I want to talk about prenatal depression and anxiety.
Why ON EARTH is this not talked about more?
Why had I never heard of it until I was 26 years old, pregnant for the first time, and sitting in my midwife’s office listening to her explain why a pregnant person might feel unbearable sadness, anxiety, and stress like I had been feeling my entire pregnancy?
Stigma, that’s why.
Let’s set aside for a moment the frustratingly common stigma surrounding mental illness as a whole and address the atrocity that is the stigma that comes when a woman is anything but overjoyed while she creates life inside her body. I mean, heaven forbid it not all be sunshine and roses, right?
For the most part, the loved ones of a pregnant person expect there to be plenty of uncomfortable physical symptoms of pregnancy, and they are quick to recognize them and do whatever can be done to help relieve those symptoms. But what about when those unanticipated emotional and mental symptoms begin to show up?
Unfortunately, those symptoms don’t get noticed or treated with nearly as much swiftness or understanding. In fact, when the pregnant person finds the courage to talk to their loved ones about the feelings and thoughts they are having, more often than not, they are faced with comments like, “You’ve always wanted this. Why aren’t you happy?” or “It’s just hormones, it will get better. Just think positive.”
This. Needs. To. Change.
Studies on the prevalence of prenatal depression have found that between 7% and 20% of pregnant women in high-income countries suffer from it, and even higher than 20% of pregnant women in low- to middle-income countries suffer from it (Biaggi A, Conroy S, Pawlby S, Pariante CM., 2016). That is so many women who are suffering!
When I was in the first trimester of my pregnancy, my depression and anxiety got so bad that I went ten whole days without getting out of my bed except to go to the bathroom and (thankfully) shower. But it was literally all I could do to get myself into the shower each day. As soon as I got out of the shower, I would immediately go back to my bed and lay down without even brushing my hair out. My hair was a ratty mess for weeks because it was actually too overwhelming to me to even think about running a brush through it.
When my husband came home from work for the tenth day in a row to find me still asleep in bed and still unwilling to be anywhere other than that bed, he knew I needed help even though I couldn’t see that myself. He took me to my midwife and got me to tell her what I had been feeling. That’s when she asked me if I was still taking my antidepressants, since she could see on my chart that I had been taking them for about four years prior to my pregnancy. I said no. I told her that I stopped taking them when we started trying to conceive because I thought I needed to in order to avoid harming my baby. That’s when she asked me if I thought I was truly helping my baby by putting myself through such a difficult time emotionally and mentally. She explained to me that the benefits of taking antidepressants during pregnancy when they are needed often outweigh the potential risks to the fetus. She said that even people who have never taken antidepressants before have found them to be needed during pregnancy due to severe depression and/or anxiety.
After explaining all of this to me, my midwife looked me straight in the eye and said, “This isn’t permanent. We are going to get you through this.” And I did get through it. It wasn’t permanent because I got the help that I needed. It took a couple of weeks for the medication to fully take effect, but when it did, it was like I was a whole person again.
As it turns out, the number one risk factor for developing prenatal depression and anxiety is a history of previous depression and anxiety. But, as my midwife explained, even those who have absolutely no history of depression or anxiety can develop it during pregnancy.
If you take nothing else from this post, I hope that you know that if you are experiencing depression and/or anxiety while pregnant, you are not alone. It is so common and it can be treated! There are many treatment options, including, but not limited to, medication, talk therapy and diet/exercise changes. Healthcare providers can be SO helpful in finding the best resources and tools for you and your mental health throughout your pregnancy. My midwife helped me find what worked for me without an ounce of judgement, and I will forever be grateful to her for that.
Biaggi A, Conroy S, Pawlby S, Pariante CM. Identifying the women at risk of antenatal anxiety and depression: a systematic review. J Affect Disord. 2016;191:62–77.