Depression during Pregnancy: Causes, Symptoms, Prevention, and Support

A pregnant woman’s body goes through many changes throughout the pregnancy. The physical and emotional changes may have an impact on how she feels about herself, her family, and her everyday life. Due to this, she may experience depression during pregnancy. The chances of developing depression are higher for first-time mothers, teenage mothers, single mothers and women who have experienced gender-based violence.

It is important to recognize depression and get help. Without treatment, depression can cause complications during and after your pregnancy. In this article, we will look at the causes of depression during pregnancy, how to manage it and how to prevent it. We have also included information on how to get help for depression during pregnancy.

Do all pregnant women suffer from depression?

Not all women will develop depression during pregnancy, everyone is different, but it is more common than you might expect.

According to the World Health Organization (WHO), two out of every ten pregnant women experience significant changes in mood and anxiety during pregnancy. Many people have milder symptoms of poor mental health. These conditions can last up to a year after giving birth or terminating a pregnancy.

Why should pregnant women be concerned about their mental health?

According to medical experts, the symptoms and disorders that are likely to appear when a woman becomes pregnant such as severe anxiety, mood swings, loss of appetite, and guilt can cause long-lasting harm to mothers, babies, and families if not addressed properly. Pregnant women who experience depression might not have the energy to take care of themselves, including going for ante-natal clinics, eating healthy foods, and exercising.  Depression can also get in the way of you bonding with your unborn baby There are health facilities inside and outside the refugee camps that treat depression during pregnancy and after childbirth.

What factors contribute to depression during pregnancy?

According to American Psychiatric Association, depression is a mental illness that negatively affects how one feels, thinks, and acts. It is characterized by feelings of sadness and/or a loss of interest in previously enjoyed for more than a period of 2 weeks.

During pregnancy, women’s bodies undergo biological changes, including changes in hormones. These changes can influence brain chemicals and contribute to a pregnant woman getting depression and anxiety. A woman with a personal or family history of depression, is more likely to develop it during pregnancy.

The following are some internal and external factors that may contribute to depression in pregnant women.

Internal factors

• An unexpected pregnancy and feeling ashamed or guilty about it
• A history of depression during pregnancy, either in the family or for the mother, during past pregnancies
• Losing other pregnancies before the current pregnancy, either through miscarriages or during delivery.
• Being inadequately prepared to receive and care for the baby
• History of chronic illness during pregnancy, e.g., Human Immunodeficiency Virus (HIV) and Tuberculosis.
• Relationship issues resulting in divorce and separation during pregnancy
• Previous history of having stillbirths or delivery of children with congenital disorders such as Down’s Syndrome, club foot, cleft palate, and cerebral palsy, among others
• Teenage pregnancies – young women and girls who get pregnant often face challenges such as stigmatization, forced marriage, and rejection by their families. Some due to cultural issues might be seen as outcasts. All these might result in them feeling hopeless and hating themselves.
• If the pregnancy was caused by sexual abuse.
• Where a pregnancy resulted in a job loss
• Fear of giving birth because of potential pregnancy and delivery complications

External factors that contribute to pregnancy depression and anxiety

• Relationship or marital issues, including being in a strained relationship, having an unsupportive partner, or having a difficult relationship with in-laws or separation
• Domestic violence such as being violently abused by a partner including any behaviors that frighten, intimidate, terrorize, manipulate, hurt, humiliate, blame, injure, or wound pregnant women.
• Having social phobia, which is the fear of being scrutinized or judged while performing a task in the public
• Financial constraints in the family
• Natural or man-made disasters such as wars and floods during pregnancy
• Lack of social support, or having few family members and friends who can be there for you in time of need
• Loss of a loved one while pregnant

 Symptoms of depression and anxiety during pregnancy

A pregnant woman may experience or show the following symptoms of depression and anxiety:

• Spending time away from people, including family members
• Inability to sleep (insomnia) or sleeping too much
• Mood changes such as intense irritability and anger, severe anxiety, guilt, hopelessness, reduced or lack of interest and pleasure in previously enjoyed activities, severe mood swings, and panic attacks
• Excessive fatigue or energy loss
• Weight gain or weight loss
• Concerns that they will not be a good mother, and thoughts of terminating the pregnancy.
• Increased episodes of sickness and hospitalization
• Self-neglect- neglecting basic hygiene tasks such as brushing teeth, combing their hair, and showering.
• Smoking, drinking alcohol or using harmful drugs such as marijuana.

 Graphic 1: Some common signs of depression in pregnancy [Source: Julisha.Info]

What to do if you are depressed during your pregnancy

Get plenty of rest. Sleep is necessary for both physical and mental recovery. In addition to resting, also do the following:

• Accepting that you are depressed is an important step to overcoming it.
• Speak with someone about what you are going through and seek help. It can be a family member, a partner, a friend or a professional (counsellor, healthcare provider)
• To avoid being alone or isolating yourself, engage in physical interactions with others
• Take care of your health and nutrition - eat healthy and satisfying meals, drink plenty of water and talk walks
• Attend antenatal and post-natal clinics

What support is there for women who experience depression during their pregnancy?

In addition to maternity health support from a hospital or maternity clinic, family members or trusted people close to the pregnant mother should help her in overcoming depression. They have a role to play in ensuring the mother and the baby’s safety.

Family members can help in the following ways:

• Help with household tasks to allow the mother more time to rest when she is pregnant
• Talk to her instead of criticizing her to help her accept what she cannot change
• Remind her to visit the Antenatal clinic (ANC)
• Ensure she eats a balanced diet, sleeps well, and gets enough rest
• Help her with getting items from the shops or market
• Allow her to cry or vent without judging her when she is feeling down
• Support her throughout the pregnancy
• Keep an eye on her in case she requires counseling
• Connect her with a mental health specialist.

Graphic 2: Helpful tips for pregnant women to handle depression pregnancy [Source: Julisha.Info]

Where to get help

[The contact details below focus on serving refugees in different camps in Kenya. Please contact your nearby hospital if you are not in refugee camps.]

If you feel you might be experiencing depression or anxiety during your pregnancy you can reach out to the following organizations, discuss how you feel with them and work out the next steps.

If you have any questions, please write to us via the Julisha.Info Facebook page, or chat with us on WhatsApp (+254110601820) Monday through Friday from 08:00 a.m. to 5:00 p.m.