Depression during and after pregnancy affects many women, and experts know how to treat it.
While the majority of new mothers experience some degree of the baby blues — or mild mood swings that are caused by hormonal changes after giving birth — nearly 1 in 7 will have a much more severe mood disorder before, during, or after pregnancy: perinatal depression.
While symptoms of perinatal depression vary from case to case, common symptoms include feelings of worthlessness along with extreme sadness, misery, and irritability. It can last for weeks or even months if left untreated.
The term encompasses both prenatal and postpartum depression.
Unfortunately, most women who have perinatal depression aren’t properly diagnosed or treated, which makes for a massive public health problem, states.
Now, the U.S. Preventive Services Task Force suggests that at-risk women undergo behavioral counseling in order to effectively prevent perinatal depression. The recommended counseling interventions were published in the mid-February.
To determine which treatment options worked best, the task force reviewed 50 studies that previously examined the effectiveness of various treatments for perinatal depression — such as physical activity, education, diet, medication, and counseling.
The team found that cognitive behavioral therapy and interpersonal therapy were most effective in preventing perinatal depression. In fact, both types of counseling reduced the risk of getting the mood disorder by about 39 percent.
Interpersonal therapy is performed during the pregnancy and is designed to help identify the social, psychological, and biological factors that may be influencing the woman’s mood. The counselor works with the patient to boost maternal confidence, smooth the transition into parenthood, and alleviate any interpersonal stress.
“Together they develop a plan on how to deal with potential conflict regarding workloads at home and work, sleep patterns, who does what when the baby is born, and postpartum issues such as breastfeeding,” said Dr. Samuel Malloy, a general practitioner and currently the medical director with telemedicine website Dr. Felix.
Cognitive behavioral therapy (CBT), on the other hand, is a form of psychotherapy that focuses on changing individual thoughts, beliefs, and behaviors. A CBT therapist typically helps the mother first identify any harmful thought patterns or underlying beliefs and then develop coping strategies to combat anxiety and depressive symptoms, according to Malloy.
Treatment of perinatal depression is most effective when there’s an individualized treatment plan in place, many health experts believe. Women should work with their doctors to cocreate a treatment approach that’s tailored to their specific symptoms.
Typically, psychotherapy is the first-line treatment for women with mild to moderate perinatal depression, but is often complemented by other treatment options and lifestyle changes.
“Women who have moderate to severe depression often require a combination of psychotherapy and antidepressant medication,” Dr. Elizabeth LaRusso, a psychiatrist who specializes in women’s mental health at Allina Health in Minneapolis, told Healthline.
In addition, all women can benefit from increasing their social support system, decreasing external stressors, exercising, improving their diet, and getting sufficient sleep, LaRusso added. Family planning and breastfeeding decision support can also help women transition into motherhood.
Despite the fact that perinatal depression is one of the most common complications of pregnancy, doctors still haven’t identified a standard screening tool to accurately determine whether or not a woman is experiencing perinatal depression. As a result, many individuals who have the disorder go untreated.
Researchers have found that those who have a previous history of depression or depressive symptoms, a family history of depression, or external stressors — like a teenage or unwanted pregnancy, financial issues, abuse, or unemployment — have a greater risk.
That being said, more research is needed to identify why certain women are predisposed to perinatal depression.
Knowing what causes and prevents perinatal depression could not only drastically improve the mother’s life, but the child’s as well. Maternal depression can negatively impact the health of the baby and increase the risk of premature birth, low birth weight, amongst other developmental problems.
Some of the most common warning signs include oversleeping, excessive crying, and feeling overwhelmed, hopeless, or restless. However, symptoms are broad and vary with each woman.
If you begin experiencing symptoms or suspect you may have perinatal depression, you shouldn’t feel guilty or ashamed to ask for help, health experts advise. Experts want expectant mothers to remember that having perinatal depression doesn’t mean you’re a bad mother. All women are susceptible to perinatal depression and it’s important to remember you aren’t alone.
“If you are pregnant or a new mother and having more bad than good days, reach out to your support system, talk to your OB/GYN or midwife. Let people know you are struggling!” LaRusso advised. “Depression is treatable, and when identified early, the burden of suffering is significantly less.”
While perinatal depression is one of the most common complications of pregnancy, most women who have it go untreated. Now, a special task force suggests that at-risk women undergo counseling intervention in order to prevent getting the mood disorder.