You might have heard about postpartum depression, the mood disorder that affects mothers after giving birth. But did you know that depression can also be experienced during pregnancy?
Antepartum depression, also called prenatal depression, is a type of depression that occurs during pregnancy. Symptoms can range from mild to severe and usually involve feelings of persistent sadness, hopelessness, and anxiety. It’s more common than you think, experienced by around 16% of women at some point during their pregnancy. Thankfully, many treatments are available to help manage the symptoms of antepartum depression.
In this article, we explore antepartum depression, including what it is, its symptoms, causes, and different treatments that are available.
What is antepartum depression?
Antepartum depression, also known as prenatal or maternal depression, is a mood disorder that occurs during pregnancy. It is characterized by feelings of sadness, anxiety, and despair, and can develop at any point throughout a pregnancy. Symptoms can range from mild to severe.
The word antepartum means ‘before childbirth’. Just like postpartum depression, antepartum depression can significantly impact the well-being of both the mother and unborn child. People with prenatal depression might find themselves withdrawing from family or friends and losing interest in activities they once enjoyed.
Antepartum depression is different to the ‘baby blues’. The ‘baby blues’ typically last around two to three weeks and symptoms resolve quickly. With antepartum depression, symptoms don’t go away without treatment. If you experience symptoms of antepartum depression, it’s important you find support from a healthcare professional. Many treatment options are available, including lifestyle changes, therapy, and medications.
Sometimes you will hear antepartum depression referred to as perinatal depression. This is an umbrella term for depression experienced by both pregnant and postpartum women.
Who can get antepartum depression?
Anyone can get antepartum depression, however certain people are more likely to be affected by the condition. You are more likely to experience antepartum depression if you or a family member have a history of:
- Depression
- Anxiety
- Panic disorder
- Obsessive-compulsive disorder (OCD).
Antepartum depression is also more common amongst people who:
- Are dealing with stressful life events during pregnancy, including divorce, health issues, or financial stress
- Are expecting twins or triplets
- Are carrying a child with special needs or a health problem
- Were not planning to become pregnant
- Don’t have a support system around them
- Struggled to fall pregnant due to infertility.
Symptoms of antepartum depression
Antepartum depression manifests through various emotional, physical, and behavioral symptoms. While it’s normal to experience occasional mood swings during pregnancy due to hormonal changes, depression symptoms can last week or months and worsen over time.
Here are some common symptoms to be aware of:
- Persistent sadness
- Hopelessness or dread
- Anxiety or excessive worry, which may be focused on the health of the baby or ability to parent
- Irritability or frustration
- Loss of interest in activities that were once enjoyable
- Lack of energy
- Fatigue
- Changes in appetite or poor eating habits
- Unexplained weight loss or weight gain
- Sleep disruption (i.e. excessive or lack of sleep)
- Changes in libido
- Low self-esteem
- Lack of motivation
- Feelings of worthlessness
- Restlessness
- Difficulty concentrating or remembering things
- Withdrawing from friends, family, and loved ones
- Physical symptoms with no clear cause (i.e. muscle aches, pains, headaches, cramps, or digestive issues)
- Thoughts of suicide, death, or harming oneself or the unborn baby.
If you are experiencing thoughts of suicide or self-harm, or are worried about someone else who may be, call the Suicide & Crisis Lifeline immediately at 988. This national network of local crisis centers provides free and confidential emotional support 24/7 to those experiencing emotional distress or suicidal crisis.
Causes & risk factors of antepartum depression
Like other forms of depression, antepartum depression is complex with multiple contributing factors. While the exact cause isn’t fully understood, there are certain risk factors that might give people a higher chance of getting antepartum depression. We discuss some of these below.
Lack of support network
Limited social support from family, friends, or partners can increase the risk of antepartum depression. One study suggests that feeling supported throughout your pregnancy can help improve mental health and reduce the risk of antepartum depression. Pregnancy is a huge milestone in your life and it’s important to not feel isolated.
Whether it’s a prenatal yoga class or support from your partner and family, seeking support during your pregnancy can help prevent antepartum depression.
Stress and other mood disorders
Experiencing significant stressors during pregnancy, such as financial difficulties, relationship problems, or work-related stress, can contribute to antepartum depression. On top of that, research shows that women with a history of mood disorders like depression or anxiety are also at a higher risk of experiencing antepartum depression
Sleep issues
Good quality sleep is important as it is, but even more so when you’re pregnant. One study shows that sleep disturbances, like not getting enough sleep or poor sleep quality, is linked to antepartum depression symptoms such as suicidal ideation. According to the research, improved sleep quality could help relieve some antepartum symptoms.
Nutrition
Some studies suggest a link between poor nutrition and perinatal depression. Inadequate intake of essential nutrients, such as vitamin D, vitamin B, iron, and zinc, might play a role in why certain women experience perinatal depression. That said, more research is needed on whether poor nutrition is a risk factor for antepartum depression.
Other risk factors
Beyond these potential causes, there are other risk factors which may contribute to experiencing antepartum depression. These include:
- Having a personal or family history of depression or mental illness
- Smoking
- History of physical or sexual abuse
- Unintended pregnancy depressive symptoms
- Smoking
- Complications during pregnancy.
How antepartum depression can affect your pregnancy
Antepartum depression can impact both your physical and emotional health as well as your baby’s well-being. Some studies demonstrate that untreated depression can contribute to health risks during and post-pregnancy. These include:
- Preeclampsia (characterized by high blood pressure, protein in urine, and severe swelling during pregnancy)
- Low birth weight
- Early delivery
- C-section delivery
- Postpartum depression.
Antepartum depression can also affect the development of your baby’s brain. One decades-long study examined the children of women who had antepartum depression and followed them for 49 years into adulthood. It was found that many of these children, particularly men, had an elevated risk of developing mood disorders, such as antisocial personality disorder (ASPD).
How is antepartum depression diagnosed?
If you or someone you know has signs of antepartum depression, it’s important to get screened or tested as soon as possible. You can complete a depression self-assessment test or speak with a mental health professional. Generally, the American College of Obstetricians and Gynecologists (ACOG) recommends that pregnant women are screened for antepartum depression at least once during pregnancy.
Diagnosing antepartum depression is similar to diagnosing other forms of depression. Your doctor or healthcare provider will ask about your symptoms using a standardized questionnaire used to diagnose antepartum depression. They may recommend seeing a mental health professional if further evaluation and treatment is needed.
Treatment for antepartum depression
Antepartum depression can be challenging to live with, however it is treatable. You may start to feel better through a combination of talk therapy, medications, or self-care strategies.
Speaking to a licensed mental health professional is the best way to receive personalized treatment that targets your specific antepartum depression symptoms. Your symptoms will likely be different to others, and these experts will find the right treatment to meet your needs.
Treatment for antepartum depression typically involves antidepressant medication, psychotherapy, or a combination of the two. Other lifestyle changes, such as exercise and eating a healthy diet, can also help. We look at each of these treatment options below.
Medications
Antidepressant medications work by increasing mood-regulating neurotransmitters in the brain (mainly serotonin, norepinephrine, and dopamine). There are conflicting opinions when it comes to taking medications to treat depression during pregnancy. Some antidepressant medications are considered safer to take while pregnant. These include:
- Sertraline (Zoloft)
- Duloxetine (Cymbalta)
- Venlafaxine (Effexor CR)
- Bupropion (Wellbutrin)
- Citalopram (Celexa).
It’s important to speak to a licensed medication management provider to find the right medication and dosage while minimizing risks and side effects.
Psychotherapy
Also known as talk therapy, psychotherapy can help you better understand your symptoms and how they are impacting your life. You will also learn coping strategies that help manage or reduce the intensity of your symptoms.
There are many types of psychotherapy, however the two most popular for treating antepartum depression are:
- Cognitive behavioral therapy (CBT): This type of therapy focuses on identifying and reframing negative thought patterns and behaviors that contribute to depression. It also teaches coping skills and problem-solving strategies to help you respond to certain situations more positively.
- Interpersonal therapy: This type of therapy focuses on improving interpersonal relationships and resolving conflicts with others. You might explore how your relationships and life events may be contributing to your depression and develop skills to build relationships and strengthen support networks.
How to manage antepartum depression
If you’re experiencing antepartum depression, there are many things you can do to help improve your wellbeing in addition to a traditional treatment plan. Below, we share some helpful self-care and coping strategies to relieve some of the symptoms of pregnancy depression.
Find a support network
Feeling supported has been shown to improve mental health during pregnancy. Reach out to your existing community or build a new one around you to help ease feelings of stress and loneliness. Whether it’s your friends, family members, partner, other pregnant women, or a therapy support group, connecting with others can help you feel supported and find new ways of coping.
Focus on your health
Health should always be a focus, but it’s even more important when you’re pregnant. Your body needs additional calories and nutrients, so focus on a healthy diet of fresh fruits and vegetables, healthy fats, and lean proteins. Your diet has more of an impact on your physical and mental health than you think.
At the same time, stay physically active and get plenty of exercise. Focus on activities you enjoy and try to do them most days of the week. If you’re not sure what forms of exercise are safe during pregnancy, speak to your doctor.
Prepare for your baby
Sometimes, antepartum depression can be caused by anxiety or worry about having a baby and feeling unprepared. One way to cope with these feelings is to prepare for your baby’s birth. Learn about their growth and milestones and keep up with your prenatal care appointments. It may ease your mind to know you’re prepared and ready for childbirth.
Stay active, but get enough rest
It may be easy to fall into the trap of staying home, but try to stay active and spend time with friends and loved ones. Getting out of the house can be a huge mood-booster.
At the same time, be sure to get enough rest and focus on high-quality sleep. Insufficient or low-quality sleep can contribute to antepartum depression and make life’s stressors feel more challenging and overwhelming. Focus on cultivating good sleep hygiene and try to squeeze in at least seven hours of sleep per night.
Mindfulness & relaxation techniques
One way to ease stress and anxiety associated with antepartum depression is to try mindfulness and relaxation techniques. These include yoga, breathing exercises, and meditation.
When to get help
If you’re experiencing symptoms of antepartum depression, know that you are not alone and help is available. There are many effective ways to treat and manage antepartum depression and help you feel better. The best thing to do is reach out to a licensed mental health professional who can review your symptoms and provide you with the best treatment options to improve your well-being.
If you or someone you know are experiencing thoughts of suicide or self-harm, you can call the Substance Abuse and Mental Health Services Administration (SAHMSA) at 800-662-HELP (4357). This 24/7 helpline will connect you with mental health resources in your area.
Summary: Antepartum depression
Antepartum depression is an important women’s health issue that is experienced by countless women around the world. From the rollercoaster of emotions to the stress and hormonal changes, there’s a lot that can trigger or worsen depression during pregnancy. But knowing the signs and seeking support can make all the difference.
If you think you are experiencing signs of antepartum depression, help is available and we are ready to support you. Our mental health services at BestMind include medication management and telemedicine. You can start by filling out our depression self-assessment or reaching out to our friendly team to book a consultation. Every mother-to-be deserves to navigate pregnancy with support and well-being, and we’re here to help you along that journey.
