Depression in pregnancy & postpartum

Depression in pregnancy & postpartum

“Congratulations!” …That’s what so many of us hear or say when someone says they are expecting a baby. We are eager and excited to help plan projects; we offer advice on everything from getting baby to sleep to rekindling our sex lives. But, one piece of advice that many pregnant women may be looking for isn’t there—how to deal with prenatal and postpartum depression.
Pregnancy is a unique time for a number of reasons

 Pregnancy is a huge transition in a woman's life, and it involves a complex mix of emotions such as fear and anxiety. Some women may cry more easily and frequently. If a woman has been crying a lot and it doesn't seem to let up, it may be a symptom of depression, which can affect about 10 percent of women during and after pregnancy.

 During the second and third trimesters, as a woman's baby bump becomes more visible and she gains more weight, she may feel dissatisfied with her body and its appearance, and this
may affect her self-esteem. These changes to a woman's looks, shape and perceived attractiveness may bring up a complicated mix of feelings  At a biological level, the hormones estrogen and progesterone are ramping up, and some women are more sensitive to progesterone changes and this may make them more irritable. The levels of Oxytocin (cuddle hormone) and serotonin go down. Significant changes in the hormones can affect the levels of neurotransmitters-the brain chemicals that regulate mood.

 There are also a lot of issues for mothers-to- be to work through both psychologically and socially, such as what will a baby mean for her life going forward? How will it affect her relationships, and will she have support from her partner and family members once the baby arrives? Will she be a good mother, and can she handle her new responsibilities?

 MRI brain scans have shown that a pregnant woman’s brain actually shrinks (however it goes back to original size within 6 months after delivery) which may cause the mental fogginess and occasional memory lapses has sometimes been described as "pregnancy brain" or "baby brain." Postpartum Depression can affect anyone, including women who experience a normal delivery and give birth to a healthy child.

Virtually all women can develop depression during pregnancy and in the first year after delivery, but the following generally increase risks:-
a) Poverty
b) Having a family history of mental health issues
c) Complicated pregnancies and/or miscarriages, having gone through infertility treatments
d) Prior history of depression
e) Drug abuse
f) Emotional stressors, including financial strain, job changes, illness, or the death of a loved one
g) Cultural factors e.g. Violence (domestic, sexual and gender-based)
h) Social and political instability
i) Stigma
j) Changes in social relationships and low social support
k) Hormonal fluctuations
l) Raising a child with special needs or an infant that is challenging to care for
m) Multiple pregnancies

Symptoms can start anytime during pregnancy or the first year postpartum. They differ for everyone, and might include the following:-
• Feelings of anger or irritability
• Lack of interest in the baby
• Appetite and sleep disturbance
• Crying and sadness
• Feelings of guilt, shame or hopelessness
• Loss of interest, joy or pleasure in things you used to enjoy
• Possible thoughts of harming the baby or yourself
• Having feelings of anxiety, worry, panic attacks or racing thoughts
• Feeling down or depressed for most of the day for several weeks or more
• Feeling distant and withdrawn from family and friends

To manage depression in pregnancy and postpartum it’s important to note that:-
 Early prediction will bring a better outcome
 Multidisciplinary team of medics, nutritionists, counselors, psychologists and psychiatrist should be involved
 Psychological therapy is superior to pharmacological therapy (except when dealing with a medical condition).
 Lifeskills training is important
 We need to get rid of the stigma for mental conditions…”If you have asthma you take asthma medicine. If you have diabetes you take diabetes medicine. But as soon as you have to
take medication for your mind there’s such a stigma behind it”. This is an excerpt of a presentation I made recently. Lets engage on this…

Have a beautiful weekend.
"Wacha niKwambie Uzima"
May 2017 – Afya nzuri. Maisha nzuri.
Focus on mental health and physical fitness
© Lucy Ngari, Counseling Psychologist, May 2017.

Kindly note that this blog post is only for information guidance purposes; for indepth information and professional consultation please engage the services of a registered mental health practitioner.