Pregnancy: I'm expected to be happy and glowing, but I feel so low...am I depressed?

Motherhood is the most complex phase in a woman’s life. A woman’s physical and mental health is vulnerable at this time so each expectant mother needs attention and empathy during this period.

For most women, pregnancy is a joyful period, but for some, it can be challenging. Various biological as well as psychosocial factors can cause mental health problems such as depression, anxiety, OCD, and postpartum psychosis.

The psychological wellbeing of pregnant women must be considered just as important as their physical health needs, and included in routine antenatal care.  

Pregnancy

The nine-month duration of pregnancy is known as antenatal period. During this time, women can be prone to depression and anxiety due to various biological or psychosocial factors. However, these mental health problems are frequently undiagnosed and ignored because the symptoms of depression are similar to physiological complaints of pregnancy such as irritability, tiredness, sleep or appetite disturbance.

Some of the risk factors that can cause depression in the antenatal period include:

• Poor marital relationship

• Unplanned or unwanted pregnancy

• Domestic violence (physical, sexual, and emotional)

• Family or personal history of depression, bipolar disorder, postpartum psychosis or other serious mental illness

• Pre-existing mental illness can be exacerbated during pregnancy such as OCD or Post Traumatic Stress Disorder (PTSD)

• Reducing or stopping medication for previously diagnosed mental illness, during pregnancy

• Complications experienced in the previous pregnancy or bereavement

• Financial burden

• Addiction to alcohol, illicit drugs or prescribed drugs

• Migrating from a rural area or town to the city, where there is no family or social support

• Extreme stress due to work pressure and deadlines

Pregnancy changes – this is normal

This is not normal

Every woman experiences some of these common symptoms during pregnancy, and they are mostly due to hormonal changes.

• Nausea/vomiting especially during the first trimester

• Mood changes, weepy or emotional

• Irritability

• Reduced self-esteem

• Concerns with body image

• Disturbed sleep especially in third trimester

• Fatigue, more in first and third trimester

• Anxiety, related to impending delivery and wellbeing of baby

These symptoms suggest that a woman is suffering from antenatal depression:

• Weight loss or failure to gain weight during pregnancy

• Continued reduced appetite even after recovering from ‘morning sickness’

• Altered sleep pattern

• Agitation or restlessness

• Fatigue or loss of energy

• Feelings of worthlessness or guilt

• Anhedonia (no interest or pleasure or enjoyment)

• Markedly reduced concentration

• Recurrent thoughts of death or suicide

If you notice these changes in yourself during pregnancy or in your wife/daughter during pregnancy, seek professional help.

Important: Antenatal depression can be easy to diagnose. If the woman is diagnosed and treated, she may get well before her baby arrives.