Depression in pregnancy. What causes it in expectant mothers?

Pregnancy is not only a beautiful time before the baby comes into the world, but also a time of many physical and psychological changes in the expectant mother. Physical changes, such as the growth of the tummy, are familiar to everyone. Mental changes are sometimes not even realized by the pregnant woman.

Depression during pregnancy is not uncommon. More than a quarter of pregnant women experience it. However, almost 70% of all pregnant women experience milder depression.

So, if you have been thinking that it only affects you, you are mistaken.

What does antenatal depression mean?

Postpartum depression is a well-known and often discussed term. Antenatal depression is a less common term. Some moms-to-be may have heard of it, but most have gone through it without knowing about it.

Antenatal depression (prenatal) can be an indicator of the onset of postpartum one. Therefore, it is important to catch the first warning signs, whether by mom, family, or doctor (gynecologist). There are many non-pharmacological methods to help alleviate or eliminate it.

Why depression arises or manifests itself to a greater degree in pregnancy and before childbirth is a mystery to some, understandable to others. A baby is a miracle. With the exception of unplanned and unwanted pregnancies, it is usually a cause for joy. As it happens, joy also means worry.

Many women are worried about whether everything will go well, about possible complications or about giving birth. Hitherto confident and ready for anything, a pregnant woman suddenly begins to doubt her abilities.

Worrying is normal to a certain extent, but nothing should be exaggerated. Worry and fear can grow into something deeper and be the cause of a depressive mindset.

Depression occurring in previous history

Depression is a serious psychiatric illness that can be hereditary or develop over a lifetime. Many factors are involved in its onset, which are long-lasting, highly stressful and negatively affect a person's thinking. Ultimately, a depressed mood is part of a person's personality.

Therefore, genetic predisposition is only one of several factors that result in its onset or more severe course.

Diagnosis of depression in a mother-to-be

As such, depression and psychiatric illness have occurred in the past, persist in the present, and most likely, with increasing stress and demands on the individual, will be with us in the future.

They used to be taboo, but today we regard them as common ailments like any other. Depression is quite common. It is even on the increase, despite better psychotherapy options.

Up to 25% of people suffer from moderate and severe depression. However, many sufferers do not seek medical help, so the true statistics are probably much higher.

Diagnosed depression can be a problem in pregnancy. Especially if the patient is kept on medication.

But if an unexpected pregnancy comes with the need to stop the medication, it can mean a rapid deterioration of the condition. Failure to stop the medication is in turn a major risk to the unborn child.

The reduction of medication should be gradual, so that the mother can cope. A sudden discontinuation of medication usually only results in a worsening of the pregnant woman's depressive state, sometimes with the need to reintroduce psychopharmaceuticals.

Important:
For women suffering from depression, it is advisable to plan the pregnancy in advance.
Before becoming pregnant, the doses of medication are gradually reduced to zero.
If the patient is coping, she is ready to become pregnant.

Family history of depression

Research in the field of genetics is the breakthrough of the millennium and has proved the heritability of various diseases. Psychiatric diseases are no exception. Genetics is also involved to some extent in the occurrence of depression. This means that depression is hereditary.

The fact that women suffer from depression more often than men is no coincidence. Recent studies have shown a higher incidence of the disease in the female line. This means that women whose mothers or grandmothers suffered from the same illness are more likely to develop depression.

If you have a family history of depression or other mental illness, it is very likely that you or your offspring may suffer from it. Depression, however, usually manifests itself over the course of a lifetime, before pregnancy. It is not just timed to the period of pregnancy.

However, the symptoms may intensify during pregnancy. The causes are the same as for healthy pregnant women.

It is important to remember that not every disease is automatically inherited. Its occurrence in the family history only increases the possibility. If you did not have any symptoms of pathologically sad mood before pregnancy, you do not have to worry too much.

Interesting:
Research in genetics is far from over.
Further research by scientists may give us a lot of valuable information in the near future.
Despite the results so far and the association of various diseases with genes, heredity is only one of many factors contributing to a particular disease.
All of them should be taken into account.

Fear of pregnancy and childbirth

A positive pregnancy test, confirmation of pregnancy by a gynaecologist and the joyful announcement of this status to partner and family are memorable moments in a woman's life. But not all experience these moments in the same way.

Getting pregnant at a young age, in a dysfunctional relationship, accidentally or, God forbid, violently, provokes negative feelings. These can result in the onset of depression. Often a young woman also lacks support from loved ones and health and economic complications are added. In such cases, the depression deepens.

Health complications during pregnancy

Either way, pregnancy brings with it conditions of nausea, vomiting, excessive fatigue and sleep disturbances. Their intensity and frequency is very individual. Some pregnant women do not even feel these symptoms properly and they gradually disappear. The less fortunate ones deal with them for most of their pregnancy.

In worse cases, gestational diabetes, pressure problems, digestive problems, increased protein in the urine, swollen legs, varicose veins, hyperpigmentation or excessive hair loss occur.

Most serious health risks associated with pregnancy:

Fear of childbirth itself (tokophobia)

Fear of childbirth is a perfectly normal and common phenomenon. It is more pronounced in first-time mothers who have had no previous experience of childbirth. Also, multiple birth mothers with poor previous experience of childbirth may be more fearful.

Tokophobia is a medical condition in which a woman has an unnatural and irrational fear of impending childbirth. This causes states of depression and a tendency to avoid the situation at all costs.

In some severe cases, the pregnancy is terminated by caesarean section at the mother's request. The reason for the operation is therefore not a medical indication but the mother's psychological state.

Feeling unprepared for the baby and parenthood

Before becoming pregnant, many women may have thought they were ready for motherhood and parenthood. However, during pregnancy, many lose this confidence. This is because of new information, experiences and problems that come to us from other parents.

Thoughts of all sorts of possible situations and ways of dealing with them begin to emerge. It is then that the mother-to-be realises that there are many hardships related to parenthood that she had not anticipated and that she will have to face in the future. Fears about how she will cope emerge.

If these thoughts cross your mind too, don't despair. No matter how hard you try and prepare for the future, you can't prepare 100% for everything. That's life.

Every situation, positive and negative, should be dealt with when it happens. Unnecessary and especially unwarranted stress in advance is not the way to go.

Concerns about the health of the newborn

"Do you want a boy or a girl?"

"It doesn't matter, as long as it's healthy."

Having a healthy baby is the wishful thinking of all parents. Especially nowadays, when we can look up all sorts of diseases occurring everywhere in the world on the internet, these fears are greater.

However, many of the diseases that we find are very rare. Therefore, searching for them and praying that my baby will not be born with this disability is not necessary.

All that is needed is a healthy diet, adherence to pregnancy restrictions, and regular visits to the gynecologist. Thinking about diagnoses that your baby may not even have only causes stress and depression. And these should be eliminated during pregnancy.

Fears of damage to health in connection with childbirth

The vast majority of births proceed naturally and without complications. There are those that need to be helped with medication. A certain percentage of births are risky. In such cases, the obstetrician prefers a cesarean section.

Its indication is medical, provided there are medical complications during delivery either on the part of the mother or the fetus.

Important:
Nowadays, the latest trend is to deliver at home. However, all mothers who choose to do so should take into account the high risk of postpartum complications.
The subsequent transfer to a medical facility may not be carried out in time. This not only endangers their life, but also the life of their baby.
In case of aspiration or hypoxia of the newborn, they are helpless in a home environment where there is no neonatologist.

Despite sufficient information and years of experience of obstetricians, unforeseen medical complications can always occur and must be dealt with here and now.

Complications during childbirth

Concerns about genetic diseases of the newborn

Genetic diseases, congenital developmental defects of organs and systems or various fetal malformations have existed in the past. However, people were unable to explain why they occur and how to properly care for damaged babies. Therefore, babies died soon after birth or in early infancy.

Advances in medicine have enabled us to understand these diseases better and to recognise those that were previously unknown. This does not mean that they did not occur, but their manifestations were minimal.

In various developmental disorders, especially behavioural disorders, learning disabilities and autism, children were not considered sick, but simply strange.

Tip: Do you have a hyperactive child at home?

Concerns about these disorders rise in direct proportion to the amount of information we have about them. On the positive side, most of even terrible-sounding diseases like Asperger's Syndrome are not as terrible as they sound.

They are manageable with the right approach. Children with Asperger's often have above average IQs, so there is no need to take everything tragically at once.

More serious are congenital, developmental defects and malformations of the fetus and organs. We encounter various diseases such as Down syndrome, ventricular septal defect, cleft palate, developmental brain defects, Klinefelter's syndrome and others.

How to avoid depression during pregnancy?

Depression during pregnancy is mainly influenced by genetics, the mother's health condition and external factors affecting her psyche during pregnancy. Genetic predisposition to depressive state is the worst affected.

When the mother is depressed before pregnancy, planned pregnancy and gradual withdrawal of medication is recommended. Depression arising during pregnancy due to fear of the unknown is the easiest to influence.

How to deal with it?

Pregnancy education

Educating yourself about what pregnancy is and how it takes place is very important. It helps mothers-to-be get enough information about what to expect and what they should prepare for.

Education means being informed and educated. However, it should not be an excessive search for rarities, complications and diseases that stress a woman unnecessarily.

Avoiding stressors

Avoiding stress is important in everyday life and especially for pregnant women. Stress causes a wide variety of health disorders and can cause, for example, false contractions or premature birth in a pregnant mother.

Therefore, it is important to maintain a positive mindset and the joy of the arrival. There is no need to spoil this beautiful period.

Meeting other mothers, exchanging information

There are various centres where mothers-to-be meet, interact with each other, exchange information, experiences or exercise or otherwise relax together. These meetings and conversations help relieve stress during pregnancy and also serve as a preparation for the birth itself.

Pregnancy, depression and psychopharmaceuticals

General information related to the use of drugs during pregnancy is well known. Many drugs directly harm the fetus. The effects of a large number of drugs on the unborn child are not fully proven, but are assumed.

Important:
Drugs used to treat psychiatric conditions and illnesses - psychopharmaceuticals and their metabolites - cross the placenta. Therefore, they pose a major problem for the baby. This fact should be borne in mind and their use should be considered in advance.

Psychopharmaceuticals are very rarely indicated for pregnant women. They are usually used for severe psychiatric diagnoses, less often for depressive conditions. Treatment is usually short-term (only for the time of need) and the doses of the drugs are lower.

What negative effects do psychopharmaceuticals have on the fetus?

There are several negative effects on the unborn foetus. They can cause premature birth, miscarriage and various developmental damage to the foetus on both physical and psychological levels.

This does not automatically mean that every pregnant woman taking medication will give birth to a damaged baby. However, in many cases the risks outweigh the benefits of psychopharmaceutical treatment.

The fetal effects of drugs