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Antepartum Depression: Depression During Pregnancy

Daniel Hageman 

One of the more significant challenges during pregnancy is the physical and emotional impacts of surging hormones which affect the brain chemistry, sometimes causing a Major Depressive Disorder (MDD). There is growing awareness concerning Postpartum Depression; however, there is practically no awareness and information being shared about the very real potential of suffering from depression during pregnancy- referred to as Antepartum Depression.

Pregnancy is one of life’s greatest journeys, and like any new quest, there brings change, unique challenge and discovery. The expecting mother and her partner will likely confront many additional commitments and unique challenges. From numerous doctor visits to added relationship strain and career stress, expecting couples learn to balance and adapt to these new demands. One of the more significant challenges during pregnancy is the physical and emotional impact of surging hormones which affects brain chemistry, sometimes causing a Major Depressive Disorder (MDD). 1 There is growing awareness concerning Postpartum Depression- a period of about 6-weeks following the baby’s birth; however, there is practically no awareness and information being shared about the very real potential of suffering from depression during pregnancy- referred to as Antepartum Depression.

Elevated hormonal levels that are crucial for the developing baby can cause the expecting mother to endure a roller-coaster ride of emotions. Emotions ranging from elation to sadness, from anger to frustration and even to serious depression. According to the American Congress of Obstetricians and Gynecologists (ACOG), between 14 – 23% of women will struggle with symptoms of depression in pregnancy. 2 If left untreated, antepartum depression can lead to premature birth, low birth weight, developmental delays and behavioral problems in children, and a staggering 50% greater risk for postpartum depression. Pregnant women experiencing depression and anxiety are also more prone to smoking, drinking alcohol, using illicit drugs and are less likely to attend consistent prenatal care. 3

Obstetricians should regularly screen their patients for depression starting from the early phases of family planning throughout the duration of the pregnancy and all the way through the postpartum period. 4 Despite this necessity, many obstetricians do not inquire into the emotional well-being of their patients because they have not received appropriate training in depression and/or general mental health evaluation. As a result of this unfortunate disconnect, it is critical for the expecting mother to self-advocate and seek professional help if she is experiencing any symptoms of depression or other emotional issues.

Signs of Depression in Pregnancy

  • Persistent sadness
  • Difficulty concentrating
  • Sleeping too little or too much
  • Loss of interest in activities that are usually enjoyed
  • Recurring thoughts of death, suicide or hopelessness
  • Anxiety
  • Feelings of guilt or worthlessness
  • Changing in eating habits

Treatment for Depression in Pregnancy

There are a variety of treatment options for depression including psychotherapy, medication, a combination of the two, and alternative therapies. Due to the ongoing controversy of taking certain medications while pregnant, an increasing number of women and physicians are exploring non-drug alternative treatments such as Acupuncture, Herbal Medicine and Light Therapy. Another therapy, one that brings the latest in technology and a non-invasive, non-drug alternative for treating depression is Transcranial Magnetic Stimulation Therapy (TMS). 5

TMS Therapy uses gentle magnetic pulses to stimulate areas of the brain known to control mood. These specific areas have been identified as underactive in people who suffer from depression. TMS Therapy causes neurons, cells that process and transmit information, to become active and stimulate brain activity.

In a 2011 study conducted at the Department of Psychiatry, University of Pennsylvania, 10 women diagnosed with a Major Depressive Disorder during their second or third trimester of pregnancy were treated with TMS Therapy. The study showed that 7 of the 10 (70%) women positively responded to TMS Therapy with a 50% or more decline in their depressive symptoms. All babies were born in good health, admitted to the well-baby nursery and discharged with their mothers. Mild headache was the only common reported side effect of treatment in 40% of the women. 6

Take Action

Emotional and mental health are critically important to enjoying a healthy pregnancy and delivering a healthy baby. Diagnosis and treatment of psychiatric illness during pregnancy is vital to the long-term health of both mother and baby. Early intervention and treatment for depression during pregnancy will also serve to lessen one’s chances of suffering with postpartum depression. With Winnie the Pooh in mind, keep your adventure grand and please seek help from your obstetrician if you are experiencing any symptoms of depression or other emotional struggles. Make sure to ask them about Transcranial Magnetic Stimulation Therapy (TMS) as a possible alternative treatment to medication.

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Schedule A Free Consultation To get started with nasal esketamine, schedule your free consultation today.
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