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Women who are pregnant are expected to bloom and embrace the experience with confidence and joy. But what happens when, in spite of your hopes, you find that the elation of pregnancy and impending motherhood unexpectedly turns into something you did not expect. Depression during pregnancy is more common than we think. Betty Chetcuti investigates this lesser known aspect of pregnancy and says that women needn't suffer in silenceAntenatal Depression height

Women who are pregnant are expected to bloom and embrace the experience with confidence and joy. But what happens when, in spite of your hopes, you find that the elation of pregnancy and impending motherhood unexpectedly turns into something you did not expect. Depression during pregnancy is more common than we think. Betty Chetcuti investigates this lesser-known aspect of pregnancy and says that women needn't suffer in silence.

What is it?

We've all heard of post-natal depression but few people are aware that women can become
depressed during pregnancy too. Antenatal depression exists and anyone can experience it.

The symptoms are very similar to any other depression, eg feeling low all the time, having poor self-esteem, lacking confidence, feeling numb, empty and despondent,blaming yourself for the things that seem wrong in your life feeling guilty,finding it difficult to concentrate and make decisions, being unusually irritable and impatient sleep problems, eating problems,no longer enjoying normally pleasurable activities, substance abuse, wanting to hurt yourself, suicidal thoughts, reduced energy, cutting yourself off from others, feeling pessimistic and bleak about the future.

If you feel depressed, speak to someone you trust, or contact your early childhood nurse, GP or a psychologist.

Sometimes, others can very dismissive, eg, “Your feelings are normal first-time mother
experiences”, “Get over it”, “You are so lucky being pregnant, what are you
worrying about?”. Ensure that you find someone else who will help, and who does
not make you feel worse than when you first spoke to them.

Antenatal depression can be treated successfully with the right help.

Who gets it?

At any one time, a certain proportion of women may feel depressed, whether pregnant or not.

Men can experience antenatal depression as well as women. In our society it is not
common for men to talk about their feelings, so it often goes unnoticed. Also,
in our culture, there is much emphasis on the woman during pregnancy, and the
role of the man during the pregnancy (not conception!) is not really
acknowledged as if they do not exist until they are needed to stand by for
breathing support during labour.

If you experience a major stress or life event, including pregnancy, or are prone to
thinking and feeling in a depressed way you may be more likely to experience depression during pregnancy as well, though not necessarily.

If you are experiencing antenatal depression, you are more likely to experience post-natal
depression.

New research published in the British Medical Journal suggests that antenatal depression may be even more common than post natal depression.


The study looked at 9 000 pregnant women and used a clinically approved scale for measuring depression. It was revealed that nearly 12 per cent of women were depressed at 18 weeks rising to 13.5 per cent at 32-weeks. After delivery the women seemed to get happier. Depression rates dropped to 9.1 per cent at eight weeks after birth and 8.1 per
cent at eight months.


Why?

A common response is: “Maybe it’s the hormones”. True, but all pregnant women have
hormonal changes? What is different in those women who are feeling depressed?

Some women feel they are not ready for this baby and start worrying about their ability to
cope.

Some women feel that it was a mistake – how could they have been so irresponsible in taking on such a huge responsibility. “This baby was a mistake and I am feeling unhappy
about this situation”.

Some women do not think they deserve to have a baby – a baby belongs to a happy mother, and “I do not feel happy at all, even though I should”.

Some women are angry at the changes it has already made to her life – increased pain, loss
of sleep, nausea, forgetfulness, changed sexual desires, changed relationship
with her husband /partner, changed identity – becoming public property, tiredness and exhaustion just to name a few. “ I do not feel like I am being supported by my husband, he does not understand what I am going through – is this really what my life has come to?”.

Certainly,the role of unhelpful thinking patterns plays a huge role in feelings of
depression. If you are feeling depressed, it is important that you deal with it
so that it does not interfere with your life.

Knowing that you can feel depressed and that you are not alone is a critical part of dealing
with antenatal depression. Becoming aware of your feelings and thinking at this
time is also very important. Often, the first person we see about these
experiences is our GP or obstetrician / gynecologist wanting to know if we are
normal, the reasons we are having these experiences, and what we can do about
them.

What happens tomy baby?

The stress, anxiety, anger, and depression experienced during antenatal depression can
impact the baby. Research has shown that the baby’s heart rate increases when
the mother is stressed, in the same way that the mothers heart rate increases
under stress. Antenatal depression may also be associated with pre-term
delivery. Either way, if you are unhappy, then this needs to be the priority.
Mothers should concern themselves more with feeling better than with feeling
guilty that will make the depression worse.


What can I do?

Treatment comes in a range of options that do work. You need to choose the one that suits your needs. It is important that you remain hopeful as you find the best
treatment that works for you.

Group programs for women experiencing similar feelings:

The Being a Mother Workshop is a group program for mothers who are feeling depressed and want to learn ways to enjoy motherhood and deal better with depression, anxiety and frustration. Small group discussions about your pregnancy experiences and practical strategies to deal with the emotional changes are part of this innovative program. “I wish I had ofknown about this when I was pregnant” Annie.

Talking with trusted friends and family – choose people who will listen, and are genuinely interested in your welfare. Some people may be very uncomfortable, so step back and start slowly, enquiring whether they are available to listen to you without needing to feel they have to solve your problems as well.

Talk with a recommended professional.
Whilst psychologists are trained to help people deal with distressing emotions,
you may find help by seeing your early childhood nurse or local GP. You really
need to ensure that you walk out feeling better and more empowered. If you are
feeling worse or that ‘nothing happened’ find someone else. The Australian Psychological Society is a good source of referrals (see www.psychsociety.com.au) and ask for a psychologist trained in Rational Emotive Behavioural or Cognitive Behavioural Therapy.

Antidepressant medication may be recommended by your GP. If you agree
wholeheartedly, then you need to trust yourself and the decision of your GP.

If you are uncomfortable about this recommendation, contact a psychologist. Psychologists
are trained in non-medical approaches to dealing with depression. They will help
you to identify the causes of the depression and ways to treat it that do not
involve medication. Sometimes, for some people, medication is a good choice,
however, the chances of recovery are also considerably higher when combined with
psychological methods.



by Betty Chetcuti
BBSc (Hons) MEdPsych MAPS