Elizabeth Robbins, Ph.D.

             Licensed Psychologist

                                                                                                         Birmingham, Michigan

Depression During Pregnancy


Women's experiences of pregnancy and mothering includes transitions in their lives. Social, economic, emotional and physical changes affect their roles in society. Some women have difficulties coping with pregnancy and find support from friends, health nurses, neighborhood groups and family doctors. However, other women may frequently encounter emotional difficulties.

How common is depression during pregnancy?

A study published in the British Medical Journal in 2000 found that depression was just as prevalent during pregnancy as after. According to researchers at the Dartmouth-Hitchcock Medical Center, as many as 70% of pregnant women experience some symptoms of depression, while between 10% and 15% meet diagnostic criteria for a depressive disorder.

What causes depression during pregnancy?

Sometimes the stresses of pregnancy can cause a first episode of depression in a woman.  In other cases, the pregnancy may trigger a recurrence or worsening of an already-existing depressive condition. Risk factors for developing depression during pregnancy include:

       Previous history of depression
       Family history of depression
       Hormonal changes and/or chemical changes to the brain
       Marital problems
       Stressful life events (new job, loss of job, death of family member, a move, etc.)
       Other stresses relating to the baby (anxiety about the baby, problems with previous pregnancies)
       Little or no support

What are the effects of depression during pregnancy?

The consequences of untreated depression in pregnancy can be serious and include the following:

       Interference with a woman's ability to care for herself during a pregnancy. It can
       impair nutrition, sleep and ability to follow medical recommendations.
       Increased risk of use or abuse of substances which have a negative impact on
       pregnancy (tobacco, alcohol, illegal drugs).
       Interference with prenatal bonding feelings with the developing baby.
       Increased risk of suicide.
       Higher risk of depression after childbirth, which can lead to less maternal
       interaction with the baby and result in children with emotional, behavioral and
       learning problems.

Is treatment available for women who are pregnant and depressed?

The good news is that effective treatment for depression during pregnancy exists. Treatment can include psychotherapy (talk therapy), medication, or a combination of both.  Some women may be afraid to take medication for depression, fearing for the health of their unborn child. But fortunately, many of the currently available medications are considered safe for treating a major depression during pregnancy.  And, no birth defect syndrome is known to be associated with the most commonly used medicines.  The risks and benefits, however, should be reviewed with a health care provider.

Besides alleviating current symptoms, the treatment of depression during pregnancy may decrease the risk of depression in mothers after pregnancy.  Identifying and treating depression during pregnancy often has a practical benefit. It is generally easier for women to attend medical appointments while they do not have the added responsibility and stress of caring for a newborn.

In my experience, however, I have learned that despite the effective treatments available, many women do not share their symptoms with their physicians, either because of a lack of knowledge about depression or because of  the shame and guilt they feel for having these symptoms. They say, "I kept it together for my doctor's appointments. I didn't want my doctor to think that I'd be a bad mother."  Of course, this comment is understandable. After all, pregnancy is supposed to be one of the most joyous times in a woman's life.  

As a speaker for the Beaumont Parenting Program, I have had the opportunity to talk with many new mothers about their prenatal and postnatal experiences. When discussing symptoms of depression, women have told me that they didn't know that these symptoms could be treated during pregnancy.  Others have said, "I didn't realize that all women didn't feel this way. I didn't know there was help for how I was feeling."

Some women, however, hide their feelings because they have encountered friends or relatives who say, "Come on, this should be the happiest time of your life." They feel guilty for having these negative emotions and try to hide them from the rest of the world. Fortunately, with treatment, these feelings can be replaced with positive thoughts and emotions.

If you are feeling depressed, please contact your health care provider for a referral to a psychologist who can help.

I'm pregnant, how can I tell if I should seek help for how I'm feeling?

Some changes in mood are normal during pregnancy, just as when you're not pregnant. Signs and symptoms that may indicate a depressive disorder include:

       Depressed mood/sadness, crying spells for no apparent reasons
       Disturbed sleep or change in appetite
       Guilty ruminations or feelings of worthlessness
       Excessive worries about your own or your baby’s health
       Panic attacks with heart palpitations and shortness of breath
       Thoughts of death or suicide

If symptoms are present every day for at least two weeks and significantly interfere with daily life, you should be seen by a mental health professional for diagnosis and treatment.

If you are experiencing any of the above symptoms, please contact a health professional for treatment.

Copyright, Elizabeth Robbins, Ph.D., February, 2003

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