Studies show depression during pregnancy is even more common than postpartum depression, affecting as many as 1 in 8 women. Yet it often goes unaddressed because women may miss or dismiss the warning signs, says Ruta Nonacs, MD, PhD, author of Baby Blues (Simon & Schuster, 2004).
"We hear a lot about mood swings during pregnancy, and so I think many pregnant women who are depressed discount it as a normal experience," says Dr. Nonacs. But while pregnancy may trigger some ups and downs, the lows of depression are chronic and pervasive, causing a woman to lose interest in or become unhappy with her work, relationships, and even her pregnancy. In severe cases, a depressed woman may become obsessed with thoughts of dying.
Treating depression in pregnancy is vital for the health of both mother and baby, says Dr. Nonacs. Depressed pregnant women are less likely to keep prenatal appointments, eat a healthy diet, and avoid alcohol and tobacco. Depression also causes a surge in stress hormones such as cortisol, further raising the risk for pregnancy complications. Studies have linked depression in pregnancy to preeclampsia and preterm labor. Moreover, 75 percent of these women go on to suffer postpartum depression.
The first-choice treatment for depression in pregnancy is psychotherapy, says Dr. Nonacs, but women should not rule out antidepressants. In studies, selective serotonin reuptake inhibitors (SSRIs) such as Prozac and Zoloft have not been found to cause birth defects. And though some recent research suggests that newborns exposed to SSRIs in utero experience more tremors, spontaneous startles, and rapid eye movement (REM) sleep, such side effects, says Dr. Nonacs, typically resolve quickly and without medical treatment. More important, she adds, studies have found no long-term effects on the cognitive development of children exposed to antidepressants in the womb.