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Although the phenomenon of perinatal depression is mainly associated with the postpartum period, depression also occurs during pregnancy. How to distinguish depression from bad mood? Who is particularly affected by depression during pregnancy and how should you react?

Depression in pregnancyseems impossible to many people. After all, waiting for a baby is almost universally regarded as a joyful and hopeful time. Meanwhile, this is not always the case. Although we are more and more openly talking about the fact that pregnancy is a difficult time, not free from fears and problems, the topic of pregnancy depression rarely appears in public. This is a very serious matter.Depressionis a serious disease, the detection of which requires action - coordinated treatment, support from relatives, family and environment. Ignoring a problem will not resolve it on its own, and moreover, it can have fatal consequences. We write about this in order to draw the attention of both future mothers and their relatives, especially their partners, to depression. They may be the first to notice when something disturbing is happening. Be vigilant, this disease of the soul affects approx. 10 percent. future mothers. And with depression, the person with depression does not have to be aware of it. A pregnant woman in particular will displace such suspicions from her own consciousness. He doesn't want to admit to being depressed because he feels guilty about not being able to feel happiness and joy because of his pregnancy - and these are the social expectations resulting from the idealistic perception of motherhood as a "blessed state".

Depression in pregnancy: who's at risk

Any life event that causes a big change - both negative and positive - is stressful. Pregnancy is never emotionally indifferent - even when it is expected, it causes anxiety and forces you to give up certain plans. The more negative emotions are experienced by a woman who is surprised by pregnancy, especially when she does not have a permanent partner or is underage. The new situation causes her to fear whether she will cope - both financially and psychologically. She sees her pregnancy as a disservice. On the other hand, a very independent, active woman may perceive pregnancy as a loss - for her it is the loss of freedom, body shape, and the possibility - for some time - of self-realization. For many women, pregnancy is primarily a threat - they are afraidthey for their he alth and their child's he alth, they are afraid of what awaits them, they anticipate dangerous situations in the future. So pregnancy is almost always associated with negative emotions initially, only some women can deal with them and others not. People who are flexible, open to changes and with high self-esteem do better. It is certainly more difficult for women who are oversensitive, anxious, with a pessimistic view of the world and themselves. Future mothers who find it difficult to establish relationships, have problems with communicating with the environment, and are unable to turn to support and help, are more at risk. In addition to these personality traits, psychologists have identified a few more factors that increase the risk of depression during pregnancy. Here they are:

  • moving to another city in the last 6 months
  • bad relationship with your partner
  • bad relationship with own mother
  • financial problems, unemployment
  • previous miscarriage, complications in previous pregnancy or birth
  • mental illness in the family
  • family suicide
  • mental problems of the mother in the past: psychiatric treatment, self-harm, suicide attempts.

Depression symptoms in pregnancy

Detecting depression in a pregnant woman is not an easy task. Pregnancy, even the expected one, is always a mentally and emotionally difficult period. A woman, especially in the first months of pregnancy, often feels depressed, experiences extreme emotions, including sadness and anxiety, is tired, discouraged from being active, and lacks energy. They are the so-called depressive symptoms that occur - according to various estimates - in 30-70% pregnant. But when anger, sadness and discouragement are mingled with joy, excitement, and hope - this is not depression, but the emotional ambivalence that is typical of pregnancy caused by hormonal changes. However, when the feeling of depression does not go away, and even deepens, when a woman lives at a slower pace for weeks, she is permanently tired, sad, she is not interested in anything - it ceases to be a normal behavior. Disturbing symptoms are disturbances in the rhythm of the day (tiredness already in the morning, difficulty falling asleep or excessive sleepiness) and changes in appetite (e.g. sudden, drastic decrease in appetite or its increase), but often these behaviors are made up of pregnancy. Similarly to problems with concentration and memory - other important symptoms of depression. We can talk about the disease when a woman assesses herself and reality in a very critical and depressive manner, has constantly lowered self-esteem, is accompanied by a feeling of guilt and worthlessness. She is not happy about anything - also what she used to like shows nothinginterest, she lost the ability to experience joy. He does not see the way out of the situation, he does not want to go on - to the point that suicidal thoughts appear. Many such stories are heard by psychologists on duty at the helpline for pregnant women. It is called by women who cannot stop crying for the next few days and weeks, or desperate husbands who are afraid to leave their wife alone in the room, lest she jump out of the window during this time.

Depression in pregnancy: diagnosis

Relatives generally do not understand what is happening to such a person and believe that a woman should instinctively deal with such a natural state as motherhood. The woman therefore feels guilty that she is not coping and hides her condition from those around her. Or he is afraid to ask for help because he is afraid of being labeled as a mentally disturbed person. That is why it is so important to be aware of this problem. You should know that depression affects 10-15 percent of people. pregnant women and it is a serious disease that requires treatment. Treating it with indulgence, calling it a woman's whim or pregnancy-like behavior, can have very negative consequences. Untreated depression is associated with more pregnancy (premature birth, low birth weight) and postpartum complications. Children of women with untreated depression in pregnancy are more tearful and anxious, and later in life, they are more likely to experience sleep disorders, anxiety and depression symptoms themselves, and require psychiatric treatment. They also develop worse psychomotor and more often suffer from chronic somatic diseases. If only for this reason, you absolutely need to seek specialist help and start treatment. The gynecologist plays an important role here, especially when the pregnant woman herself does not directly indicate the problem.

Depression in pregnancy: treatment

The perinatal period is a stage in a woman's life in which the risk of mental disorders increases several times. The doctor should know this and conduct a very detailed interview, encouraging the patient to tell not only about previous pregnancies and births, but also about her family and professional situation, etc. A questionnaire developed by psychologists may also be used to monitor risk factors. When the gynecologist finds disturbing signals or reports them to him by the pregnant woman herself, he should offer the patient a psychiatric consultation. It is not enough for him to say: "Please see a psychiatrist." This is not enough, the woman herself may not have the determination or knowledge of where to find a specialist. Especially that many psychiatrists, unfortunately, do not want to undertake treatment of pregnant women because of their greater responsibility. Therefore, it would be good if you had a gynecologisthe recommended a specific psychiatrist to the patient and consulted him, and then he made contact with a psychiatrist himself. Caring for a pregnant woman with mental disorders requires close cooperation between an obstetrician and a psychiatrist. The gynecologist should not order the patient any antidepressants or even sedatives. It often happens, for example, that the gynecologist orders the use of relanium, which is more harmful than helpful in pregnancy. Treatment must be carried out by a specialist.

Methods of treating depression in pregnancy

The primary treatment for depression in pregnancy is antidepressant medication. There are no preparations that are completely indifferent to the developing child, but several drugs can be used. Sometimes, especially during the first 2-3 months of pregnancy, the psychiatrist has to weigh the potential benefits and risks when deciding whether or not to start pharmacotherapy. As for other treatments, psychotherapy may be sufficient in less severe cases, while electroconvulsive therapy is successfully used in severe depression. For a layman it sounds scary, because it brings to mind drastic scenes from movies, but it is a very safe and effective method. Electroconvulsive therapy is currently performed under general anesthesia (the patient does not feel anything), and its effects are in some cases exceptionally quick and positive. The problem in Poland is the lack of facilities offering comprehensive care for a pregnant woman and difficult access to psychiatrists, especially psychiatrists. who have contracts with the National He alth Fund, thanks to which you do not have to pay for visits out of your own pocket (information on this subject should be found in the regional branch of the National He alth Fund). But when you have a serious problem like depression, don't give up - specialist help is essential. It is also important that the expectant mother, in addition to the therapy, can count on help from relatives and distant people: family, friends, employer, various aid institutions, etc. Treatment of depression is a difficult and often long-lasting process - it may extend to the period after childbirth. The more support the treated person receives, the greater the chances of good results of the therapy.

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