When you’re pregnant people expect you to be happy, joyful and glowing. But it doesn’t always work that way. Feeling low during pregnancy is more common than you’d think. Our guide answers some frequently asked questions surrounding prenatal depression, what it is and how to seek help.
You’re pregnant and people probably keep telling you how elated you should feel. After all, this is the happiest time of your life, right?
Yes, it’s true, pregnancy can be magical. But it’s not like that for everyone. Sometimes, our emotions don’t play ball. And, more often than we might care to admit, we don’t feel like we expected to. So, what if you don’t share everyone else’s joy about your own pregnancy? What if, rather than bubbling with excitement, you feel sad, anxious and overwhelmed instead?
No doubt you’re aware of postnatal depression, which can affect new mums following the birth of their babies. But have you heard of prenatal – or antenatal – depression? Although less commonly discussed, it’s a very real problem. In fact, according to PANDAS Foundation, a charity providing Pre and Postnatal Depression Advice and Support, prenatal depression is more common than you’d think.
Experts have found that, at any one time during pregnancy one in every 10 women will be depressed and around one in every 30 will be depressed in both pregnancy and the postnatal period.
It can be hard to admit you’re struggling in pregnancy, but it’s important to understand why you might be feeling low, and how to get the right help. Here are the answers to some of the common questions surrounding prenatal depression.
What is prenatal depression?
Put simply, it’s a form of clinical depression that can affect women during pregnancy, whether they have a history of depression or not.
What are the causes of prenatal depression?
Pregnancy hormone changes
In early pregnancy, you’ll probably start dashing to the toilet more frequently. Your breasts may swell and become tender, too. All this is down to a surge of the hormones oestrogen and progesterone in your body.
“Ideally, these hormonal changes create a sense of maternal ‘bloom’,” says Donna Collins, Managing Director of PANDAS Foundation. “However, in some pregnancies the placenta doesn’t produce enough progesterone. This doesn’t affect the baby but can lead to feelings of depression in mums-to-be.”
Another side effect of hormone imbalance is the dreaded morning sickness. Let’s face it, for many women it should be renamed ‘all-day-long sickness’. Feeling permanently nauseous can affect your state of mind, leaving you feeling low. Pregnancy can also deplete your body’s iron and zinc reserves. Deficiencies in both these key minerals have been linked to depression.
Although growing a bump is exciting, it can be a shock to see your body changing so rapidly. “In pregnancy, we’re expected to gain at least two stone and feel radiant about it,” says Donna. “Yet weight gain can severely affect a woman’s confidence, leading to feelings of worthlessness and low self-esteem.
Finally, some women may become depressed due to life stresses during pregnancy, such as debt, relationship, health or work issues. “Pregnancy can feel like a very vulnerable time for a lot of women, so changes in circumstances can be a trigger,” says Donna. “Particularly if a woman has previously suffered a miscarriage or stillbirth, this can lead to feelings of anxiety and sadness during a new pregnancy.
Your questions answered!
What are the symptoms of prenatal depression?
No two women are the same and no two experiences are the same, but there are some tell-tale symptoms. You might feel constantly anxious or find yourself crying at the drop of a hat. You may find it impossible to drag yourself out of bed, and feelings of guilt and isolation are also common.
How can you tell if you have prenatal depression or if you’re just feeling a bit down or suffering normal pregnancy side effects?
“Looking at the symptoms should give you an idea of what to be checking for,” says Donna. “Really, it’s down to the amount of time you’ve experienced symptoms. If you’re feeling down for a few days every now and then, it may well be due to pregnancy side effects. But if you’ve had symptoms consistently for several weeks, you should speak to a healthcare professional.”
Is anyone more at risk of prenatal depression?
Prenatal depression can affect anyone. But there are particular factors which put you more at risk. These include unplanned pregnancies, previous fertility issues, miscarriages or stillbirths. Women who’ve suffered abuse are also more at risk.
Can prenatal depression affect your baby?
“There’s no evidence to suggest that a baby whose mum is experiencing prenatal depression is affected during pregnancy,” says Donna. “However, if a mum is unhappy or struggling to cope once her baby arrives, it could cause issues around bonding. So it's in everyone's best interests to provide early support and treatment.”
What should you do if you think you may be suffering from prenatal depression?
It’s hard to admit you’re feeling low during pregnancy. You might feel guilty for not being on top of the world, but resist the urge to clam up.
“Talking is a great tool,” says Donna. “Whether you talk to friends, family or healthcare professionals, it can make it easier to cope. Your GP can assess whether you’re suffering from prenatal depression and you may be referred for counselling. PANDAS Foundation offers peer support services because we know how important it is to talk to people who’ve been in the same position.”
Is there anything you can do to help yourself?
Thankfully, there are many simple, positive steps you can take. “It’s really important for all mums-to-be to take time out for themselves,” says Donna. ”From small things such as enjoying a cup of tea on your own in the garden to the more luxurious choice of having a regular massage. Anything that gets you doing something that you love.
“Mindfulness is also a great technique. This doesn't mean you have to sit meditating. It can be simple things, such as sitting and concentrating on what you can see or hear for five minutes to refocus your mind.”
You can boost your state of mind by eating a healthy diet, too. “It’s crucial that your pregnancy diet is full of iron- and zinc-rich foods,” says Donna. “Vitamin C is also essential as this aids the absorption of iron into the body.” So now’s the time to put spinach, broccoli, turkey, low-fat yoghurt with fruit and fresh orange juice on your shopping list.
Does having prenatal depression mean you’re also going to suffer postnatal depression?
Nothing is certain. Although in the majority of cases prenatal depression will disappear with the birth of the baby, one third of new mothers will go on to develop postnatal depression. That’s why it’s so important to seek help if you feel low during pregnancy. The more quickly you get treatment, the more likely it is that you will be able to face the future – with your beautiful baby – feeling happy and back to your normal self again.
“I started feeling low during the second trimester of my third pregnancy. Not only was I running my business, I’d been diagnosed with gestational diabetes. With so much going on, I didn't feel excited about the pregnancy and had no interest in buying baby equipment or choosing a name.
“Each morning, I’d put on my mask of make-up before dropping my older sons off at school. Then I’d creep home and sleep all day. When my boys were around, I kept up a front and pretended that I was loving being pregnant.
“Having never heard of prenatal depression, I was too ashamed to seek help in case people judged me for not coping. No one guessed I was secretly terrified of gaining weight, losing my independence and being under financial strain. Sadly, after having George in August 2010, I developed severe postnatal depression. That’s when I sought treatment, including CBT counselling.
“It was the hardest time of my life. But today, I’m recovered and have had another son, Stanley, now three. Wanting to help other mums, I now work in Perinatal Mental Health and also run a PANDAS support group. I’d urge anyone struggling to reach out. Talk to your loved ones or a professional. Don’t suffer alone.”
Sally, 36, mum of four from Stoke-on-Trent
We really hope you've found this post useful. Prenatal depression is incredibly common, so don't keep it to yourself. Speak out to family and friends and, especially, your GP. You may also want to read our Guide to Postnatal Depression