Mallory Welsh, LCSW

Depression. Most people, if not all people, have heard of depression and understand it to a certain degree and are talking about it more openly, which is wonderful. But how many people are taking the time to talk about prenatal depression? I work with many clients who experience depression whether it be related to their personal or professional life, but it appears to be less common for clients to talk about prenatal depression, maybe simply because there is less awareness about it.

I recently read an article from The New York Times that touched on this very topic, “I’m Embarrassed by My Prenatal Depression. Here’s Why I Talk About It Anyway” by author Jessica Grose. Grose discusses her personal experiences of prenatal depression and her discussions with doctors who helped her cope with it.

Below are some key points from her article.

  • What is prenatal depression? It is clinical depression that affects woman who are pregnant and sometimes can be a precursor to postpartum depression. 1 in 5 women will have a mental health issue during or right after their pregnancy.
  • Risk-Risk. Grose discusses that Dr. Pooja Lakshmin, clinical assistant professor of psychiatry at the George Washington University School of Medicine, discusses that there can be risks of preterm birth and low birth rate for women who are on S.S.R.I’s during pregnancy, but there also risks of preterm birth and low birth rates for babies whose mother’s depression goes untreated without medications. So yes, either decision to go or not go on medications has risks.
  • What are the risk factors for prenatal depression? Dr. Meltzer-Brody, founder and director of the University of North Carolina Perinatal Psychiatry Program, discusses there are number of risk factors for prenatal depression: history of mental illness, sexual abuse, lack of social support, and being homeless. He also points out the hormonal component that women who are more sensitive during their menstrual cycle, those that have premenstrual dysphoric disorder, or those that act poorly to hormonal birth controls are more vulnerable to prenatal depression.
  • Being proactive about conceiving. If you do believe you are more susceptible to prenatal depression, Dr. Lakshmin recommends to be proactive in the appropriate steps prior to conceiving. He recommends to start speaking to a psychiatrist you trust prior to conceiving that you feel will support your decisions regarding your medications during your pregnancy.
  • Choosing to go off of your medication during pregnancy? Dr. Lakshmin recommends to speak with your psychiatrist before making that decision. Psychiatrists will help create a medication tapering plan for you as it is not recommended to go off of your medication cold turkey. After speaking to your psychiatrist, he encourages you to be off of your medications 2-3 months prior to you starting to conceive. This allows you to see how you feel prior to the pregnancy hormones that will start occurring once you do become pregnant.
  • Extra Supports. It is incredibly important to not only have a psychiatrist to give you support, but also social support as well. Dr. Lakshmin recommends having friends, family, and a therapist support in place. He also states prenatal yoga can be a helpful coping skill as well.
  • When to get help? If you continue to feel anxiety and depression during your pregnancy, Dr. Lakshmin recommends to get help. Untreated anxiety and depression do not just go away once you have the baby, it is actually a major risk factor for postpartum depression. Dr. Meltzer-Brody discusses that prenatal depression is typically missed in the first trimester due to the woman feeling nauseous and feeling fatigue. If you are feeling moody or anxious without relief during any of your trimesters (and it is not typical for your baseline), it is time to seek out help.

If you are currently struggling with prenatal depression, it may be a good idea to connect with one of our skilled counselors at Symmetry Counseling today. You can contact them at 312-578-9990 to set up an appointment.