Depression & pregnancy

During pregnancy and again in the postnatal period, most women in Australia will be screened for depression.

You will be screened using a questionnaire that asks a number of set questions about how you are feeling. Your answers will let the health professional know whether or not you have symptoms of depression. Reasons for screening include:

• Women with depression may not recognise they have it (especially if they have never had depression before).
• Depression can have serious consequences for both you and your baby.
• Early treatment is the most effective, and screening can detect symptoms early.

Ten to fifteen per cent of women will be diagnosed with depression during pregnancy and in the postnatal period.  The most likely time for depression to begin is in the first few weeks after the baby’s birth.  Common symptoms and signs of depression during and following pregnancy include:

• feeling depressed or miserable consistently for most of the day and for most days of the week
• feeling irritable, angry or anxious a lot of the time
• increased crying, sometimes for no apparent reason
• reduced interest in things that you would normally enjoy
• not able to sleep (even when your baby is sleeping) or sleeping more than usual
• reduced appetite or over-eating
• excessive fatigue and tiredness
• difficulty concentrating and being forgetful
• preoccupation with morbid thoughts or being anxious about multiple things, such as bad things happening to you, your pregnancy, your baby or your partner
• feeling disconnected from your baby, that your baby is not really yours or that you do not have a bond with your baby
• excessive feelings of guilt and/or failure, that you are a ‘bad mother’
• thoughts of harming yourself
• thoughts that things would be better for you and your baby if you (and your baby) were dead, leading to thoughts of suicide.

What causes depression?

There are many things that can contribute to, or make you vulnerable to depression, including:

• a  history of depression or anxiety
• family members who have had or have depression or anxiety
• stress during your pregnancy or if it was unplanned 
• your expectations of motherhood are unrealistic and you can’t meet them
• a traumatic or complicated birth
• relationship/marriage difficulties
• lack of social support
• your baby is sick or unsettled.

If you have depression or anxiety during pregnancy you are more likely to have postnatal depression. It is important to get professional help and treatment during pregnancy, rather than leaving it until after your baby arrives.

Treatment for depression

The first step to getting treatment is to see your GP. Initially, your GP may do some blood tests to rule out any medical illnesses that mimic depression, such as iron deficiency, anaemia or thyroid problems. They can then tailor a management plan according to the severity of your illness. Mild to moderate depression can be improved with psychological treatment and increasing the supports around you. In some cases of more severe depression, you may need to take antidepressants. There are antidepressants that are quite safe when you are pregnant and when you are breastfeeding.

If you are already taking antidepressants when you get pregnant you will need to talk with your GP about your ongoing treatment. If you stop taking your antidepressants when you discover that you are pregnant it can cause a relapse of your symptoms.

Herbal and complementary treatments such as St John’s Wort may not be safe in pregnancy or may interact with other medicines.

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