.
Stressful Life Events
Some especially challenging situations, such as financial problems, family conflicts, lack of social and family support, or traumatic events, can increase the risk of perinatal depression.
Social Isolation
When a mother feels isolated, lonely, or lacks social and family support during pregnancy and after childbirth, she becomes more prone to developing perinatal depression.
Complications in Pregnancy or Childbirth
Medical complications during pregnancy or childbirth, as well as experiencing a previous traumatic childbirth, can contribute to the development of perinatal depression.
Cultural Pressures and Unrealistic Expectations
Women may feel immense pressure to conform to an idealized and unrealistic image of motherhood, depicted as a period of constant happiness and complete fulfillment.
What are the symptoms of Perinatal Depression?
Perinatal depression symptoms may vary from person to person, but generally include:
Persistent Sadness
Sadness is a normal emotion that everyone experiences during difficult times in life, but in perinatal depression, it is intense, enduring, and unrelated to specific events. Mothers may feel down, discouraged, and unable to experience joy, regardless of positive events in their lives.
Hopelessness and Helplessness
Women with perinatal depression often report deep feelings of hopelessness and helplessness. They may believe that they will never get better or that they have no control over their lives.
Irritability and Mood Swings
In addition to sadness, mothers may become easily irritable and experience intense mood swings. They may react disproportionately to minor frustrations or feel deep and uncontrollable anger.
Anxiety
Anxiety is common during perinatal depression and may manifest as excessive worrying, constant nervousness, or even panic attacks.
Obsessive Symptoms
Women may have distressing and repetitive thoughts that they recognize as absurd but cause them great distress. These thoughts are often related to the baby, such as thoughts of accidentally dropping the baby.
Extreme Fatigue
Fatigue in perinatal depression goes beyond the normal tiredness associated with pregnancy and motherhood. Mothers may experience deep exhaustion even after a reasonable period of rest. This fatigue can make it difficult to perform daily activities and contribute to feelings of discouragement.
Loss of General Interest
One of the hallmark characteristics of perinatal depression is a loss of interest in activities that were once rewarding and pleasurable. Mothers may feel apathetic and unable to find joy in things that used to be satisfying.
Difficulty Concentrating
Perinatal depression can affect concentration and reasoning abilities. Mothers may have trouble focusing on simple tasks and making decisions.
Changes in Appetite
Some mothers may lose their appetite and interest in eating, leading to unintentional weight loss, while others may turn to food as a way to cope with emotional distress, leading to weight gain.
Difficulty Bonding with the Baby
Mothers with perinatal depression may have negative thoughts about motherhood and feel emotionally detached from their babies, even though they deeply desire to establish an emotional bond. This can create a sense of emptiness and guilt. It is important to remember that this difficulty is not a sign of lack of love for the baby but rather a symptom of a mental health condition that affects the mother's emotional capacity.
How is the diagnosis of Perinatal Depression made?
The diagnosis of perinatal depression is made by a psychiatrist. The first step is a detailed clinical interview in which the psychiatrist asks a series of questions about the symptoms to understand their duration and severity. Subsequently, the professional will determine whether the symptoms meet diagnostic criteria and recommend the best treatment.
Additional diagnostic tests may also be necessary to rule out other conditions that may be causing the symptoms, such as thyroid disorders, anemia, or others. The professional will also assess the risk of suicide to ensure the patient's safety.
What does Perinatal Depression Treatment involve?
The treatment of perinatal depression is an individualized approach that may involve various therapeutic modalities to help the mother overcome the symptoms and regain emotional well-being. Treatment is provided by a team of healthcare professionals, including psychiatrists, psychologists, obstetricians, pediatricians, nurses, and social workers, depending on the patient's needs.
Psychotherapy
Psychotherapy is a fundamental part of perinatal depression treatment. Specialized therapists can use different approaches, such as cognitive-behavioral therapy, to help the patient identify negative thoughts, learn adaptive strategies, and improve self-esteem. Addressing mother-baby bonding is also an important aspect.
Antidepressant Medications
In cases of moderate to severe perinatal depression, the psychiatrist may prescribe antidepressant medications, such as selective serotonin reuptake inhibitors or other antidepressants that are safer during pregnancy or breastfeeding. This decision should be carefully evaluated in consultation with a doctor, considering the risks and benefits.
Social Support
Family, partner, and friends' support is essential. Having an emotional support network helps the patient cope with the stress and challenges of motherhood. Participating in support groups for mothers going through similar experiences can also be helpful in treatment.
Self-Help and Self-Care
Encouraging self-care practices such as physical exercise, good sleep hygiene, and a healthy diet can contribute to overall well-being. Patients can also learn relaxation techniques such as meditation to cope with stress more adaptively.
It is important to remember that taking time for oneself is not a selfish act. On the contrary, it is a demonstration of self-care and self-love that, in turn, allows one to be a more present and healthy mother. It is essential for mothers to overcome the guilt associated with self-care and seek support from friends, family, or professionals whenever needed to have time to rest, recover, and take care of themselves.
How to Prevent Perinatal Depression?
It is not always possible to prevent perinatal depression, as many risk factors are beyond the control of mothers. However, there are some measures and strategies that can help reduce the risk of developing perinatal depression or minimize the severity of symptoms.
Consult with a Healthcare Professional
If you have a history of depression, bipolar disorder, anxiety, or other psychiatric conditions, it is essential to talk to a healthcare professional before getting pregnant or early in pregnancy. Professionals can help develop a treatment plan or prevention strategies.
Social Support
Invest in and maintain a strong support network. Having friends and family to talk to and seek practical help during pregnancy and after childbirth is crucial. Do not hesitate to ask for support when needed.
Regular Exercise
Regular physical activity can help improve mood and reduce the risk of depression. Consult your doctor before starting any exercise program during pregnancy and follow appropriate guidelines for expectant mothers.
Adequate Sleep
It is important to try to maintain a regular sleep and rest pattern, even if the demands of motherhood make this step especially challenging. Sleep deprivation can contribute to the onset of depression.
Stress Management
Learn and implement stress management techniques such as meditation, yoga, or deep breathing to cope with the emotional challenges of pregnancy and motherhood.
Participate in Support Groups
Consider joining support groups for pregnant women. Talking to other women who are going through similar experiences can be comforting and provide useful insights.
Communicate with Your Partner
Maintain open and honest communication with your partner. Talking about your feelings, concerns, and expectations can help strengthen the relationship and reduce stress.
Joaquim Chaves Healthcare: Your Partner in Treating Perinatal Depression
If you are experiencing these symptoms or know someone who may be at risk, it is essential to seek help from a mental health professional for timely diagnosis and appropriate treatment. Perinatal depression is treatable, and emotional support as well as treatment can make a significant difference in the well-being of the mother, the baby, and the entire family.
Count on the Joaquim Chaves Healthcare team to prevent and treat this condition. Take the first step and schedule your consultation through the personal area of our website or our app.