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Summer 2003
Results from a recent study show nearly one in five pregnant women are clinically depressed. Depression can be defined as an ongoing (usually 2 weeks or greater) feeling of sadness, hopelessness or loss of interest in life. It can be accompanied by other symptoms such as appetite change, sleep disturbance, and anxiety (nervousness). As many as 70% of women have some depression symptoms during pregnancy and 10-20% meet the diagnostic criteria for minor or major depressive disorder. Many women don't talk about this problem because pregnancy has long been viewed as a period of well being during which, the women should "glow and be happy". Since untreated depression can have a negative impact on the pregnancy and postpartum, prenatal visits are an ideal time to screen for symptoms and inform the woman about treatment options.
Several factors increase one's risk for depression in pregnancy. These include: Signs of depression during pregnancy are:
Depression can impact the pregnancy in many ways. Untreated, it can interfere with the woman's ability to care for herself such as impaired nutrition, sleep and inability to follow medical recommendations. This can result in low birthweight, early delivery and impaired brain development. Some women will resort to alcohol, tobacco or drugs and in the extreme situation, attempt suicide. Finally, depression may interfere with prenatal bonding and place one at increased risk for post partum depression and attachment disorders.
The pregnant woman can decrease her chances of developing depression by utilizing several popular stress management techniques. Nurture the relationship with your partner. Make sure you have quality time together. Strengthen the bond so that once the baby comes, you have that connection on which to rely. If you're in a troubled or conflicted relationship get counseling now. Don't assume that things will get better after the baby arrives. Establish lines of communication with friends and family. Talk about your concerns and worries regarding the future. Childbirth education classes can facilitate such discussion. Don't let frustration build up and pay attention to your emotional needs. Consider a doula for pregnancy and labor support if your partner is unwilling or needs help. Alternative treatments also show promise in the treatment of depression in pregnancy. Several studies have shown that an adequate intake of Omega 3 fatty acids is important for emotional well being. The developing fetus will draw this nutrient from the mother for optimal neurological growth and possibly deplete maternal reserves. Omega 3 can be obtained from eating salmon, Omega 3 supplemented eggs and cereal, or taking a one gram Omega 3 pill a day. Other dietary changes include a diet high protein (to prevent hypoglycemia) and B complex vitamins. Finally, a Yale research study has some promising findings with the use of light therapy. Further research is ongoing in all these areas to determine their usefulness, but we know of no harmful side effects at this time. Discuss this with you health care provider for medical advice or referral to a mental health professional if anxiety and depression is severe or lasts greater than two weeks despite the above measures. Current medical evidence suggests that many antidepressant medications show no short-term effects on the baby when used during pregnancy or breastfeeding. However, long term effects have not been adequately studied so one must carefully take into account the risks vs. benefits when considering this option. Additionally, psychotherapy can be very successful and it develops a professional support network for after the baby is born. In conclusion, depression in pregnancy is a potentially serious disorder that, like many mental health issues, may not receive the attention it deserves. There are several simple techniques that may significantly improve the quality of life of the pregnant woman and her family. If the depression is severe or non-responsive, medical and psychotherapeutic options may be useful. Improving the mental well being of the pregnant woman is beneficial to strengthening the family unit and ultimately, society at large. In conclusion, depression in pregnancy is a potentially serious disorder that, like many mental health issues, may not receive the attention it deserves. There are several simple techniques that may significantly improve the quality of life of the pregnant woman and her family. If the depression is severe or non-responsive, medical and psychotherapeutic options may be useful. Improving the mental well being of the pregnant woman is beneficial to strengthening the family unit and ultimately, society at large.
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