Depression during pregnancy is characterized by mood swings, anxiety and sadness, which can result in a lack of interest in the pregnancy and have consequences for the baby.
This situation can happen due to common hormonal variations during pregnancy or be a result of the fear of becoming a mother for the first time, for example. Teenagers are most likely to suffer from depression during pregnancy, especially if they have had an anxiety attack or depression before.
The diagnosis of depression during pregnancy is made by the doctor based on observation of the signs and symptoms presented by the woman. From the moment the diagnosis is made, it is possible to begin treatment, which is often done through psychotherapy.
Main symptoms
The main symptoms of depression during pregnancy are:
- Sadness most days;
- Anxiety;
- Choro attacks;
- Loss of interest in daily activities;
- Irritability;
- Agitation or slowness almost every day;
- Fatigue or loss of energy every day, or most of the time;
- Sleep disorders such as insomnia or excessive sleepiness, practically every day;
- Excess or lack of appetite;
- Lack of concentration and indecision practically every day;
- Feelings of guilt or devaluation most of the time;
- Thoughts of death or suicide, with or without a suicide attempt.
Symptoms normally appear in the first or last trimester of pregnancy and in the first month after the birth of the baby.
Mood variations during pregnancy are normal, as they result from changes in hormonal levels that women experience at this stage. However, if these variations persist for weeks or months, the woman should talk to her obstetrician to assess the situation and check whether she may be suffering from depression.
Can depression affect the baby?
Depression during pregnancy, when not identified and treated, can have consequences for the baby. This is because depressed mothers have greater hormonal changes, less care with their diet and health, in addition to having little interaction with the developing baby, which harms fetal development and increases the chances of premature birth and low birth weight babies.
Furthermore, women with depression in the last trimester of pregnancy have a greater need for epidurals, forceps delivery and newborns have a greater need for hospitalization in neonatology.
It was also found, in a study carried out by the Institute of Psychiatry and Neuroscience of a University in London, that the babies of women who had depression during pregnancy had higher levels of circulating cortisol, which is the hormone related to stress, and that they were more hyperactive and reactive to sound, light and cold than the babies of women who did not present any psychological changes during pregnancy.
Causes of depression during pregnancy
The main causes of depression during pregnancy are:
Situations such as lack of emotional support, comfort, affection, and assistance can trigger depression in women during pregnancy. Other factors that also contribute to the development of depression at this stage of life are:
- Having depression or some other psychiatric disorder before pregnancy, such as an anxiety attack, before pregnancy;
- Complicated previous pregnancy, previous miscarriage or loss of a child;
- Lack of emotional support;
- Not being married;
- Not having financial security;
- Be separated;
- Not having planned the pregnancy;
- History of sexual abuse;
- Problems in the relationship;
- Serious health problems;
- Having experienced a difficult situation, such as the loss of a loved one.
It is also possible for depression during pregnancy to develop in women who have not been exposed to any of the situations, so it is important that they go to prenatal consultations and receive medical care to prevent the development of this condition.
What is the treatment like?
Treatment for depression during pregnancy varies according to the number of symptoms presented and the presence or absence of signs of severity. Therefore, when a woman presents between 5 and 6 symptoms, the recommended treatment is psychotherapy, which improves quality of life and increases women’s self-confidence. Alternative therapies, such as acupuncture, are also indicated to treat depression.
Practicing physical activity or some activity that promotes women’s relaxation, maintaining a healthy diet and having family support are other essential ways to treat depression during pregnancy.
In more serious cases, the use of medication may be indicated, however there is no antidepressant medication that is recommended for pregnant women and is completely safe. Therefore, before starting medication, the doctor needs to assess the risk and benefit that the medication may provide.
Furthermore, it is not recommended to take natural remedies because they can harm the baby, including St. John’s wort, normally used against depression, which is contraindicated at this stage.
When to use antidepressants
The use of antidepressants is only recommended by the doctor after the first 12 weeks of pregnancy and when the woman has 7 to 9 symptoms of depression, however the use of this medication should only be done if it is verified that there are no risks to the baby. This is because some antidepressants can result in malformations in the fetus, increase the risk of premature birth and hinder the baby’s normal growth.
Therefore, to reduce the risk of changes caused by the use of antidepressants, it is normally recommended that women who have never used this type of medication, use selective serotonin reuptake inhibitor antidepressants, such as sertraline, fluoxetine or citalopram, as they are considered safer during this period.
Despite being considered safe, some studies indicate that the use of these antidepressants in the last trimester of pregnancy can result in some neonatal changes such as agitation, irritability, changes in eating and sleeping, hypoglycemia and respiratory discomfort, for example, however it is reported that These changes last a few weeks and have no impact on the baby’s long-term development.
