Prenatal depression has recently gained much attention in the world of psychological disorders. It is believed to affect around 1 in every 5 pregnancies, which means that if you are pregnant, you or someone you know might be suffering from it. Pregnancy is an exciting time in women’s lives and can also bring about a lot of anxiety, guilt, and different emotions.
What Is Prenatal Depression
Prenatal Depression is a type of depression that occurs during pregnancy. It’s different from the kind of depression that happens after you have your baby, postpartum depression. The symptoms of prenatal depression can be similar to postpartum depression, but they are not precisely the same.
It can happen anytime during pregnancy, but some women begin to feel symptoms as early as the first trimester (the first 3 months).
If you think you might be experiencing prenatal depression, it’s important to tell your doctor immediately so he or she can help you get treatment.
Prenatal Depression in Singapore
Help is at hand for mums-to-be to cope with the blues during and after pregnancy. In a study by the National University of Singapore, findings conclude that antenatal depression affects 12 per cent of pregnant women compared to 7 per cent of postnatal depression in women in Singapore. It is not known why prenatal depression is more common.
According to The Straits Times, hospitals have started screening pregnant women for antenatal and post-natal depression. National University Hospital (NUH) started the programme in 2008. Singapore General Hospital (SGH) started screening for post-natal depression in 2004, and 2011, antenatal depression.
KK Women’s and Children’s Hospital (KKH) has trained obstetricians to identify antenatal depression in women since 2008.
Pregnant woman feeling depressed
Ms Chin is now a mother of a 9-month-old boy. When pregnant, she did a routine screening for depression on her first visit to NUH. She saw a psychiatrist during her second trimester, as she felt plagued by anxious thoughts. Her depression went away without medication as her psychiatrist advised her to overcome it.
Even when it surfaced just before her baby was due, she was able to remain calm. Depression during pregnancy is not as recognized as postnatal depression, although both can negatively impact mother and child.
What Causes Depression During Pregnancy
Prenatal depression can be especially dangerous for the health of the mother and her baby, so it’s important to know how to recognise the signs and get help.
There’s no one cause for depression during pregnancy, but there are several factors that can contribute to it:
- The physical changes your body undergoes during pregnancy can cause mood swings and other emotional issues. These include weight gain, hormonal changes, and increased blood flow to your breasts and pelvic area.
- You may also be dealing with other stressful situations in your life that could make you feel depressed or anxious (such as losing your job or moving). Or maybe there are problems at home or work that have nothing to do with being pregnant! It’s important not to blame yourself if this is happening—you’re going through a lot right now!
- Many women experience symptoms of depression before they even realise they’re pregnant because of what happens to their bodies when conception occurs (doctors recommend getting tested for various illnesses before trying for children). The hormones produced during pregnancy can also trigger feelings of sadness or unhappiness.
When Does Prenatal Depression Start
Prenatal depression can start as early as the first trimester and continue through the third.
In most cases, it starts with a change in hormone levels. The increased estrogen that comes with pregnancy is often responsible for increased serotonin levels, the neurotransmitter that helps us feel happy and relaxed. This can increase energy, making you feel more productive and motivated to get things done around your house or at work.
However, many other factors could contribute to the onset of prenatal depression:
- A history of depression or anxiety disorders (especially if they were severe)
- Stressful life events such as moving, death of a loved one, or divorce
- Prenatal risk factors like smoking or drug use during pregnancy
Prenatal Depression Symptoms
If you’re pregnant and feeling sad, anxious, or irritable for more than two weeks, you may be experiencing prenatal depression. While it’s normal to feel down in the dumps from time to time during pregnancy, sustained feelings of sadness can interfere with your ability to take care of yourself and your baby.
Prenatal depression symptoms often include:
- Feeling sad or hopeless
- Having trouble sleeping or concentrating
- Not enjoying activities you used to enjoy
- Being overwhelmed by simple things like housework
- Feeling angry or irritable
- Lack of appetite
- Feeling isolated and withdrawn from family, friends, or others who could offer support
Risks of Ignoring Prenatal Depression Signs
Prenatal depression is a problem that affects many pregnant women, but it’s not something that always gets talked about. Many women feel like they can’t tell anyone about their depression because they are afraid of being judged or worried about how others will react.
But we need to discuss this more because there are dangers in ignoring the problem—especially for yourself and your baby.
Women diagnosed with depression during pregnancy have a 50 per cent increased risk of giving birth to a child with developmental delay and potentially giving birth prematurely by about two weeks. Also, they may turn to consuming alcohol and smoking to cope with depression if left unchecked.
This will have long-term adverse health effects on the baby. This is cited from a 2008 study in the United States, said Dr Chua Tze-Ern, the associate consultant at KKH Mental Welfare Service. Dr Chen also added that antenatal depression often indicates post-natal depression, and about half of the women remain depressed.
A study by KKH has shown that a combination of medication or counselling helps about 80 per cent of the patients recover within months if detected early. Mums-to-be are screened in every trimester and after birth. Whilst an obstetrician at SGH guides the patient through the questionnaire adapted from The Edinburgh Post-natal Depression Scale, the patient completes the form independently in NUH.
Studies show that if left untreated, prenatal depression can lead to miscarriage, pre-term birth, and developmental delays in the baby. The mother herself can also experience long-term physical health issues as well as mental health issues after giving birth.
It’s thought that up to half of women who suffer from prenatal depression will experience postpartum depression after birth.
Prenatal Depression Treatment
If you’re experiencing any symptoms of depression, it’s important to seek treatment as soon as possible. Hormones can make your depression worse during pregnancy, and untreated depression can have lasting effects on you and your baby.
Fortunately, there are several options for treating prenatal depression.
If you think that you may have symptoms of prenatal depression, talk to your doctor about it. They’ll be able to diagnose and treat your condition more quickly if they know what’s happening. Plus, they’ll be able to help you develop a plan for managing your symptoms throughout the remainder of your pregnancy.
Some women find that taking antidepressants helps with their prenatal depression symptoms. These drugs should only be taken under the guidance of a doctor who has experience with treating pregnant women with mental health conditions like depression since they may cause some birth defects in babies born from mothers who took them during pregnancy.
You should also avoid alcohol while taking antidepressants because this combination can cause serious side effects for both mother and child, including fetal alcohol syndrome (FAS).
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Try Alternative Treatments
Prenatal depression is real and can be treated—but not always with traditional medicine. Sometimes, alternative treatments are more effective.
One of the easiest ways to get started is with acupuncture. Since acupuncture is based on the theory that energy flows through the body and is blocked by illness, it’s a great way to treat prenatal depression. The needles are placed at strategic points on your body, which allows them to unblock your energy flow and help you feel better.
If that’s not enough, there are other options for you: yoga and massage therapy can also help relieve stress and anxiety and improve mood.
You should always talk to your doctor before trying any alternative treatments for prenatal depression—but if they don’t work for you, or if they aren’t available where you live (or if your insurance doesn’t cover them), this list will give you some ideas of other things that might help!
A pregnant woman suffering from prenatal depression seeking professional help | Image from Pexels
Can Prenatal Depression Be Prevented?
Depression can be cured but is not entirely preventable. Unpleasant life events or illnesses are unexpected risk factors that cause the onset of depression. Other factors, such as having a balanced diet, moderate physical activity, adequate preparation for motherhood, and healthy and supportive marital relationships, help reduce the risk of depression.
Mums-to-be are encouraged to seek physical and emotional support from family and friends.
KKH Mental Wellness Service, Dr Helen Chen, said that the number of pregnant women referred for psychological help has exceeded by almost double the number of postnatal depression women. The figure of depression for postnatal depression is lower than for depression during pregnancy because the screening process has been well-documented and more established.
Prenatal Depression Screenings in Singapore
SGH and NUH offer to screen all mothers, and appointments are made for those who registered high scores on the questionnaire. There are staff who will do the follow-up to see if assistance is required. A woman before and after pregnancy may need to visit the doctor at least 10 to 15 times.
NUH has screened 12,000 women since 2008, of which over 9,000 were screened during pregnancy. About 1 in 3, or 3,300, were at risk. But about 2,200 women agreed to follow up for further assessment. Depression is still generally unacceptable within society. About two-thirds out of the 800 diagnosed with depression have since recovered.
Dr Cornelia Chee, consultant psychiatrist and the director of the NUH Women’s Emotional Health Service, said that the stigma of seeing a psychiatrist is still prevalent in society. Another obstacle would possibly be the cost of seeing a psychiatrist, although it is of no charge to fill up the questionnaire.
Women should seek help, as tragedies can be avoided if signs are recognized and heeded. A lack of manpower has shelved plans for fathers to be screened for depression.
Take a Simple Test
The Edinburgh Post-natal Depression Scale questionnaire can be found here. It is a rough guide to screening women for depression during and after pregnancy. If your score is 13 and above, please consult a psychiatrist to confirm the diagnosis.
If you are pregnant and experiencing the symptoms of prenatal depression mentioned above, do not hesitate to consult your doctor.
Updated by Pheona Ilagan
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