The Dangers of Untreated Prenatal Depression

The Dangers of Untreated Prenatal DepressionPostpartum depression receives a lot of attention from the media and health care providers - and rightly so. It’s a serious psychiatric condition with the potential for significant consequences for a woman and her infant. However, depression during pregnancy – prenatal depression - can have a serious impact on women and their unborn children as well. If you’re pregnant and worried you may be clinically depressed, keep reading in order to gain a better understanding of this challenging condition. Depression is a serious mental health disorder that changes the way you think and feel. Symptoms include persistent feelings of sadness or anxiousness; restlessness; loss of interest in pleasurable activities; excessive feelings of guilt or shame; hopelessness; insomnia; and difficulty concentrating and making decisions.  In some cases, depression can cause you to have thoughts of suicide.  Those thoughts can lead to suicidal behavior.  

Prenatal depression can occur in any woman, even in women who’ve never had symptoms before. As many as 1 in 5 women experience symptoms of depression during pregnancy, according to the March of Dimes [1]. Despite the fact that it’s prevalent and has a negative impact on unborn children, at least one review of related research notes that prenatal depression remains understudied [2].

Causes of Prenatal Depression

As with many mental health conditions, there is no one single cause of prenatal depression. However, there are factors that are known to increase the risk of depression during pregnancy.  These include having a history of mood disorders (like depression or bipolar disorder) and having a family history of depression. Stress plays a role as well. Women often feel anxious about their new role as a mother or feel the strain of being pregnant while working or caring for other children or elderly parents.

Other factors that contribute to prenatal depression include marital conflict and ambivalence regarding the pregnancy. Living alone or feeling limited support from family and friends can also make you more likely to experience symptoms.

Risks to the Unborn Baby

Untreated depression during pregnancy can have serious consequences for your child. Depression symptoms make it difficult for any person to care for themselves and others. You may find it hard to get out of bed or feel as though you have no energy to do anything. The danger of this is that you may not be doing the things you need to do for your child’s health. You may end up missing prenatal appointments or neglect to take necessary medications or prenatal vitamins.  Symptoms can also cause you to eat and sleep poorly, increasing the stress on your body.  This, in turn, places stress on the baby.

One review of research suggests that depression during pregnancy increases fetal activity, delays prenatal growth, and possibly triggers prematurity and low birth weight. Additionally, the biochemical profiles of the newborns mimicked those of their mothers, featuring elevated levels of the stress hormone cortisol and lower levels of the mood-related brain chemicals dopamine and serotonin [3].

If you’re depressed, you may be tempted to abuse alcohol and other substances in a desperate attempt to feel better, have more energy, or numb the emotional pain.  Using alcohol, taking illicit drugs, or abusing prescription drugs not only creates the potential for lifelong harm to an unborn child, it also creates problems for you in many different ways.

Risks to You, the Mother

Untreated depression can significantly complicate – and devastate – your life as well as your unborn baby’s.  It can weigh you down with feelings of constant sadness, worry, or helplessness. Symptoms can leave you unable to function and carry out necessary daily tasks, like going to work or caring for other children in the home. Untreated depression can trigger or worsen an existing problem with substance abuse, which, in addition to harming your unborn baby, can also harm you. Depression also has potential adverse physical effects, including an increased risk of stroke, heart disease, and diabetes.

The most serious risk to you is that of suicide. Depression and other mental health disorders are linked to about 90% of all suicides in the United States [4]. An unsuccessful suicide attempt can have serious physical and emotional consequences.  A successful suicide may seem like a good way to escape an unbearable or seemingly hopeless situation, but it will have a devastating toll on your loved ones.

If you are having suicidal thoughts, call the 24/7 National Suicide Prevention Lifeline at 1-800-273-8255 (TALK), go to the nearest hospital ER, or contact a local mental health agency as soon as possible. The suicide hotline will connect you to a trained counselor in your area who will listen to you.  Most emergency rooms have trained mental health staff to evaluate you and get you connected to the help you need.  Mental health clinics often have an after-hours crisis line, and during regular hours may offer urgent / same-day appointments.

Treating Depression during Pregnancy

If you’ve been feeling depressed for more than two weeks but aren’t currently under treatment, it’s imperative that you talk with a mental health professional as soon as possible. Don’t expect to snap out of depression during or after your pregnancy. If you’re not sure where to go for help, ask your obstetrician or primary care physician for a referral.

Talk therapy is a common treatment option that will help you identify which emotions and behaviors trigger your symptoms. A psychiatrist, psychologist, or licensed therapist will show you how to make changes in the way you think and act. Over time, the shift will affect your mood in a positive way. Your mental health professional may also recommend strategies like meditation, exercise, prenatal yoga, or deep breathing exercises to lift mood and refocus your thinking patterns.

Depending on the severity of your symptoms, a psychiatrist may recommend an antidepressant medication. However, some antidepressants can harm an unborn child [5]. Potential risks include low birth weight, preterm birth, and heart problems. Other depression medications are considered safer for pregnant women. It’s essential to work closely with physicians during treatment for depression so you can regain health and protect your baby.

If you were being treated for depression before becoming pregnant, talk with your physician about whether your treatment plan should be adjusted. It’s important to have a discussion weighing the risks and benefits of continuing antidepressant treatment. However, never stop taking medication or alter the dosage without first speaking to your physician.

Finding support from others can relieve depression symptoms, too. Learn from women who have been in your situation by finding a support group. Your obstetrician, midwife, or mental health professional may be able to refer you to a local network. In addition, many churches host mothers groups that offer fellowship and support to moms-to-be and mothers of young children. Some groups are available only to church members, but others are open to all moms.

Other changes can also alleviate depression symptoms. Consider asking others for help with chores or tasks that you don’t have the energy to do. Ask a friend to mow the lawn, enlist a fellow mom to drive your older son to soccer, or ask your nephew to tackle the garden. There’s no shame in asking others to help during a challenging time, and it will go a long way toward helping you feel less overwhelmed by everyday tasks.

Untreated depression can have very serious consequences for both you and your unborn child. Don’t wait for the feelings of sadness, hopelessness, or despair to pass on their own, as that may not happen.  A mental health professional can provide you with the tools and guidance you need, to help you start overcoming your depression. No matter how hopeless things may appear, help is available. Please don’t hesitate to reach out today.

References:

[1] //www.marchofdimes.com/pregnancy/depression.aspx

[2] //www.ncbi.nlm.nih.gov/pubmed/22215285

[3] //www.ncbi.nlm.nih.gov/pubmed/17138297

[4] //www.nimh.nih.gov/health/publications/suicide-in-the-us-statistics-and-prevention/index.shtml#Moscicki-Epi

[5] //www.ncbi.nlm.nih.gov/pubmed/17671283

Posted on December 29th, 2013
Posted in Depression

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