Risk for Depression During and After Pregnancy

Source: Pixabay, public image

How many women who are pregnant or in the first postpartum year develop depression? The number is quite high—about 1 in 7.

What increases a woman’s chances of becoming depressed during these times? It’s not a mystery; the risk factors are known.

The problem is that not enough attention has been given to helping susceptible women get help early enough to prevent the onset of depression.

The U.S. Preventive Services Task Force is recommending that physicians screen pregnant women and new mothers to find those that have a greater likelihood of developing it. But until this screening becomes standard practice – and even then - everyone will benefit from knowing the risk factors. That way, they can alert their doctors, and also keep a closer eye on themselves.

Who is most susceptible?

Women with:

• a previous episode of depression.
• a family history of depression.
• a younger age, typically adolescence
• a lower income.
• service in the military.
• the situation of being a single parent.
• new symptoms that can be characteristic of depression, such as stronger and persistent feelings of sadness, and onset of trouble sleeping.

What can be done?

Every pregnant and postpartum woman should be aware that the potential to develop depression during these time periods exists – and more so, those with the risk factors for it.

The earlier the symptoms of depression: such as new persistent feelings of sadness and trouble sleeping, are recognized the better the chance to treat it promptly and shorten the time until it remits.

• Counseling/Psychotherapy. Talk therapy can be very effective for depression at these times of life. Two particular kinds of psychotherapy have been shown through research studies to have good treatment results: CBT (cognitive behavioral therapy) and IPT (interpersonal therapy.
• Medication. Most women, if they are already on antidepressant medication or develop depression, prefer not to have their fetus or nursing infant exposed to drugs – and so do their doctors. Sometimes, these women may do well with talk therapy. In other instances, medication will be very necessary, as determined when the woman and her doctor discuss the potential risks and the important benefits of taking it.

The Importance of preventing/treating depression early

Once depression sets in, it can take 1-2 months for it to be resolved with treatment. Those two months not only cause suffering to the mother – but might negatively affect the pregnancy and the baby. For example, if she loses her appetite and doesn’t eat well (the opposite of the usual situation during pregnancy!), she may not get the nutrients the fetus needs as it grows. If she is depressed after the birth, she may not interact with the baby enough to optimally foster its cognitive development.

Fortunately, depression can often be prevented, and most always can be successfully treated with early recognition.