Depression in pregnancy
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Depression during Pregnancy
The psychological state of the expectant mother changes for a variety of reasons. Not only the successful carrying of the child, but also the course of childbirth and the postpartum period depends on her well-being. The problem may arise both in the first trimester and closer to the resolution of the condition.
Depressive disorders in pregnant women (prenatal) occur in 10-25% of cases. The number of cases increases in the late term (33-37%).
Negative symptomatology often varies in intensity throughout the entire period of pregnancy. However, objective studies are insufficient to provide clear criteria for a distinction.
After the discovery of the “interesting situation” a girl has to adapt to the changed conditions of life. Not everyone easily accepts the news of possible motherhood, which is accompanied by severe psycho-emotional stress. The situation worsens considerably with the development of early toxicosis (not everyone).
Emerging circumstances are not always planned, so the disruption of the usual routine causes internal discomfort and panic. Questions about the future, work/study, the financial side of the issue, interpersonal and family relations are raised. Affective disorders (mood disorders) can be a reaction to social and psychophysical changes.
Normal intrauterine development of the fetus is carried out through a variety of neurohumoral processes occurring in the female body. This complex mechanism is controlled to a greater extent by hormones, which also affect other systems.
In the second half of pregnancy, the girl’s appearance changes and her general health may deteriorate. The likelihood of psycho-emotional disorders increases with the development of gestosis or other complications. In severe cases, patients are hospitalized for observation until delivery.
Before and after delivery
Depression can increase or first occur just before the birth of the child, with a further transition to the postpartum period. The process of bringing a baby into the world can hardly be called an easy one. The experience is a strong stress factor not only for the body, but also for the human psyche.
Not everyone can immediately adapt to the role of mother, especially in the absence of adequate support from close relatives. The burden of care, the need to be at the infant’s bed 24 hours a day, the responsibility for a new life – only worsen the situation. Danger to the lives of the mother and child ensues.
Pregnancy can rarely be a trigger for mental disorders or aggravate pre-existing conditions. A complex of unfavorable factors (biochemical, social, psychological) influencing the person is important in the development of the disorder, among which the following are more often identified
- Genetic disorders and hereditary predisposition;
- previous aborted or lost pregnancies, including abortions and miscarriages;
- Neuroendocrine changes in the body;
- marital conflicts;
- Primary dysmenorrhea – pre-existing menstrual cycle disorders;
- Fears of new experiences;
- Criticism from loved ones or others
- social disadvantage;
- Psychotraumatic experiences, including long-term ones (childhood, stresses during puberty);
- concomitant somatic diseases, especially severe or incurable;
- low marital satisfaction;
- harsh working conditions or impending unemployment;
- Exposure to pharmaceuticals that the pregnant woman was taking unaware of her condition;
- A history of drug or alcohol abuse;
- Societal pressure on the girl “in the position”; concerns about stereotypes;
- Severe pregnancy, threat of termination, severe toxicosis/gestosis;
- Unfavorable microclimate in the family, the work team.
Stressful events usually precede the symptoms of a depressive episode or provoke them, but not necessarily. Symptoms can occur for no apparent reason. Girls who were originally predisposed to the appearance of neuropsychiatric problems (premorbid personality features) are at increased risk.
Anxiety of varying severity occurs in almost 40% of women in normal pregnancy. In addition, we should not forget about the possible sharpening of individual character traits. Timely detection of signs of emerging disorder can only be a doctor, which is why it is so important to regularly appear for examinations by an obstetrician-gynecologist, honestly reporting even minor (at first glance) experiences.
For a formal diagnosis, the criteria for the disease specified in ICD-10 (International Classification of Diseases) are used. Possible disorders are indicated by the occurrence of such symptoms:
- Anxiety about the course of pregnancy, his own life;
- pronounced fear of complications in childbirth, loss of the child;
- thoughts of his own death;
- sharp irritability;
- appetite fluctuates from severe hunger to complete absence and disgust for food;
- the woman ceases to enjoy activities which she used to enjoy;
- steadily increased fatigue, unrelated to physical condition;
- a depressed mood most of the time, which is independent of others or personal circumstances
- emotional estrangement from the partner, indifference to the growing fetus;
- suicidal behavior;
- obsessive ideas of harm to the child;
- problems with sleep;
- staying in seclusion – the person does not want to see even the closest people;
- low self-esteem;
- obsessive feelings of guilt, shame, worthlessness.
Emotional “outbursts” of the type of sudden mood swings are characteristic, but temporary improvement of the condition does not indicate the absence of the disorder. The pregnant woman goes deep into endless worries about the fate of the child and changes in her own life. Some patients, on the contrary, go into “denial,” reacting negatively to the development of the fetus.
The somatic symptoms of depression are difficult to distinguish from possible toxicosis, gestosis, or acute exacerbation of chronic pathology. Often patients have a lack of criticism of their condition. Changes in behavior, personality and mood begin to be noticed by people around them.
What is the danger of depression in pregnant women?
Anxiety-depressive disorders can run in mild forms with unexpressed symptoms. However, there is a possibility of the development of such consequences:
- Pregnancy failure.
- Increased risk of bleeding, hypertension, maternal mortality.
- Delayed fetal growth, rapid heartbeat, risk of mental (rarely – somatic) diseases in the newborn.
- Severe course of gestosis, the appearance of pre-eclampsia.
- Suicidal thoughts and behavior.
- Premature delivery, the need to resort to a cesarean section.
- Addiction of the expectant mother to cigarettes, alcohol, drugs.
- Low adherence to obstetric and gynecological care, late application for help.
- Underweight of the child at birth, subsequent appetite problems.
- Self-harm, attempts to self-inflicted miscarriage and even to get rid of the fetus.
Clinical studies have established a link between prenatal depression and the occurrence of neuropsychiatric disorders in children later in life, such as ADHD (attention deficit hyperactivity disorder). Depression can be life-threatening for the mother and child. However, in most cases, babies develop absolutely normally.
Depression during pregnancy
Depression in pregnant women is quite common. One in ten representatives of the weaker sex encounters this condition. According to scientific research, women experience prenatal depression much more often than they experience postpartum depression. But the depth of depression during pregnancy tends to be less and the condition is milder. The appearance of depression during pregnancy is related not only to psychological, but also to hormonal changes in the body. Every pregnant woman has severe mood swings, as well as emotional ups and downs. When these experiences linger in a wave of low moods, then depression sets in. It is characterized by increased irritability, insomnia, anxiety, fatigue, a constant feeling of hunger or a complete lack of appetite.
Depression as a reaction can arise from stressful life situations that have nothing to do with pregnancy. These may include problems at work, disagreements with a loved one, a change of circumstances, a change of residence, for example, or the death of loved ones. Another reason for the appearance of depression are financial difficulties in the family. Every woman wants her baby to be fully provided not only with attention, but also with money. Unfortunately, not all expectant mothers and fathers can afford it. But more often than not, exaggerated expectations about money, security spoil life more than the acceptance of real opportunities, which also happens to be enough.
Depression also occurs because of psychophysical problems during pregnancy. One such condition is toxicosis, which is accompanied by malaise and morning sickness. The appearance of depression can also be related to the complications from a previous pregnancy. Women who are expecting a second child are always reminded of the pain they experienced during childbirth.
Another problem that expectant mothers may face is the lack of support from loved ones. It is no secret that in this case, women are fragile beings who require constant attention and understanding. During pregnancy, they become especially sensitive, so they should definitely be surrounded by the warmth and care of friends and relatives. Depression in pregnant women also occurs because of violence in the past or present, we are talking about psychological violence. Such a condition can be provoked by the attitude of those family members who do not want a baby.
As mentioned above, one in ten expectant mothers experience not only physical, but also moral discomfort during pregnancy. Not only hypersensitive and emotional women may be prone to depression. This condition may occur in those members of the fairer sex who have too high demands on their appearance. During pregnancy, their usual clothes become tight, and their shoes become uncomfortable. Depression during pregnancy can also occur in women who did not plan to have a child. There may be perceptions that conditions are not quite right and the time is not yet right to allow the birth. These perceptions also affect the condition.
Pregnancy and experiencing depression are interrelated factors that can negatively affect the baby’s health and psyche. In order to get rid of this unpleasant condition, you should see a psychologist or psychotherapist if the condition lasts for 3 weeks. Every pregnant woman should know that only a doctor can diagnose and determine the level of seriousness of her depression.
If the depth of the condition allows – a consultation with a psychologist or psychotherapist will help the woman to find a positive mood and peace again. Several relaxation or hypnosis sessions may be enough, after which the depressed state will go away. To set the stage for eliminating depression during pregnancy, you should take vitamins, magnesium and folic acid. These substances are resourceful, and can improve not only the physical but also the psychological state. If the depressive state is severe, a psychiatrist can also help.
Simple exercise can also relieve a woman from depression while carrying a baby. In addition, expectant mothers are advised to spend a lot of time with positive people close to them. In order to get rid of depression, you not only need to detach yourself from sad thoughts and feelings of guilt, but also to imagine your special situation – itself unusual and full of the mystery of creating a new life. Normally, positive experiences during pregnancy are much more likely to consume the mood. These positive and uplifting experiences are very important for the proper formation of the baby. There is no scientific evidence for this, but many consider this fact indisputable: there are many clubs and psychological groups for pregnant women, in these groups prepare expectant mothers, arrange communication and various activities, from exercise and yoga to cultural events.
The above tips on how to deal with low moods and depression during pregnancy, will give professional psychologists and psychotherapists. Typically, problems arise in the period up to 3 months, during hormonal restructuring of the female body. Problems can also occur in the last month before childbirth. Don’t be lazy to go to a psychologist – it’s the right decision, don’t make up depression and trust a specialist!