I dislike having to go to my prenatal visits—it always takes so long. Do I really have to go to them?
Yes! Keeping your appointments for
prenatal care is one of the most important things you can do to help
guarantee a healthy baby.
37. Depression
Depression can occur at any time during
a person’s life. If you have a history of major depression, you’re at
increased risk of depression during pregnancy. In fact, between 3 and
5% of all women experience a major depression during pregnancy. It’s
estimated another 15% have some degree of depression.
If you’re being treated for depression
when you get pregnant, it’s important to continue treatment. Treating
depression is as important as treating any other problem. If you take antidepressants, don’t stop
unless advised to do so by your healthcare provider. Studies show up to
70% of women who stop taking antidepressants during pregnancy relapse
into depression. Stopping your medication can raise stress hormones,
which increases your risks of problems during pregnancy. The risks to
you and your baby from depression may be greater than your risk of
taking antidepressants. We know depression can be difficult to manage
without using drug therapy.
There may be a very small increased risk
of birth defects with some medicines used to treat depression when
taken during the first trimester. It may help to switch to an
antidepressant that is safer during pregnancy, including fluoxetine
(Prozac), citalopram and escitalopram (Lexapro). Pregnancy may affect
your body’s ability to use lithium. If you take an SSRI, the dose may
need to be increased during the third trimester to maintain your normal
mood. Talk to your healthcare provider about your medication before
pregnancy or as soon as you confirm your pregnancy.
There is continued concern about the
safety of Paxil during pregnancy. Research suggests that using the drug
in the first trimester of pregnancy may be tied to an increased risk of
some problems in baby. However, do not stop taking your antidepressant medicine without first consulting your healthcare provider.
If you’re feeling depressed, your level
of vitamin D may be low. Talk about it with your healthcare provider.
Other suggestions for dealing with depression include getting some
exercise and being sure you get enough B vitamins, folic acid and
omega-3 fatty acids. You can get omega-3 fatty acids by including
walnuts, flaxseed, salmon and scallops in your meal plan. Taking about
3.5g of omega-3 fatty acids every day has been shown to help fight
depression.
Additional therapies include
massage and reflexology. Another option is light therapy, similar to
the type of treatment given to those who suffer from “seasonal
affective disorder.”
38. Depression during Pregnancy
Depression during pregnancy does
occur. Experts believe it’s one of the most common medical problems
seen in pregnant women. Studies show up to 25% of all moms-to-be
experience some degree of depression, and nearly 10% will experience a
major depression. If left untreated, 50% of women who are depressed
during pregnancy will experience postpartum depression.
Treating depression during pregnancy is
important for your health and baby’s health. This is one of the many
reasons healthcare providers make treating depression a priority.
Depression is actually more common during
pregnancy than after giving birth. If you have a family history of
depression, you may be at higher risk during pregnancy. If you don’t
have enough serotonin, researchers believe you may be at higher risk.
If you’ve been struggling with infertility or miscarriage, you may also
be more prone to depression.
If you’re depressed, you may not take
good care of yourself. Babies born to depressed women may be smaller or
born prematurely. Some women use alcohol, drugs and cigarettes in an
attempt to ease their depression. You may also have trouble bonding
with your baby after birth.
Consider the following to measure your risks of being depressed. You may be at higher risk if:
•you experienced mood changes when you took oral contraceptives
•your mother was depressed during pregnancy
•you have a history of depression
•you feel sad or depressed longer than 1 week
•you’re not getting enough sleep and rest
•you have bipolar disorder—pregnancy can trigger a relapse, especially if you stop taking your mood-stabilizing medications
39. Symptoms and Treatment
It may be hard to differentiate between
some of the normal pregnancy changes and signs of depression. Many
symptoms of depression are similar to those of pregnancy, including
fatigue and sleeplessness. The difference is how intense the symptoms
are and how long they last. Some common symptoms of depression include:
•overpowering sadness that lasts for days, without an obvious cause
•difficulty sleeping or waking up very early
•wanting to sleep all the time or great fatigue (this can be normal early in pregnancy but usually gets better after a few weeks)
•no appetite (as distinguished from nausea and vomiting)
•lack of concentration
•thoughts of harming yourself
We know women who are depressed are more
likely to develop diabetes, and women who develop diabetes are more
likely to be depressed. This is also true for pregnant women. If you
have diabetes and untreated depression, then become pregnant, it can be
serious if you don’t get help. You may have a difficult time caring for
yourself. This could lead to difficulties in controlling weight gain
and sugar levels. Your risk of addictive-substance abuse, such as alcohol use and cigarette smoking, may increase. And you may not be able to meet the nutritional demands of your pregnancy.
Babies born to mothers with untreated
depression can have many problems. They often cry a lot, have
difficulty sleeping, are fussier and are difficult to soothe.
If you have symptoms and they
don’t get better in a few weeks or every day seems to be bad, seek help
as soon as you recognize you might be depressed. Call your healthcare
provider, or bring it up at your next prenatal visit. There are steps
to take to help you feel better again. It’s important to do it for
yourself and your baby!
