Your Pregnancy After 35 : Your Health and Medical History (part 12) - Depression, Depression during Pregnancy , Symptoms and Treatment

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- Foods That Cause Miscarriage
- Signs Proving You Have Boy Pregnancy

34. Your Medical History

To give you and your baby the best care possible, your healthcare provider will ask you for a lot of information at your first prenatal visit. You can help by gathering the information before you meet.

35. DES Use by Pregnant Woman’s Mother

In the 1940s, ’50s and ’60s, a nonsteroidal synthetic estrogen called diethylstilbestrol (DES) was given to some women to prevent miscarriage. The compound was even included in some prenatal vitamins. Research proved later that DES caused problems in some of the female offspring of women who used it, including an increased risk of miscarriage and premature labor when the younger women became pregnant. A higher rate of ectopic pregnancy has been blamed on DES-related Fallopian-tube deformities and uterine deformities. DES can also affect uterine-muscle development, resulting in an abnormally shaped uterus.

Because DES was prescribed from the 1940s through the 1960s, most affected women have passed through their years of conception. However, as an older pregnant woman, it could be significant for you. Ask your mother if she took DES while she was pregnant with you. If you were exposed to DES through your mother’s use of the medication, some researchers recommend prenatal counseling before pregnancy about the risks of miscarriage, premature delivery, ectopic pregnancy and other problems.

36. Preparing Your Medical History

This information may help your healthcare provider address potential problems.

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!

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