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Prenatal Depression: Not “Just Pregnant”

Daniel Hageman 

Glowing, happy, radiant— pregnancy is “supposed to be” a cherished and special time in a soon-to-be mother’s life. But for those who develop depression during their pregnancy, this prenatal period can be starkly different from the fairytale experience they’d imagined. Unfortunately for some pregnant women, accessing the mental health treatment they need can prove very difficult.

Glowing, happy, radiant— pregnancy is “supposed to be” a cherished and special time in a soon-to-be mother’s life. But for those who develop depression during their pregnancy, this prenatal period can be starkly different from the fairytale experience they’d imagined. Unfortunately for some pregnant women, accessing the mental health treatment they need can prove very difficult. Hormonal changes during pregnancy can impact a woman’s mood, but the seriousness of this impact is sometimes dismissed as not requiring medical intervention. Women on antidepressant medication are often advised to discontinue for fear of any adverse effects on a developing fetus, with little recourse in finding different methods of treatment.

According to Dr. Kimberly Cress , Regional Medical Director of Houston Greenbrook TMS NeuroHealth Centers, the risk of depression during the third trimester of pregnancy is even greater than during the post-partum period and untreated depression can negatively affect the health of the mother and her fetus.

In a recent column for The Washington Post , noted science writer Lauren Tanabe recounted the difficulty she had with her prenatal depression being taken seriously by health care providers. She details her concerns being routinely dismissed and being advised that there were no treatment options for her because she was pregnant and most psychotropic medication was to be avoided. When Tanabe told a midwife that she was profoundly struggling with her mental health, she recounts:

“Aww, you’re just pregnant,” [the midwife] smiled. … I told her it was beyond pregnancy. It was depression unlike I’d ever known. She shrugged and said that I was pregnant and there wasn’t much they could do. She told me she would request a mental health provider contact me, but it would be at least six weeks. Nobody ever called.

Dr. Geoffrey Grammer , Chief Medical Officer for Greenbrook TMS NeuroHealth Centers says that many doctors are unaware that there are safe and effective treatment options for pregnant women. “Providers should be prepared to discuss the spectrum of available options so patients may make informed decisions. Leaving a patient with the impression that there are no options because they are pregnant is not an acceptable outcome and does not reflect the current state of medical science.”

For pregnant women seeking non-medication depression treatments, interpersonal and cognitive behavioral therapy can be beneficial. Dr. Grammer also suggests that patients talk to their providers about Transcranial Magnetic Stimulation, or TMS Therapy. “TMS Therapy uses a magnetic field to stimulate areas of the brain involved in depression and normalizes its function. This is a non-systemic and non-invasive treatment that takes place in a short office visit, making TMS Therapy an appealing option for some pregnant patients.”

An estimated 1 in 20 women experience depression during their pregnancy, with symptoms that can include:

  • Insomnia
  • Depressed mood
  • Feelings of worthlessness or guilt
  • Difficulty thinking, concentrating, or making decisions
  • Loss of interest in activities
  • Thoughts of self-harm or suicide

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