Mental health struggles, like anxiety and depression are the most common complications of pregnancy. For many women, these manifest in the months after giving birth — a condition known as postpartum depression. But for others, symptoms can begin earlier during their pregnancy. While almost as common as postpartum depression, the mental health conditions experienced during pregnancy are much less talked about. National Mental Health Correspondent Dr. Nicole Clark looked into it.
What You Need To Know
- About one third of women who experience perinatal mental health disorders, develop symptoms during pregnancy
- The most common medications used to treat mental health disorders are considered safe to use while pregnant
- Untreated mental health issues can pose health risks to both mother and baby
When Courtney Ginder was pregnant with her second child, she started struggling to make it through the day.
“I needed to work. I needed to take care of my daughter,” remembered Ginder. “You know, I needed to do laundry and all of these things, and all I wanted to do was just lay in bed and sleep and do nothing.”
This pregnancy stood in stark contrast to her first.
“With my daughter, like it was, you know, as easy a pregnancy as pregnancy can be,” she said.
“But with my son, it was completely different just from the start. I was exhausted with him. I was nauseous. I didn’t want to eat anything.”
Ginder developed severe pelvic pain, making it difficult to even get dressed in the morning or get in and out of her car. On top of that, she was diagnosed with gestational diabetes.
Courtney Ginder began experiencing mental health symptoms during her second pregnancy (Courtney Ginder)
“It was just very difficult for me with his pregnancy,” she reflected.
While her first pregnancy was smooth, she experienced postpartum depression after giving birth and sought support from Postpartum Support International. She now works for the organization as a social media manager.
So, when she started feeling down during her second pregnancy, she recognized the symptoms. knew something was wrong.
“My motivation was completely and utterly gone, and I just, I wasn’t enjoying things at all,” said Ginder.
Prenatal mental health struggles are often less talked about than postpartum – but they do affect a significant portion of people.
“When we look at people who are depressed throughout the pregnancy and postpartum period, about a third of those people were depressed before pregnancy, about a third get depressed in pregnancy, and about a third get depressed postpartum,” explained Dr. Lauren Osborne, a reproductive psychiatrist at Weill Cornell Medicine.
She says fluctuating hormones can make pregnant women vulnerable to mental health struggles. And certain groups are at particularly high risk.
“If you’re very young, if you have low social support, if you are at a community with fewer resources, those are all going to make people much more at risk,” said Osborne.
It can sometimes be hard to determine whether the symptoms you’re experiencing are the result of the pregnancy itself or a mental health condition – for instance, fatigue and racing heart can be present in both.
She says the best indicator is how symptoms affect a person’s ability to function in day-to-day life. “Are you able to do what you need to do in the amount of time that you used to be able to do it in, and with the same degree of care that you used to be able to do it in?”
For Ginder, weekly therapy sessions helped her focus on what she could control and reframe her negative thoughts. She also ended up increasing the dose of the antidepressant she was already taking.
Ginder says therapy and medications helped her manager her mental health during pregnancy (Courtney Ginder)
When it comes to medications, experts say they can be very effective alongside therapy and lifestyle changes like exercise and seeking social support. But many people are reluctant to take medications in pregnancy. She attributes part of that to stigma.
“The other reason is when we first started doing research on the use of psychiatric medications in pregnancy, a lot of those studies were really flawed,” she said.
According to Dr. Osborne, we now know that SSRIs – the most prescribed medications for depression and anxiety – are low-risk in pregnancy. There is a slight risk of pre-term birth and of something called pre-neonatal adaptation syndrome, where babies may be more irritable in the first few weeks of life. But untreated mental health conditions also have risks.
“The risks of untreated depression are risk of pre-term birth, small for gestational age, risks to the fetus of being born with higher cortisol, so higher stress hormones being more reactive, and then the child going on to have a higher risk for psychological disorders,” she explained.
And there are substantial risks to the mother as well. Suicide and overdose are the biggest cause of pregnancy-related maternal deaths in the US.
Part of making it easier to seek help may lie in reframing the way we think about mental health conditions.
“These are real illnesses and they’re complications of pregnancy, just as if you had gestational hypertension or gestational diabetes,” Osborne said.
“If it happens to you, you’re not a bad parent,” said Ginder. “There’s not anything wrong with you. This is something that is temporary and you can get better.”
It’s a message she hopes people who are struggling will take to heart.
If you or someone you care about might be suffering from postpartum depression or another perinatal mental health disorder, you can call the Postpartum Support International helpline at 1-800-944-4773 , visit postpartum.net, or download the Connect by PSI mobile app to access support.”
link
