You’re expecting a baby – you should feel on top of the world, so why do you feel so tearful and miserable all the time? An estimated 1 in 10 pregnant women will suffer from depression, and while postnatal depression is now widely recognised, less is known about the illness during pregnancy. But suffering from antenatal depression certainly doesn’t mean you’ll be a bad mum: we’re here to put your mind at rest, and explain where to get support if you feel you need it.
What causes antenatal depression?
There is no specific cause, but various factors can play a part. A pregnancy that is unexpected, a lack of support from your partner or family, money worries or a major life event such as the death of a loved one, for example, could all trigger depression. And if you’ve had problems with a previous pregnancy or birth, or you have struggled to conceive, you’re likely to be very anxious, which can also lead to problems. Some women, meanwhile, may find it very difficult to discern a cause.
How will I be able to tell if I’m depressed?
No matter how delighted you are to be pregnant, the combination of those hormones, symptoms like sickness and tiredness, and anxiety about the health of your unborn baby will mean you’ll probably have periods of falling weepy, worried, sad or angry. This is perfectly normal, and doesn’t mean that you’re depressed.
Moreover, some common symptoms of depression, such as disturbed sleep, can be caused by normal pregnancy side effects, like physical discomfort in bed because of your bump, or getting up several times a night to pee.
“Pregnancy is a time of enormous emotional, physical and hormonal change and it’s normal to have anxieties and fears,” says Nicky Stanley, professor of social work at the University of Central Lancashire. “However, if you’re depressed, you’re likely to experience a persistent low mood, especially in the mornings, sleep problems, an inability to look forward to anything, a lack of feelings or feelings of guilt and despair and very high levels of anxiety.”
If I have antenatal depression, will I get postnatal depression?
There is no established link between antenatal and postnatal depression. “It’s a mistake to think of antenatal depression as a precursor to postnatal depression,” says Nicky, “They need to be viewed and treated as completely separate conditions.”
Although some women with antenatal depression do go on to develop postnatal depression, many others find their depression lifts soon after the birth. Take Delphi Ellis, founder of www.depression-in-pregnancy.org.uk , who was affected by depression during her third pregnancy: “The depression lifted the very moment my son was born,” she recalls. “I cried constantly, but out of happiness. In my case, it was actually being pregnant that I found stressful.”
How do I get help?
Because pregnancy is meant to be such a happy, exciting time, many women who suffer from depression are reluctant to admit to their feelings – they may feel guilty that they’re not enjoying their pregnancy. “There us a stigma attached to antenatal depression, but it’s important to realise that it’s reasonable to have anxieties and fears during pregnancy, and that what you feeling isn’t unusual or irrational,” says Nicky. “Don’t feel foolish about seeking help.”
If you think you may be depressed, make an appointment with your GP or talk to your midwife. Counselling and, if it’s thought advisable, pregnancy-safe antidepressants are available. Nicky also suggests speaking to your partner, close relatives or friends. “We adjust to big life changes by coming back to the idea again and again, and having other people as your sounding board is very helpful in making that adjustment. Talking about how you are feeling is the first step on the road to recovery.”
What to look for:
While they don’t necessarily mean you are depressed, you should speak to your midwife or doctor if you are experiencing one or more of the following symptoms:
- You feel tired but you are unable to sleep
- Loss of appetite, or overeating for the sake of it
- You begin to dread leaving the house (agoraphobia, a fear of open spaces)
- Crying, more than is usually experienced or expected during pregnancy
- Feelings of isolation and loneliness
- Chronic anxiety and stress
- Irritability and irrational behaviour
- Symptoms of obsessive compulsive behaviour (repeatedly washing your hands for no reason, for example)
- Lack of interest in anything
Helen Folbigg, 39, lives with her husband Rick, and children Jack, 6, and Rachel, 16 months. She was diagnosed with antenatal depression when she was pregnant with Rachel.
“I had a difficult birth that ended in an emergency caesarean with Jack, but I was still very happy to be pregnant the second time round – until 25 weeks. Suddenly I began waking up in the night, unable to breathe and with my heart racing. I had an overwhelming sense of dread and fear.
My GP diagnosed depression and prescribed antidepressants, but I didn’t take them. I felt confused: I didn’t want to admit I was depressed, and people kept telling me to pull myself together. In the end, I stopped talking about how I was feeling and pretended that everything was fine. I did a pretty convincing job during the day, but at night I was falling apart. Only my husband Rick knew how I was really feeling.
About a month before my due date, the depression was at its worst. I was so anxious about the baby that I was constantly at the hospital to be monitored. I also felt devoid of all other emotions: at my son’s school sports day he was winning all his races and I knew I should feel proud and happy, but I just felt nothing.
Then I came across the depression-in-pregnancy website and contacted the founder Delphi. She put me in touch with an advisor at the hospital who arranged for us to visit the operating theatre where caesareans were performed. In my mind this was a really frightening place, but seeing it again made me realise it wasn’t so scary and I felt a little calmer. I was also worried that I would have postnatal depression, but talking to Delphi really helped to reassure me.
Then, 3 days after Rachel’s birth, my symptoms stopped. It was such a relief to feel something again – I went around telling everyone how much I loved them!”