While these symptoms are normal and generally pass in a few days, some pregnant people may develop depression, which is a mood disorder that persists for weeks or months, and can make it difficult for people to go about their daily lives or care for themselves. Approximately 9% of pregnant people experience antepartum depression. It is least common in the second trimester of pregnancy and most common in the third trimester. Antepartum depression is not as well–recognized as postpartum depression, a type of depression people may experience after childbirth. Antepartum and postpartum depression are categorized under perinatal depression, which is the umbrella term for depression during or after pregnancy. In fact, perinatal depression is one of the most common complications of pregnancy and the postpartum period. This article explores the symptoms, risk factors, and diagnosis of antepartum depression, in addition to treatment options and coping strategies.
Symptoms of Antepartum Depression
Everyone experiences mental health conditions like depression differently; while some people have a few symptoms, others have many. The frequency, intensity, and duration of symptoms can vary from person to person. These are some of the symptoms of antepartum depression, according to Dr. Forray:
Feeling sad or extremely low and crying often Feeling overwhelmed Feeling excessively guilty Feeling worthless, hopeless, or like a failure Feeling excessively worried or scared about becoming a parent Losing interest in previously enjoyable activities Withdrawing from family or friends Not showing interest in becoming a parent Feeling extremely tired and having low energy, making hard it to perform daily tasks Eating more or less than usual Sleeping more than usual but not feeling rested, or not being able to sleep despite being tired Having difficulty concentrating, understanding things, remembering, or making decisions Thinking about giving up on life or dying
Causes of Antepartum Depression
Antepartum depression doesn’t usually have a single cause; it is believed to be caused by a combination of environmental and genetic factors. These are some of the risk factors that can contribute to the development of antepartum depression, according to Dr. Forray: For more mental health resources, see our National Helpline Database.
Prior history of depression, which is the most common risk factor Family history of depression or other mental illnesses Difficulties or antepartum depression during a previous pregnancy Significant life events and stressors, such as marital conflict, financial difficulties, loss of employment, moving, etc. Lack of support from family and friends Domestic violence Substance use disorders Chronic illness History of trauma Single marital status Young age (adolescent or under 25 years) Low socio-economic status Immigrant, minority, or refugee status
Impact of Antepartum Depression
People who have antepartum depression may have difficulty taking care of themselves. They may not eat healthy food, get enough rest, or attend their medical checkups. In addition, they may smoke, drink excessively, or use other substances that may harm the fetus. If untreated, antepartum depression could affect the fetus. It has been linked to pregnancy complications such as:
Growth and development issues in the fetusGoing into labor too earlyBabies being born with a low birth weight
Antepartum depression can also affect the child in other ways, resulting in emotional and behavioral difficulties. As a result, the child may be:
Irritable, with a tendency to cry more and be harder to comfortLethargic, with irregular sleep patternsEmotionally unresponsiveSlow at learningAggressive
Diagnosing Antepartum Depression
Some of the symptoms of antepartum depression, such as changes in appetite and sleep patterns, can be mistaken for the symptoms of pregnancy, says Dr. Forray. An OB-GYN or primary care doctor can offer guidance or a referral to a mental healthcare professional. The healthcare provider may conduct an interview or ask a series of questions based on standard rating scales, in order to make a diagnosis. It’s important to let them know about any previous history of depression, or use of antidepressant medication.
Proactive Measures
According to the Centers for Disease Control and Prevention (CDC), the rate of depression diagnosis at delivery is increasing; it was seven times higher in 2015 than it was in 2005. Therefore, the American College of Obstetricians and Gynecologists (ACOG) recommends that obstetricians, gynecologists, and other obstetric care providers take proactive measures to identify antepartum depression, including:
Screening every patient for depression and anxiety at least once during pregnancy. Evaluating, assessing, and closely monitoring patients who currently have depression or anxiety, have had mood disorders in the past, have multiple risk factors for perinatal mood disorders, or have suicidal thoughts.
Treating Antepartum Depression
In mild to moderate cases of antepartum depression, behavioral interventions, such as cognitive-behavioral therapy and interpersonal psychotherapy, are evidence-based treatments that have been proven effective, says Dr. Forray. On the other hand, Dr. Forray explains that antidepressant medications such as Zoloft (sertraline) and Celexa (citalopram) are commonly prescribed to treat moderate to severe cases of depression during pregnancy.
Coping With Antepartum Depression
In addition to seeking treatment, Dr. Forray suggests other coping strategies that may be helpful:
Healthy lifestyle: Eat a healthy diet, practice good sleep hygiene, and stay physically active. Behavioral activation: Set weekly achievable goals for activities that improve mood. Social support: Ask family and friends for help and explore community support options like pregnancy support groups. Alternative therapies: Try alternate therapies like yoga, mindfulness, and light therapy. Financial support: Reach out to organizations that offer assistance to pregnant people, such as Women, Infants, and Children (WIC), the Diaper Bank, and other available programs.
A Word From Verywell
Antepartum depression is a condition that affects a significant number of pregnant people; however, it may be ignored if the symptoms are mistaken for the symptoms of pregnancy. If you suspect you or a loved one have antepartum depression, it’s important to seek help for it as soon as possible.
