Patient education: Depression during and after pregnancy (The Basics)

What is depression? — Depression is a disorder that makes you sad, but it is different than normal sadness.

For many people, pregnancy is a happy time. But some people have depression while they are pregnant or after they have their baby. Doctors use different terms for this:

●Antenatal depression – This is the medical term for depression during pregnancy. "Antenatal" means the period of time before a baby is born.

●Postpartum depression – This is a kind of depression that some people get after having a baby. "Postpartum" means the period of time shortly after giving birth.

Depression can make it hard to eat, sleep, work, or enjoy life. It can also make it hard to care for yourself and your baby or other children.

What causes depression? — Depression is caused by problems with chemicals in the brain called "neurotransmitters." Some people might be more likely to have depression if it runs in their family. Other things might also play a role, including hormones, certain health problems, medicines, stress, being mistreated as a child, family problems, and problems with friends or at work.

It's not exactly clear what causes some people to have depression during or after pregnancy. It is more likely in people who had depression in the past.

Get help right away if you are thinking of hurting or killing yourself! — Sometimes, people with depression think of hurting or killing themselves. If you ever feel like you might hurt yourself or your baby, help is available:

●In the US, contact the 988 Suicide & Crisis Lifeline:

•To speak to someone, call or text 988.

•To talk to someone online, go to www.988lifeline.org/chat.

●Call your doctor or nurse, and tell them that it is an emergency.

●Call for an ambulance (in the US and Canada, call 9-1-1).

●Go to the emergency department at your local hospital.

If you think that your partner might have depression, or if you are worried that they might hurt themselves, get them help right away.

What are the symptoms of antenatal depression? — With antenatal depression, symptoms start during pregnancy.

Depression can make you feel sad, down, hopeless, or cranky most of the day, almost every day. Another common sign of depression is no longer enjoying or caring about things that you used to like. Other symptoms might include trouble sleeping, not having the energy for normal daily tasks, not gaining enough weight, or feeling restless, worthless, or guilty.

What are the symptoms of postpartum depression? — It can be hard to tell if someone has postpartum depression, since some of the symptoms might also be caused by the stress of taking care of a newborn. For example, after having a new baby, it's normal to:

●Sleep too much or too little

●Feel tired or lack energy

●Have changes in your appetite, weight, or desire to have sex

But a person with postpartum depression might not be able to sleep even when their baby sleeps. Or they might have so little energy that they cannot get out of bed for hours.

They might also feel:

●Anxious, irritable, and angry

●Guilty or overwhelmed

●Unable to care for their baby

●Like a failure as a parent

What are "postpartum blues"? — After having a baby, many people get a mild type of postpartum depression called "postpartum blues." Within 2 or 3 days after giving birth, people with postpartum blues might:

●Be moody, irritable, or anxious

●Have trouble concentrating or sleeping

●Have crying spells

With postpartum blues, these symptoms are not severe and usually go away within 2 weeks. But in people with postpartum depression, the symptoms are more severe. They last at least 2 weeks, and often longer.

How is depression treated? — The 2 main treatments for depression are:

●Medicines called "antidepressants"

●Psychotherapy (counseling) – This involves meeting with a therapist to talk about your feelings, thoughts, and behavior. There are different types of psychotherapy. For example, one type involves working on improving your relationships. Another type involves changing your thinking and behavior patterns to help you cope.

The options for treatment depend on how severe your symptoms are and whether you had depression before pregnancy. If you need treatment with medicine, your doctor will help you decide what to do based on your situation:

●If you are pregnant, your doctor will talk to you about your options. Many people take antidepressant medicines during pregnancy.

●If you are breastfeeding, you might need to avoid certain medicines. That's because small amounts of medicine can get into your breast milk. For some medicines, this can be unhealthy for your baby. But not treating depression can also be harmful for both you and your baby, and there are many medicines for depression that do not seem to harm babies. Your doctor can help you decide if you need medicine and the best one to take.

Take care of yourself by getting plenty of rest and finding healthy ways to cope with stress. Accept help from other people when possible. It can also help to move your body. Even gentle forms of exercise, like walking, are good for your health.

Is there any way to prevent depression during or after pregnancy? — Maybe. If you have had depression before, you are more likely to get it again during or after pregnancy. If you are at risk for depression, your doctor might recommend talking to a therapist.

If you had postpartum depression before and took a medicine that helped, your doctor might prescribe that medicine to take again after the next time you give birth.

More on this topic

Patient education: Depression during and after pregnancy – Discharge instructions (The Basics)
Patient education: Depression in adults (The Basics)
Patient education: Medicines for depression (The Basics)
Patient education: Caring for your newborn (The Basics)

Patient education: Depression in adults (Beyond the Basics)
Patient education: Depression treatment options for adults (Beyond the Basics)