Tragic stories have put postpartum depression in the news in recent years, but a new study suggests that depression during pregnancy may deserve the same attention. When researchers at Britain's University of Bristol evaluated women for mood problems, they found that pregnant women were more likely to meet the criteria for depression than those who had just given birth.
Some 10 to 12 percent of women will become depressed during pregnancy, "yet we rarely screen for it," says Margaret Spinelli, M.D., assistant professor of psychiatry and the director of the Women's Program for Psychiatric Services at Columbia University in New York. But untreated antepartum depression, as it's called, can lead to problems for the unborn child -- from preterm delivery to developmental delays. Depressed mothers-to-be also have a 50 percent greater risk for postpartum depression.
No one knows why pregnancy can lead to depression. Rampant hormonal shifts may play a role, but Dr. Spinelli says that other factors -- particularly young age, a family or personal history of depression, and early childhood trauma -- are probably more significant culprits.
The signs of antepartum depression are the same as those for major depressive disorder: persistent feelings of sadness, hopelessness, anxiety, or loss of interest in life, along with changes in sleep and appetite.
Pinpointing depression during pregnancy can be tricky. "Very often antepartum depression mimics the symptoms of pregnancy," says Dr. Spinelli. "A women may not be sleeping because she's depressed or because the baby is kicking." That makes it important to discuss all of your symptoms and feelings with your doctor.
Treatments for depression are highly effective in restoring emotional equilibrium, and may help prevent a recurrence after the baby is born. "Physicians in general undertreat depression during pregnancy -- they're so afraid of causing harm. But they don't take into account the consequences of not treating it," says Marlene Freeman, M.D., director of the women's mental health program at the University of Arizona in Tucson. Thankfully, she says, certain antidepressants appear safe during pregnancy. For those who want to avoid drugs, an upcoming article in the American Journal of Psychiatry suggests that light therapy -- brief daily exposures to high-intensity lamps -- can help treat antepartum depression. And for the majority of women who experience mild depressive symptoms during pregnancy, yoga, meditation, and greater reliance on friends and family often do the trick. "We put pressure on women to feel good during pregnancy," says Dr. Spinelli. "Knowing that depression can strike then is the first step toward feeling better."