Most women feel that they should be glowing with happiness while carrying. So, developing symptoms of depression often make them feel guilty, thinking they do not love their child as much as they should. But the truth is, many women suffer from depression due to the body changes occurring during this period . However, one can easily deal with the symptoms by talking to their health care provider and taking certain precautionary measures.
Pregnancy hormones were earlier believed to provide protection from depression as pregnant women often have a feeling of emotional wellbeing . But lately, experts believe that the rapidly increasing estrogen and progesterone levels can contribute to signs of depression by disrupting the brain chemistry . Depression can occur anytime during the first, second and third trimester.
Around 10% to 15% women develop prenatal depression, making it almost as common as postnatal depression (PPD) .
Women suffering from depression are more prone to postpartum depression as well as various pregnancy complications as they are more at risk of:
Those with major depression are even at risk of committing suicide .
Effects on the baby may include:
Having three or more of the above signs continuously for over 2 weeks may indicate clinical depression . It is recommended to talk to your doctor if you suspect possible depression. Your doctor may ask a few questions regarding any history of depression while also ordering some tests to rule out any physical condition that might lead to mental symptoms.
Counseling, cognitive behavioral therapy and problem solving therapy are commonly used to fight depression . Psychological treatment options used for managing postpartum depression (depression after pregnancy) are useful for dealing with depression and anxiety in pregnant women as well. Forums and support groups for antenatal and postnatal depression can also help you overcome the symptoms.
Your doctor may prescribe antidepressants for severe depression during pregnancy if their benefits overcome the potential risks . Certain anti-depressive medicines have been proved safe for short-term use in pregnant women, including:
Another drug named Bupropion (Wellbutrin, Budeprion, Prexaton) is sometimes used for fighting depression as well as smoking cessation .
Herbal depression remedies like St. John’s wort are not recommended in pregnancy without expert consultation. There is a lack of adequate research regarding the safety of such remedies and their potential effects on the fetus .
Not all antidepressants are recommended for pregnant women as certain drugs (venlafaxine) may increase the chances of miscarriage or stillbirth . Recent studies show antidepressant use in pregnancy to be associated with premature delivery. However, scientists are still researching the contribution of other risk factors like maternal obesity, socioeconomic stress and depression .
Using SSRIs during the third trimester is believed to increase the risk of preeclampsia in the mother as well as pulmonary hypertension, autism  and certain birth defects in the baby . It is also associated with certain symptoms in the newborn, including poor feeding, irritability and sleep disturbances that may last up to a week.
TCAs are considered safer than many newer antidepressant drugs, but their fatal toxicity index is higher than that of SSRIs .
Depression is quite common in pregnancy with 14% to 23% pregnant women experiencing the symptoms .
The ICD-9 codes used for indicating depression are 296.2, 296.3  while its ICD-10 codes are F32, F33 .
American Pregnancy Association
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