Did you know that women can suffer from depression and/or anxiety when they first find out they are pregnant? That it’s not just a post partum condition?
When we think about pregnancy, we get happy, think amazing thoughts, can’t wait to meet the little baby who is growing inside. We start planning, thinking of names, dreaming about the nursery. But, not everyone has this experience. For some, learning about a new pregnancy brings on deep fears, anxieties about the future, worries. All of a sudden, all these hormones are flooding the body and some women just don’t know what to do or how to handle it. Studies show that 7-20% of women will develop some type of pregnancy-related mood disorder, with approximately 1 in 20 women developing major depressive disorder (MDD).
Also referred to as Antenatal Depression, prenatal depression can often be a precursor to Post Partum Depression. To understand why, we need to look at the biology of pregnancy. First, HCG or Human Chorionic Gonadotropin, becomes present, telling the mom’s uterus to “prepare a nest” for the new baby. This hormone is always there in a woman’s body, but doubles within the first 10 days of a new pregnancy. And, while scientists aren’t certain, it’s the high levels of HCG that might contribute to morning sickness. If you weren’t aware, morning sickness is not only limited to the morning, causing some women to experience nausea and vomiting throughout the day and it doesn’t always end after the first trimester.
Next comes progesterone, which is typically created by a cyst in the ovary, however in pregnancy, the placenta takes over the production of it. This hormone, also, rises exponentially within the first 10 weeks of pregnancy before plateauing. It is progesterone that pregnant women can thank for all those gastrointestinal symptoms, such as heartburn, reflux, burping, vomiting, gas, and constipation. Progesterone also contributes to increased hair growth – that means hair growth anywhere – your head, your torso, anywhere. Estrogen is the last of the culprits. Estrogen is key to the development of the fetus and also increases dramatically in the first few weeks of pregnancy before plateauing. It is thanks to estrogen that women experience nausea, spider veins, skin changes including pigment.
So, there’s a lot going on in the woman’s body when she finds out she’s pregnant. Her pregnancy might have been planned or planted there on purpose after thousands of dollars. Or, her pregnancy might be a complete accident, whether or not preventative measures were taken. Mom might be wondering how this could have happened and grappling with thoughts that her family was complete or finances aren’t in a place to support yet another child. Or maybe mom didn’t want any children at all. And then, while dealing with all of that, mom has to consider if she wants to keep the baby or terminate the pregnancy. She might have different opinions coming from every direction. She might not know the answer to her problem. She might choose to keep it. And, if she chooses to keep it, a whole other set of worries set in. This can get so overwhelming for the new mother-to-be. With the great increase of hormones, it’s common to experience more anxiety or more depression than normal. And, depression is often under-diagnosed in pregnancy because of the assumption that it’s just “hormonal.” But, sometimes it isn’t just hormones. It’s a true depression or real anxiety. And, it can be treated.
The first step would be to take stock of what’s real and what’s a fabrication of mom’s irrational mind. What’s really happening and what are you really working with? What are real risk factors that you’ve concerned about and what is your irrational mind catastrophizing? Next, what are you in control of? What’s out of your control? Putting thoughts down on paper whether in a journal, diary, even post-its, will help externalize those feelings so you can pinpoint what exactly is worrying you – is it your irrational mind telling you to worry? Or are they bona fide issues you need to consider? When all else fails, a mental health profession can help put things into perspective for you. With my clients, we work to discover what the underlying issue is that are contributing to the anxiety and depression. It might take a few weeks, but more often than not, we are able to pinpoint the problem and work through it. Putting things in perspective is not only helpful, but relieving as well. In some cases, psychotropic medication may be indicated. If there is a need to be assessed for medication, I highly recommend for moms-to-be to consult with a psychiatrist, as well as their OB, as opposed to getting something prescribed by their regular physician.
There is help and there are people to point you in the right direction. Your job is to recognize you need the help and then to ask for it. Sounds simple, but in the midst of anxiety and depression, it could be the hardest thing ever.