Antenatal Depression

Antenatal Depression (AND) is depression that occurs during pregnancy. It can strike at any time during the pregnancy but seems to become more pronounced during the third trimester. Research suggests that AND affects 15-20% of mothers, which is a higher percentage than women who get postnatal depression.

Symptoms of AND

Frequently, when a woman is pregnant, signs of depression are overlooked by friends, relatives and even care-givers as being "normal" during pregnancy. It can also be difficult for the woman to identify depression because her state of being is so completely different from her pre-pregnant state. Often she will comment that she's "just tired" or that she's not particularly enjoying the pregnancy.

Each woman will experience AND differently and not all women will have the same symptoms. Usually AND is indicated when symptoms are excessive or when they last for two weeks or more, and most women will find that the severity of their symptoms remain fairly constant.

Physical signs

• Fatigue
• Significant changes in appetite and sleep patterns
• Lack of interest in sex
• Having no pleasure or interest in usual activities
• Irritability
• Lack of concentration or focus

Behaviour

• Lack of motivation
• Obsessive behaviour such as cleaning, walking, or pacing all the time
• Substance abuse
• Inability to cope with day to day routines
• No interest in your appearance, or taking care of yourself
• Cutting yourself off from others
• Uncontrollable crying

Thoughts

• Not wanting to be pregnant
• Irrational thoughts
• Fear of being rejected or unwanted by partner
• Blaming yourself for the things that seem wrong in your life
• Wanting to run away
• Fear of harm coming to your partner or your baby
• Fear of being alone, or going out
• Negative, obsessive or morbid thoughts
• Thoughts of suicide

Feelings

• Guilt, shame or worthlessness
• Extended periods of feeling sad
• Feeling pessimistic and bleak about the future
• High levels of anxiety or panic
• Feeling unusually irritable and impatient
• Mood swings
• Feeling 'low' or 'flat'
• Feeling pressured by others to experience the so called joys of pregnancy
• Helpless, hopeless or out of control
• Feelings of anger and resentment toward your self and/or your baby which won't go away
• Feeling inadequate, having no confidence or self-esteem
• Feeling numb, empty and despondent

Some symptoms may be caused by such things as anaemia, sleep deprivation, thyroid dysfunction or bereavement and need to be considered before diagnosing depression.

Contributing Factors

There are a number of factors that may predispose women to AND, these include:

• An unwanted pregnancy
• Difficulty getting pregnant or fertility treatment
• Previous miscarriage, termination or stillbirth
• Family history of mental illness
• Lack of partner or social support
• Health complications during pregnancy
• Fear of the birth, becoming a parent, or coping with a new baby
• Previous unresolved postnatal depression
• Change of identity, e.g. from career woman to mother

Women with AND can be more likely to go on and develop postnatal depression, so recognising it early and getting effective treatment will help reduce the chance of developing postnatal depression or the severity of it.

What Next?

No matter how severe the depression is, reaching out for help is the start of the healing process. Often because the feelings women have are very scary or seem 'wrong', they are reluctant to tell others for fear of being criticised or judged. These feelings are not a reflection of how you are as a person, but a normal part of psychological illness. Being able to share what you are going through with someone you can trust is often the first step on the road to recovery.

If after reading the symptoms you believe you may be experiencing AND, then there are a number of professionals who may be able to help you, such as:

• General Practitioner
• Antenatal Clinic
• Psychologist
• Early Childhood Nurse
• Social Worker
• Obstetrician
• Psychiatrist

Sometimes you might find that your health care professional may be dismissive of your concerns and say things like: "You are so lucky being pregnant, what are you worrying about," "Get over it," or "It's just a normal first-time mother experience". If this is the case, make sure you find someone else who will help you. Trust yourself to know that what you are feeling is very real. Often it can be helpful to tell a close friend or family member who can go along with you to offer support.

Antenatal depression can be treated successfully with the right help. The types of treatments may vary, depending on the severity of the depression or your personal choices and may include:

Cognitive behavioural therapy is a short term structured therapy which seeks to help the depressed person acquire positive thoughts and attitudes which give a more realistic view of themselves and the world about them.

Interpersonal psychotherapy examines and adapts the individual's current functioning by focusing on how past and present relationships affect them.

Trauma therapy has been found to work with those who have had trauma in their life (e.g. miscarriage, previous stillbirth or birthing trauma, or sexual abuse).

Attending support groups

Having the opportunity to simply talk about your experiences may often alleviate much of your anxiety and stress around AND. It also helps to know that you aren't the only one to experience it.

Medication

Sometimes it may be necessary to prescribe antidepressants and it is important to balance the potential risk posed by that medication to the baby against the risk that mental illness may pose for both the mother and the baby. As all medications cross the placenta, caution should always be taken, and you have the right to not only know how these medications may interact with your body or affect your baby, but also the right to refuse this method of treatment.

When medication is prescribed, it is best to use it at the lowest effective dose, for the shortest possible time, trying where possible to avoid the first trimester, and reducing the dose prior to delivery.

Other things that may be of help:

Nutrition

Because food has such a profound influence on the brain's behaviour, eating a balanced diet is extremely important. Eating regular small meals throughout the day will help to stabilise your blood sugar levels and can help to increase your energy and therefore your mood. Foods that you might want to avoid include aspartame (found in diet foods or diet soft drinks) because it blocks the formation of serotonin and can cause headaches, insomnia and depression; saturated fats (such as fried or takeaway meals) as consumption can lead to sluggishness, slow thinking and fatigue because these fats cause slow circulation of blood to the brain; alcohol, caffeine and processed foods.

Acupuncture or acupressure

Relaxation techniques - such as yoga, relaxing with a book or in a bath, listening to relaxing music, connecting in touch with nature, meditation. Meditation can help reduce stress, relieve aches and pains, lower your blood pressure and improve the quality of your sleep.

Exercise

Not only does exercise improve your overall fitness and health and give your body a boost in energy, it is also helpful in reducing stress. The best pregnancy-friendly exercises are low-impact aerobics, stationary cycle, walking or aqua classes.

Get as much rest as you need

Sometimes rest can feel like a waste of time, especially when there are so many things that need doing, but if you can keep up with your sleep requirements then everything else will be much easier to handle.

Take it easy on yourself

If working, try to limit work obligations and be sure to get your feet up during your lunch break.

Attending local antenatal classes - this will give you opportunities for lifetime friendships with other parents and provide an opportunity for you to air any concerns about how you are feeling.

PANDSI have two support groups for women with AND/PND which meet once a week. Both are run by trained facilitators and provide opportunities for friendship, support and discussion in a safe environment.

If you have other pre-school children, childcare is provided free of charge.

Richardson 10am - 12pm
Tuesdays

We are currently in the process of negotiating a location for a Northside group

To find out exact locations please call the PANDSI administrator on 02 6232 6277.

If you would like to drop in and browse through our library, we have a Coffee & Chat session on Wednesdays between 10am and 11.30am at our office located at 20 Stokes Street, Griffith ACT. This informal setting may give you the opportunity to talk to staff about any concerns you may have around AND.

Resources available for AND

02 6249 7555 Aboriginal Health Service Winnunga Nimmityjah

02 6286 2043 Antenatal Yoga

02 6284 2751 Canberra & Region Multiple Birth Association

02 6280 0900 Domestic Violence Crisis Service

02 6259 8998 Karinya House - for pregnant women and new mothers who have no appropriate accommodation or support

13 11 14 Lifeline - offers an anonymous, trusting and non-judgemental support service which can give you a chance to get things off your chest without dumping it all on your family and friends

1800 647 848 Mothersafe - provides information about medications during pregnancy and while breast-feeding

02 6248 6222 Pregnancy Information and Counselling Service

02 6247 5050 Pregnancy Support Service

02 6247 5567 The Junction Youth Health Service

02 6286 2043 Women's Centre for Health Matters - for pregnancy and childbirth options

 

Useful websites

Unplanned Pregnacies
www.unplannedpregnancies.co.uk

Birthnet
www.birthnet.com.au

 

Other resources

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