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Most pregnant women (and their companions) have heard of postpartum depression and know that the time after a child is born may be particularly difficult emotionally for the mother. What is less commonly known is that pregnancy itself is a time of increased risk for depression: In fact, between 10 to 20 percent of women are likely to experience clinical depression during pregnancy – the same percentage who are at risk after delivery (Underwood, Waldie, D’Souza, Peterson, & Morton, 2016).
Why is pregnancy such a sensitive time? Those of you who were pregnant know well that pregnancy can be a time of heightened emotional reactions: You get upset more quickly; you find yourself yelling or in tears (or both!) more often; you become more sensitive to things that you never noticed (like how the fridge smells!) and suddenly become bothered by them. These changes are partly explained by hormonal changes women go through during pregnancy. These hormonal changes are not just a “side effect” of pregnancy, they are part of what helps a woman’s brain change and become more adapted to motherhood.
So how do women change during pregnancy? Research shows that women already become more interested in and attentive towards babies during pregnancy (Thompson-Booth et al., 2014a; Thompson-Booth et al., 2014b). An example of such increased attention was found when examining the reaction of pregnant and non-pregnant women to faces of babies.
The funny thing is, pregnant and non-pregnant women both look at happy babies for the same amount of time. However, when the baby is upset, pregnant women find it difficult to look away from them. This increased attention to infant distress is something that probably helps women take better care of their own babies – since this is the baby’s way to signal that they need help and attention. An interesting study showed that this increased attention to infant distress during pregnancy is related to better bonding with one’s own baby after delivery (Pearson, Lightman, & Evans, 2011).
But what happens to this increased attention when pregnant women are depressed? In some studies, pregnant depressed women showed decreased (rather than increased) attention to baby faces – especially if the baby was in distress (Rutherford, Graber, & Mayes, 2016). When they do look at distressed babies their neural reaction is decreased compared to non-depressed pregnant moms.
The good news is that it looks like treating maternal depression improves attention to baby cues (Pearson et al., 2013) – which just goes to show how important it is to get pregnant women and new mothers all the help they need, so they are able to take care of their babies.
How can we identify depression in ourselves, friends, and partners? Depression, contrary to what many people may think, does not necessarily mean you cry all the time and cannot get yourself out of bed. In fact, many people who suffer from depression “hide in plain sight” and might not even be aware themselves that what they’re experiencing is a significant problem that should (and can!) be treated.
So what does depression look like? It’s a combination of five (or more) of the following symptoms:
- Feelings of sadness, empty, or hopeless.
- Decreased interest in fun activities, less enjoyment from things that used to be enjoyable (e.g., everything feels boring, pointless).
- Increased OR decreased appetite.
- Changes in sleep patterns (more OR less sleep; disturbed sleep).
- Difficulty to sit or stand still (e.g., fidgeting) OR visible slowness in doing things (e.g., talking or moving slowly).
- Feeling tired, without energy.
- Feeling worthless and/or extremely guilty.
- Difficulties concentrating, and/or difficulties in making everyday decisions (e.g., what to eat or wear).
- Recurrent thoughts about death, wishing for death.
Although everyone experiences some of these symptoms from time to time, if they occur for a prolonged period of time (over two weeks in which the person feels like this most of the time), it’s best to seek the advice of a mental health professional. Remember, taking care of the mom helps both her and the baby.
There are still a lot of open questions about maternal depression: Why is depression associated with decreased attention to infant distress? Is it because depression makes the baby’s distress too difficult to bear? Maybe depression is affecting the ability to pay attention to things in general? What would be the best way to help? My Lab, the Affect Regulation and Cognition Lab, is currently conducting a study on pregnant women to try to answer these questions.
Reuma Gadassi Polack (postdoctoral fellow at Yale) also contributed to the writing of this article
References
Pearson, R. M., Lightman, S. L., & Evans, J. (2011). Attentional processing of infant emotion during late pregnancy and mother–infant relations after birth. Archives of Women's Mental Health, 14, 23-31.
Pearson, R. M., O’Mahen, H., Burns, A., Bennert, K., Shepherd, C., Baxter, H., ... & Evans, J. (2013). The normalisation of disrupted attentional processing of infant distress in depressed pregnant women following Cognitive Behavioural Therapy. Journal of Affective Disorders, 145, 208-213.
Rutherford, H., Graber, K. M., & Mayes, L. C. (2016). Depression symptomatology and the neural correlates of infant face and cry perception during pregnancy. Social Neuroscience, 11, 467-474.
Thompson-Booth, C., Viding, E., Mayes, L. C., Rutherford, H. J., Hodsoll, S., & McCrory, E. (2014a). I Can't Take My Eyes Off of You: Attentional Allocation to Infant, Child, Adolescent and Adult Faces in Mothers and Non-Mothers. PLoS ONE, 9, e109362.
Thompson-Booth, C., Viding, E., Mayes, L. C., Rutherford, H. J., Hodsoll, S., & McCrory, E. J. (2014b). Here's looking at you, kid: attention to infant emotional faces in mothers and non‐mothers. Dev Sci, 17, 35-46.
Underwood, L., Waldie, K., D’Souza, S., Peterson, E. R., & Morton, S. (2016). A review of longitudinal studies on antenatal and postnatal depression. Archives of Women's Mental Health, 19, 711-720.
