a depressed pregnant woman lies on the couch with downcast eyes

Feeling Depressed During Or After Pregnancy? You're Not Alone

As many as 1 in 5 pregnant women in the world experience depression. Here’s everything you need to know about prenatal, perinatal or postpartum depression, and tips on how to cope.

Pregnancy and childbirth is celebrated as a blessing (rightly so!), but some women and mothers-to-be may instead be afflicted with negative emotions and symptoms. This could happen when you get pregnant, or after giving birth to your child.

While the condition is uncommon, it’s important to recognise that perinatal or postpartum depression can and does occur, even without any apparent trigger. 

But, as we’ll examine in this article, pregnancy-related depression is nothing to be ashamed of, and neither should you blame yourself if it happens. No matter how gnarly it gets, bear in mind that perinatal depression is temporary — this is just a phase, and it, too, shall pass.

With understanding, patience and support, you and your family can learn to navigate the tumult and together, come out the other side.

 

What is perinatal depression or postpartum depression?

Different definitions of pregnancy-related depression

Pregnancy-related depression can occur anytime during or after pregnancy, so it may be helpful to be precise when describing the condition. 

You may encounter the following definitions in a medical setting.

  • Prenatal or antenatal depression: Occurs while you are pregnant
  • Postpartum depression: Occurs during the first year after giving birth
  • Perinatal depression: Encompasses prenatal/antenatal and postpartum depression

 

Is it just the ‘baby blues’?

Many new mothers undergo a brief period of low moods shortly after birth, where they feel emotional, tearful and easily overwhelmed. 

Known as the ‘baby blues’, this experience is mild and transitory, commonly lasting between a few days to around two weeks. 

On the other hand, perinatal and/or postpartum depression, refers to a deeper and longer-term depression. Its onset can be gradual or sudden, and its effects can be quite severe. 

It is important to consider the differences between the ‘baby blues’ and actual pregnancy-induced depression, if only so you can seek help in a timely manner.

 

How common is depression during and/or after pregnancy? 

Up to 20% of women experience perinatal depression

Studies suggest that as many as 1 in 5 women worldwide[1] experience prenatal and/or postpartum depression.

The prevalence rate for high-income countries is pegged at between 7% to 15%[1], while middle- and lower-income countries report higher rates of between 16% to 25%[1]. These figures indicate that pregnancy-related depression is certainly not a rare condition and affects mothers and mothers-to-be across all income levels.

But before you get bummed out, there are two good reasons to feel hopeful. 

Firstly, this means that those afflicted are not alone. If you happen to experience perinatal depression, know that it’s not just you and there’s nothing to be ashamed about.

Secondly, the widespread recognition of perinatal depression means that there is a vast body of knowledge and resources to draw from, which will undoubtedly prove helpful in dealing with it. 

 

Signs, symptoms and causes of perinatal and postpartum depression

Common signs of perinatal depression

  • Excessive anxiety about your baby and/or impending parenthood
  • Low self-esteem, feelings of inadequacy, feeling easily overwhelmed 
  • Severe mood swings, exaggerated or muted emotional responses
  • Once-pleasurable activities no longer confer the same enjoyment 
  • Seeks reassurance, but responds poorly
  • Withdrawal from family and loved ones
  • Foregoes proper prenatal care, and may even indulge in substance abuse
  • Poor weight gain, caused by decreased appetite or inadequate diet
  • Lack of libido
  • Sleep problems, such as insomnia, or excessive sleep
  • Thinking about suicide or self-harm

 

Common causes and risk-factors of perinatal depression

  • Hormonal changes in the body during pregnancy and after birth, leading to poor mood, low energy and other negative effects.
  • Major changes and upheavals to life — adapting to the demands of a new baby and motherhood can be stressful.
  • Real or imagined pressure to live up to being a ‘great’ mother.
  • Personal history of depression or mental health issues — having family history of such may also increase risk.
  • Lack of support from partner, family and loved ones, marital, financial or family problems.
  • Negative or anxious feelings about the pregnancy. 

 

How can families cope with perinatal or postpartum depression?

Perinatal depression is a multifaceted issue, due to the complex interplay between mental health, bodily changes and societal factors. As such, teasing out solutions that are actually helpful or beneficial may require some work or effort.

It is important to recognise that you or your partner may not be properly equipped to properly manage the condition, especially if it is severe. Hence, the single, most important thing is to ask for help, whether from your obstetrician, gynaecologist, mental health professionals, or even just from family members. While depression during pregnancy can leave you feeling alone, that doesn’t mean you have to deal with it all by yourself. 

Having said that, there are certainly things you can do or try to help keep yourself in balance during this difficult time. 

 

Here are some tips for keeping your spirits up during pregnancy and motherhood[2,3,4]:

  • Be kind to yourself. Let go of preconceived notions and expectations, and recognise the futility of trying to measure up to some arbitrary and imaginary standard.
  • Journal, or take voice memos. Set aside some time to periodically note down your feelings and moods. This can act as an outlet to relieve pent-up frustrations or stress, and may provide insight into potential triggers.
  • Talk it out. Sharing your experience with a friend or someone who has been in the same boat can provide valuable support.
  • Look after your appearance. A large part of our self-esteem is tied to how we look, so be sure not to neglect your physical appearance. Try on flattering or fashionable maternity wear, have a new haircut, focus on your skincare routine, or invest in post-natal massages or fitness classes.
  • Take things one step at a time. Hurrying to get better or ‘feel normal’ can make you feel frustrated and stressed out. Instead, focus on the moment, and allow things to unfurl in their own time.

 

Perinatal depression is temporary, manageable and curable

In closing, we would like to leave you with this takeaway.

Perinatal depression can be dreadful, and every woman who is pregnant is at risk. However, don’t be overly worried, as the condition is quite manageable, and it lasts only for a time. 

Many pregnant women and their families have successfully made it through the experience, no doubt with varying degrees of medical and professional help. 

So if you require help, don’t hesitate to ask for it. You will find that the support you seek is available, and that you are not alone. 

 

Sources:
[1] Maternal Health Task Force, Perinatal Mental Health, https://www.mhtf.org/topics/perinatal-mental-health/ 
[2] Help Guide, Postpartum Depression And The Baby Blues, https://www.helpguide.org/articles/depression/postpartum-depression-and-the-baby-blues.htm
[3] Healthline, 7 Ways To Cope With Postpartum Depression, https://www.healthline.com/health/depression/how-to-deal-with-postpartum-depression#reevaluate-breastfeeding
[4] Raising Children, Antenatal And Postnatal Depression In Your Partner: How To Help, https://raisingchildren.net.au/grown-ups/fathers/mental-health-wellbeing/pnd-your-partner