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Coping With Anxiety and Depression During Pregnancy
Research has shown that up to 33 percent of women experience clinical depression or an anxiety disorder at some point during pregnancy. Yet some studies indicate that fewer than 20 percent seek treatment, and that treatment is often inadequate, says Healy Smith, M.D., a reproductive psychiatrist at the Women's Mental Health Clinic at New York-Presbyterian Hospital in New York City. "The myth that pregnant women must be happy is still really prevalent," Dr. Smith explains. "Because of that, treatment providers may be less likely to inquire into a woman's mental state, and a woman might feel ashamed to bring it up." But you don't have to suffer -- there are safe ways to treat depression and anxiety during pregnancy.
Symptoms of Depression and Anxiety
Risk Factors for Anxiety and Depression
Risks of Untreated Depression and Anxiety
Treatment for Depression and Anxiety
Taking Antidepressants During Pregnancy
Finding Support and Specialists
Symptoms of Depression and Anxiety
It can be tricky to diagnose mood disorders during pregnancy because "some of the symptoms can overlap with symptoms of pregnancy, such as changes in appetite, energy levels, concentration, or sleep," Dr. Smith says. "It's also normal to have some degree of worry over the health of the pregnancy." But if you experience persistent symptoms of depression and/or anxiety, especially if you're unable to function normally, get help.
Symptoms of depression include:
- Being in a depressed mood most of the time for at least two weeks
- No longer enjoying the things you used to enjoy
- Decreased interest in the world around you
- Guilt
- A sense of worthlessness
- Low energy
- Poor concentration
- Appetite changes
- Feeling hopeless
- Thoughts of suicide
- Getting too much sleep, or not enough sleep
The symptoms of anxiety vary by type of anxiety disorder, and include:
Generalized Anxiety Disorder:
- Excessive worry that's difficult to control
- Irritability
- Tension/muscle aches
- Disrupted sleep patterns
- Feeling restless inside
- Fatigue
- Poor concentration
Obsessive-Compulsive Disorder:
- Recurrent, persistent, intrusive thoughts
- Compulsions to relieve those thoughts through repetitive thoughts or behaviors
Panic disorder:
- Recurrent panic attacks
- Persistent fear of having a panic attack
Risk Factors for Anxiety and Depression
Anyone can experience depression or anxiety during pregnancy, but women with these risk factors are especially susceptible:
- A personal or family history of a mood disorder, such as depression or anxiety
- A history of premenstrual dysphoric disorder (PMDD)
- Being a young mother (under the age of 20)
- Having poor social support
- Living alone
- Experiencing marital conflict
- Being divorced, widowed, or separated
- Having experienced traumatic or stressful events in the past year
- Feeling ambivalent about being pregnant
- Pregnancy complications
- Having a low income
- Having more than three children
Risks of Untreated Anxiety and Depression During Pregnancy
"There are well documented, but often overlooked, consequences of untreated depression and anxiety during pregnancy for the fetus and the mother," Dr. Smith says. Risks to developing babies whose mothers have untreated depression or anxiety during pregnancy include:
- Low birthweight
- Premature birth (before 37 weeks)
- Low APGAR score (which rates a newborn's health after delivery)
- Poor adaptation outside the womb, including respiratory distress and jitteriness
Risks to the mother include:
- Suicide
- Pregnancy termination
- Postpartum depression or anxiety
- Use of substances such as alcohol or drugs
- Impaired attachment to the baby
- Not taking good care of her physical health
- Preeclampsia
- Preterm labor
- Having a C-section
There are several therapies that don't involve medication and are therefore considered generally safe for a developing baby. For women who need medication, there are low-risk options that can deliver real relief.
Nonmedicinal Approaches
The following treatments have been shown to help pregnant women with mild to moderate depression.
- Psychotherapy, such as cognitive behavioral therapy (CBT), in which a skilled therapist teaches new approaches to managing thoughts and emotions
- Omega-3 essential fatty acids, which are found in foods such as oily fish and walnuts, and can act as a natural mood-booster
- Light therapy, in which patients are exposed to artificial sunlight at specific times of the day to help relieve depression symptoms
- Acupuncture, a Chinese practice that (in this case) involves placing tiny needles into areas of the body thought to influence mood
Antidepressant Medication
If you're currently taking medication for depression or anxiety, consult your psychiatrist before you stop. A 2006 study published in the Journal of the American Medical Association showed that "women who discontinued an antidepressant around conception had a 68 percent chance of recurrence of depression during pregnancy, compared to 26 percent for those women who continued their medication," says Stephanie Ho, M.D., a reproductive psychiatrist in private practice in New York City. Of those that relapsed, the majority had to restart their medication during pregnancy.
Below are common Q&As on taking antidepressants during pregnancy:
Is it okay to take antidepressants during my first trimester? >>
Are antidepressants especially risky during the third trimester? >>
Is it okay to take more than one antidepressant during pregnancy? >>
Will taking antidepressants during pregnancy affect my child later in life? >>
Finding Support and Specialists
If you're pregnant and you're having depression and/or anxiety symptoms, talk to your ob-gyn or midwife. She should be able to treat you directly, or connect you with the appropriate mental health care provider. These organizations can also offer confidential help:
Postpartum Support International will connect you directly to a local coordinator who can help you find local resources, offer support, and give you tips on managing mood and anxiety disorders during and after pregnancy (www.postpartum.net).
Women's Mental Health Consortium maintains a database of mental health care providers who specialize in treating women; search using the key word "pregnancy" (www.wmhcnyc.org).
The MGH Center for Women's Mental Health offers credible information on the risks of untreated depression or anxiety during pregnancy, as well as evaluation and treatment options (www.womensmentalhealth.org).
Copyright © 2012 Meredith Corporation.
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Try Lexapro - it's one of the most studied anti-depressants during pregnancy with no side effects for the baby. Don't suffer if you don't have to. It's not good for the baby. I've been on Lexapro for about 10 years - it's great.
11/7/2011 10:08:36 AM Report AbuseI know I am in a deep depression. I feel like most of you. I just want to lay here and die. But the thought of my unborn child and my mother are the only things that are keeping me going (alive). I need help.
8/23/2011 12:46:32 PM Report AbuseI was super happy about my baby till I found out it was boy #3. People don't understand is that I feel like I live in a frat house, an outsider looking in, as though I only matter to serve their wants and needs. It feels like an arrow being drawn further and further into my heart with each beat, it gets worse when I see all the pink and dresses for girls. My mom said I can choose happiness, my husband ignores it all like it will magically disappear.
5/18/2011 12:07:21 PM Report AbuseTaking meds is such a tough decision, and HAS to be a decision made with your doctors. I also want to say that is okay for you not to feel joyful during pregnancy, and that this mom who has dealt with depression knows that it hurts like nothing else. That said, I took the lowest dose of Zoloft from 6 months on, and I wish I had not.
4/23/2011 02:52:21 PM Report Abusei tried tlkin to my baby's dad about feeling depressed and if i should get help and all he did was turn off his phone. the next day he was like i went to bed. seriously how can u tell someone u love them and turn away when they have a serious problem. and now im hearing from ppl he is out partying and hanging out w other girls. im 31 weeks pregnant and we were supposed to be getting place. sometimes i just want to lay in bed forever and just die...
1/27/2011 01:11:15 PM Report AbuseI have definitley been suffering from depression lately. All i do when i get home from work is want to lay down on the couch and watch tv, or sleep. Laughing is like a foreign concept to me, and i am just going through each day. Not actually living my life. I am an active person and i am not motivated to even leave the house. I have suffered something similar before when my dad died, and this feeling is so overwhelming.
12/20/2010 02:52:07 PM Report Abuseam 9 months pregant and feel like most of you my husabnd does not show any kind of affection to me he does not even touch me or rub my belly or come to my appointments i feel like am doing this by myself sometimes i feel like he diding want a baby with me cause its both of our first child you would think he's happy but he's not we dont talk about the baby or our future i just hope when i give birth he there for me holding my hand and telling me its gonna be ok
12/16/2010 01:12:15 PM Report AbuseI think i am going trough the same is really hard to see myself not really excited about this, my husband is far away right now and i am saying at his mom's even if his family are nice to me i feel like i can't deal with all this at the same time. I'm almost 6 months and i wish it just get better
12/7/2010 12:38:00 PM Report AbuseI think I'm goin through the same thing. I eat like twice a day.I can be hunger but dont eat.I can sleep the whole day and not eat. I look for my boyfriend to tell me I look pretty. I be afraid noone care about this pregnancy. Its so much and this bein goin on the whole pregnancy. I think sometimes imma die or have to chose between my baby and my life. ugh i really dnt kno!!!!
12/1/2010 05:42:03 AM Report AbuseI know it's hard, but try to focus on your baby. I know this may not apply to all the previous posters, but I can relate to the feeling about the baby's Dad and it does seem to consume you. But think of the future and how things will be different one way or another down the road. I try to focus on staying calm and healthy for my baby. If the Daddy can't be cool with you, that's on him. Focus your energy on someone that deserves it, your sweet baby.
11/26/2010 04:21:03 PM Report AbuseIt's so hard to just keep going sometimes, I feel for everyone going through this depression while pregnant, or anytime. I am 25 weeks and happily married. I thought since we had been trying for over three years to get pregnant that he would be so into everything, and he's just not. I put the crib up by myself yesterday and cried the entire time. Hope things get better.
11/26/2010 01:24:33 PM Report AbuseThe whole situation was hard on me, getting pregnant after my first miscarriage..getting fatter by the day..mixed feelings..heavy breathing..I am now almost 5 months and my obgyn has finally approved that I dye my hair! Yes, I went & had a super nice haircut + covered the grey hair..finally I feel it¿s me again I swear it helped me a lot. So ladies treat yourself good, after all what we are going thru is a gift from GOD and we should be happy and thankful about everything :) good luck to all
6/7/2010 04:27:06 AM Report Abusemy man has been talking serious with and seeing other women. i feel so sad about it. it's like i never existed. he wants to cuddle up with other females and kiss on them. i feel like my pregnancy has been a waste. i am six months pregant now and it has felt like the worse pregnancy ever. i feel like forrest gump i wish i could fly far far away from here and just be free. i just wanna cry. i feel stupid, fat, and ugly now. i wish i had a man to love me...
5/23/2010 05:29:00 PM Report AbuseAnd im sorry sagittariuslove, i wish i knew what to tell u, but im lost in a similar boat!All of youre feelings are the same as what im going through! Im losing this battle and Im lost with no direction. We cant give up is all that i know. if you want to talk to someone in a similar situation my e mail address is nikkis409@yahoo.com.We might do some good for each other being a support system. goodluck with everything and hope to hear from you
5/16/2010 03:35:15 AM Report AbuseThe whole pregnancy has been hard on me from the start, but i thought i could get through it with him and now im totally alone and depressed.I feel like im going crazy and getting ready to explode!I want to be revengeful and tell our work (that has threatened his job recently about him fathering my baby) that hes the dad, but ill lose my job too.And its almost is worth it in my time of being a bitter and scorned preg woman, just to hurt him like hes doing to me and his child.
5/16/2010 03:23:27 AM Report AbuseWell TY girls, i feel like i am the only 1 in a situation like this, too.Im 6 months "knocked up" and when i told the dad he was really supportive and said he wanted to start a relationship and be a family.4 months later he dosent know and is going to give me some answers on mon if he does or not, but i know hes going to tell me he dosent want to be with me.Even worse we work together so i have to see him all happy every night at work and its killing me inside!Hows he so happy when im miserable!
5/16/2010 03:05:04 AM Report Abusewow!! I thought i was the only one going threw things like this, me and my boyfriend planned our baby, now that i am 6 months, he just up and left me. I find myself crying all the time because I dont understand and I know that he is seeing someone else. When I asked him to bring me something for pain he just hung up on me..what gets me through the day..I know that his karma will come back and bite him in the a$$
5/15/2010 07:58:51 AM Report AbuseDFD
4/30/2010 07:36:30 PM Report Abuseuuuuuugh,,,...im in da worst possition anyone can ever be,... dude,,,at least the guy is with u. In my case im 16 weeks, jus found out boyfriend who is in the Alaska (army) been lying to me bout this relationship with this woman, and to find out she told me they are getting married,...soo devastaded,, waiting for his response bout the surgical abortion money i need ends on,,, the worst thing that me which im only 19 and in college had the best life ever before i took this guy home, find out no
4/24/2010 02:56:22 PM Report Abusehe knows i dont want to leave him because im pregnant, and he knows that i dont want him to leave me.. so hes showing is ass right now... as soon as i have our baby im going to have him wrapped around my finger..
3/15/2010 05:46:15 PM Report Abusewell today is a new day i guess and there really hasnt been any change in our relationship.. come to find out hes doing drugs.. smoking weed and taking x pills. he has not be active with me because he concerned about his boys and the drugs.. i dont know if hes seeing someone else even though we havent had sex in almost 2weeks. i have my good days and bad..and im learning how to deal with all the drama.. but i believe after i have the baby, its when everything will hit the fan with me and him.
3/15/2010 05:41:56 PM Report Abusehes leaving me.. maybe its a good thing, i just never had a baby alone before. im ashamed.. im 30 and i dont have a real relationship... it hurts OMG.. it hurts.. why is this so hard for me.. why do i have to go thru this.. i wanna be loved... im sooo sad, i cant stop crying.. lord help me im drowning
3/3/2010 06:09:32 PM Report Abusei need help.. im really doing bad emotionally, my partner has totally lost all respect for me.. im depressed and i know it, im crying constantly cause all i want is a health relationship but its not at all. We fight all the time and he even calls me names (bitches)it hurts. i just dont know what to do anymore, im alone in this pregnancy... he doesnt care he told me i should of got an abortion..
3/3/2010 05:56:10 PM Report Abusei know how you feel seximomma. i have been so depressed finding out i was pregnant and now a partner who is pushing for an abortion cause he thinks we aren't financially and emotionally ready. i am 10 weeks along right now. you're not the only one and i know how this doesn't exactly help. i cry and hope he comes around.
2/17/2010 10:39:28 PM Report AbuseI'm sorry, Seximomma, I can only imagine how hard that must be. This is a reflection on his character not you.I pray your boyfriend grows up and takes responsibility for the life he has created ((hugs))I personally would look for a local pregnancy center. There, you will get the help and support you need. Just google pregnancy center and where you live and you should find one. This is a very difficult time in your life but you will emerge stronger for it. I'm sorry it is so hard.
2/16/2010 09:16:51 AM Report Abusewhy can't just stand to be around the baby's father when you are pregnant.
1/5/2010 07:35:53 PM Report AbuseI have depression really bad. My boyfriend doesnt want to help he wants to end the relationship what should I do?
10/16/2009 02:39:02 PM Report Abuse