At one time, doctors believed that the hormones associated with pregnancy were a good protection against depression. In more recent years, however, there has been a growing body of evidence that depression during pregnancy is a serious problem, affecting 10-20% of all women - the same proportion that women as whole suffer without adding pregnancy into the equation. With figures like that and with the added concern that depression can factor into the health of the baby, it is important to know something about how depression and pregnancy are connected.
First, it's important to recognize what depression is and what the symptoms are. Depression is a mood disorder that may have both biological and behavioral roots. Although healthy women frequently experience some of the following symptoms during a pregnancy, depression is usually diagnosed when the patient experiences three or more of the following symptoms in the space of two weeks:
- A sense that nothing feels enjoyable or fun anymore
- Feeling blue, sad, or "empty" for most of the day, every day
- Difficulty concentrating
- Extreme irritability, agitation, or excessive crying
- Trouble sleeping or sleeping all the time
- Extreme or never-ending fatigue
- A desire to eat all the time or not wanting to eat at all
If a woman experiences three or more of these, she may be suffering from clinical depression and should report the symptoms to her doctor.
Depression is a serious disorder, and is more than just having "the blues." Untreated depression can interfere with a woman's ability to care for her self during pregnancy, and can push a woman to neglect vital personal care, thus hurting her unborn child. In extreme cases, the condition can also put her at risk for suicide, and for abuse of substances such as tobacco, alcohol, and illegal drugs. Depression may also interfere with the ability to bond with the child, and can also increase the risk for having an episode of depression after delivery (postpartum depression). In addition, recent studies have shown the possibility of links between depression in the mother and such serious conditions as premature delivery, low birth weight, spontaneous miscarriage, and gestational hypertension, or preeclampsia.
Doctors feel that there are several major causes which can contribute to a depression during pregnancy. Having an existing history of clinical depression or PMDD (Premenstrual Dysphoric Disorder, a severe type of premenstrual syndrome or PMS) is paramount among these, as a predisposition to the disorder can increase the chance that pregnancy and its attendant stresses will bring on an episode. Age at time of pregnancy is also a factor -- the younger the woman is, the higher the risk of depression.
There are also environmental factors to consider. If the woman is living alone, without the support of a partner, and has limited social support; if there are already multiple children in the family, or there is a history of marital conflict and ambivalence about the pregnancy, there is a greatly increased risk of a significant clinical depression.
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