Antenatal depression

Antenatal depression, also known as Prenatal depression, is a form of clinical depression that can affect a woman during pregnancy, and can be a precursor to postpartum depression if not properly treated. It is estimated that 7% to 20% percent of pregnant women are affected by this condition.[1] Any form of prenatal stress felt by the mother can have negative effects on various aspects of fetal development, which can cause harm to the mother and child. Antenatal depression is often caused by the stress and worry that pregnancy can bring, only at a more severe level. Other factors that can put a person at risk for antenatal depression is an unplanned pregnancy, difficulty becoming pregnant, history of abuse, and economic or family situations. Commonly, symptoms involve how the patient views herself, how she feels about going through such a life changing event, the restrictions on the mother's lifestyle that motherhood will place, or how the partner or family feel about the baby.[2] Pregnancy puts a lot of strain on a woman's body, so some stress, mood swings, sadness, irritability, pain, and memory changes are to be expected. Antenatal depression can be extremely dangerous for the health of the mother, and the baby, if not properly treated.

Signs & symptoms

Antenatal depression is classified based on a woman's symptoms. During pregnancy, a lot of changes to mood, memory, eating habits, and sleep is common. When these common traits become severe, and begin to alter one's day-to-day life, that is when it is considered to be antenatal depression. Symptoms of Antenatal depression are:

Other symptoms can include the inability to get excited about the pregnancy, and/or baby, a feeling of disconnection with the baby, and an inability to form/feel a bond with the developing baby.[4] This can drastically effect the relationship between the mother and the baby, and can drastically effect the mother's capacity for self care. Such inadequacies can lead to even greater risk factors for the mother.[5] The symptoms can vary in lengths of time from woman to woman, depending on severity, and can be resolved almost instantaneously after certain events. One such example is that of Claire Kilroy, a writer for The Guardian, who recently wrote about her experiences with antenatal depression during her first pregnancy. She only encountered symptoms for the first few months of her pregnancy, and once she was actually able to see her baby on ultrasound, she said "Six months into the pregnancy and I want to meet him even more than David Bowie."[6] Antenatal depression can be triggered and caused by various events within a woman's life. Some possible triggers can include relationship problems, family or personal history of depression, infertility,previous pregnancy loss, complications in pregnancy, and a history of abuse or trauma[7]

Onset & duration of symptoms

Antenatal depression is usually caused by many factors. Usually, it is associated with the fear and stress of the pregnancy. Other times it can be caused by family situations, unintended pregnancy, economic/money issues, living situations, relationships with the father & family, Jobs and/or other responsibilities, and many more. Typically, depression symptoms associated with pregnancy are categorized as postnatal depression, due to the onset of symptoms occurring after childbirth has occurred. The following is a breakdown of when a group of various women began to feel the onset of symptoms associated with depression:

In a recent article posted by The BabyCenter, the authors stated that "For years, experts mistakenly believed that pregnancy hormones protected against depression, leaving women more vulnerable to the illness only after the baby was born and their hormone levels plunged."[9] This is a possible explanation as to why antenatal depression has just recently been identified.

Causes

Antenatal depression affects about one in every eight women. It's becoming more prevalent as more medical studies are being done. Antenatal depression was once thought to simply be the normal stress associated with any pregnancy, and was waved off as a common ailment. It can be caused by many factors, usually though involving aspects of the mothers personal life such as, family, economic standing, relationship status, etc. It can also be caused be hormonal and physical changes that are associated with pregnancy.[10]

Treatment

Treatment for Antenatal depression poses many challenges because the baby is also affected by any treatments given to the mother.[11] It is suggested that the emotional aspects are handled first which includes;

Counseling is highly recommended to any woman suffering from antenatal depression. It is a very effective way for the mother to express her feelings and explain in her own words what she is feeling. This is very effective in that it gives the doctors a better insight into the symptoms and their severity. In severe cases Medication can be prescribed. This is usually only done if the symptoms have proven so severe that they interfere with day-to-day life, self care, and ability to sleep.[13] During pregnancy, there are two main kinds of antidepressants used during pregnancy; Tricyclic antidepressants (TCAs)and Selective serotonin reuptake inhibitors (SSRIs).Once prescribed, anti-depressant medication has been found to be extremely effective in treating antenatal depression. Patients can expect to feel an improvement in mood in roughly 2 to 3 weeks on average, and can begin to feel themselves truly connect with their baby. Reported benefits of medication include returned appetite, feeling of connect, increased mood, increased energy, and better concentration. Side effects are minor, though they are reported in some cases. Currently, no abnormalities of the baby have been associated with the use of antidepressants during pregnancy.[14]

It may be true that maternal SSRI use during pregnancy can lead to difficulty for their newborn adjusting to conditions outside of the womb immediately following birth. Some studies indicate that infants with exposure to SSRIs in the second and third trimester were more likely to be admitted to intensive care following their birth for respiratory, cardiac, low weight and other reasons, and that infants with prenatal SSRI exposure exhibited less motor control upon delivery than infants who were not exposed to SSRIs. Newborns who were exposed to SSRIs for five months or more prior to birth were at a greater risk for lower Apgar scores 1 and 5 minutes after delivery, indicating they were of lesser health than newborns who were not exposed to SSRIs before birth. However, prenatal SSRI exposure was not found to have a significant impact the long-term mental and physical health of the children. These results are not independent of any effects of prenatal depression on infants.[15]

Connection to postpartum depression and parenting stress

Studies have found a strong link between antenatal depression and postpartum depression in women. In other words, women who are suffering from antenatal depression are very likely to also suffer from postpartum depression. The cause of this is based on the continuation of the antenatal depression into postpartum. In a logistical light, it makes sense that women who are depressed during their pregnancy will also be depressed following the birth of their child.[16] This being said there are some factors that determine exclusively the presence of postpartum depression that are not necessarily linked with antenatal depression. These examples include things like socioeconomic class, if a pregnancy was planned or not, and the parents' relationship prior to conception and delivery of the child.

See also

References

  1. ↑ Wilson, Pamela. "Antenatal Depression". health.ninemsn.com. Retrieved 4 April 2013.
  2. ↑ "Antenatal depression". www.nct.org.uk. Retrieved 4 April 2013.
  3. ↑ "Antenatal Depression". www.panda.org.asu. Retrieved 4 April 2013.
  4. ↑ "Antenatal Depression". www.babiesonline.com. Retrieved 4 April 2013.
  5. ↑ Leigh, Bronwyn; Jeannette Milgrom (16 April 2008). "Risk factors for antenatal depression, postnatal depression and parenting stress". BMC Psychiatry 8 (24). doi:10.1186/1471-244X-8-24. PMC 2375874. PMID 18412979. Retrieved 5/10/13. Check date values in: |access-date= (help)
  6. ↑ Kilroy, Claire (9/7/12). "Antenatal depression: 'I cried at my baby's predicament'". The Guardian (London). Retrieved 4/7/13. Check date values in: |access-date=, |date= (help)
  7. ↑ "Depression in Pregnancy". americanpregnancy.org. Retrieved 4 April 2013.
  8. ↑ Sharps, Linda (2012-10-18). "Prenatal Depression Warning Signs: Here's What to Look For". The Huffington Post. Retrieved 2013-04-21.
  9. ↑ "Is it common to suffer from depression or anxiety during pregnancy?". The Baby Center. Retrieved 2013-04-21.
  10. ↑ "Prenatal (Antenatal) Depression". www.pandasfoundation.org.u. Pandas Foundation. Retrieved 2013-05-13.
  11. ↑ Geetha, Shivakumar,; Anna R. Brandon; Peter G. Snell; Patricia Santiago-Muñoz; MNeysa L. Johnson; Madhukar H. Trivedi; Marlene P. Freeman (December 13, 2101). "Antenatal Depression: A Rationale for Studying Exercise". Depress Anxiety 28 (3): 234–42. doi:10.1002/da.20777. PMC 3079921. PMID 21394856. Retrieved 2013-05-13. Check date values in: |date=, |year= / |date= mismatch (help)
  12. ↑ "Depression during pregnancy". The Baby Center. Retrieved 2013-04-21.
  13. ↑ "Depression in Pregnancy& Antidepressant Medication Use" (PDF). www.mhcs.health.nsw.gov.au/. Division of Mental Health St George Hospital and Community Health Services. Retrieved 5/11/13. Check date values in: |access-date= (help)
  14. ↑ "Depression in Pregnancy& Antidepressant Medication Use" (PDF). http://www.mhcs.health.nsw.gov.au/. Division of Mental Health St George Hospital and Community Health Services. Retrieved 5/11/13. Check date values in: |access-date= (help); External link in |work= (help)
  15. ↑ Casper R. C., Gilles A. A., Fleisher B. E., Baran J., Enns G., Lazzeroni L. C. (2011). "Length of prenatal exposure to selective serotonin reuptake inhibitor (SSRI) antidepressants: effects on neonatal adaptation and psychomotor development". Psychopharmacology 217 (2): 211–219. doi:10.1007/s00213-011-2270-z.
  16. ↑ Msiri, Shaila; Kendrick, Kristen; Oberlander, Tim; Norris, Sandhaya; Tomfohr, Lianne; Zhang, Hongbin; Grunau, Ruth (April 1, 2010). "Antenatal Depression and Anxiety Affect Postpartum Parenting Stress: A Longitudinal, Prospective Study". Canadian Journal of Psychiatry 55 (4).
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