Pregnancy Week by Week : Week 24 (part 1) - Depression

Depression

Depression can occur at any time during a person’s life. Many things can contribute to depression, including chemical imbalances in the body, stressful life events and situations that cause anxiety and tension. If you have a history of major depression, you’re at increased risk of depression occurring 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.

The fetus doesn’t appear to have a great deal of
room to move in the uterus by the 24^th week.
As the weeks pass, space gets even tight

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 by your healthcare provider to do so. 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 as soon as you confirm your pregnancy.

There is continued concern about the safety of Paxil during pregnancy. Research suggests using the drug in the first trimester of pregnancy may be tied to an increased risk of heart 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. 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.”

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. And 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 today 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

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

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 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!