Depression during pregnancy is less well known than depression after giving birth. In the past it was often thought that pregnancy only made women feel happy and could even protect against depression. It is now known that 8 -12% of women may have intense feelings sadness and depression during pregnancy. The good news is that it can be treated.

Depression affects how a woman feels, her activities, her thoughts, and her physical well-being. A woman who is experiencing depression during pregnancy may:

• feel depressed or extremely sad, most of the day and nearly every day
• feel irritable or angry, guilty or worthless
• feel hopeless and overwhelmed
• lose interest in things she used to enjoy
• sleep a lot more than usual
• eat more or less than usual
• withdraw from family, friends, and social contact
• cry for no apparent reason
• be restless
• have little energy
• find it hard to concentrate or make decisions
• have headaches, upset stomachs or other physical symptoms
• have thoughts she will be a bad or terrible mother
• have frightening thoughts that keep coming back about harming herself or the baby

A physician may diagnose depression if a woman has symptoms:

• that last for more than two weeks
• are very upsetting to the woman
• make it difficult to carry out her daily activities

Risk factors for depression during pregnancy

Some women have a higher risk of developing depression during pregnancy.  The most common risk factors are:

• the woman has had an episode of depression or anxiety in the past
• close family members of the woman have had depression or anxiety
• the woman has stopped taking prescribed medications for depression or anxiety before or during pregnancy
• the woman does not have enough support from friends, family or community and feels isolated
• there are significant life stressors such as bereavement, relationship difficulties or breakdown

Talk to your healthcare provider if you have any of these risk fators.

How does depression in pregnancy affect women?

Women who are depressed in pregnancy are more likely to avoid prenatal care and as a result, do not get the care they need. They may not eat or sleep well. These combined factors added to the stresses of depression may increase the risk of premature labour or small birth weight babies.

Women struggling with troubling thoughts and feelings of despair may self-medicate with alcohol or drugs which may lead to other situations where there is exposure to health risks, risky behaviors or violence.

Untreated depression in pregnancy is a risk factor for post partum depression which may take longer to respond to treatment and affect how the mother and baby interact with each other.

Is help available?

There are many treatment options available for women experiencing depression during pregnancy. There is more information on this website in the section on Treatment Options and in the Depression During Pregnancy Fact Sheet and Perinatal Depression Treatment Options Fact Sheet produced by the BC Reproductive Mental Health Program.

The guide Coping with Depression During Pregnancy and Following the Birth  includes detailed information about depression and describes using Cognitive Behaviour Therapy as part of self management in addition to information on self-care and worksheets to practice useful exercises.

The first step however, should be to talk to a healthcare provider and discuss all symptoms with them. The healthcare provider may help the woman work through a self-help guide in addition to assessing whether medication or a specialist referral is needed.