Antepartum depression, or depression during pregnancy, affects more than 10% of pregnant women. Learn the symptoms and tips for what to do if you are dealing with this rarely discussed symptom of pregnancy for too many mothers.

While I was contemplating if and when to have a second child, I thought a lot too about the more obviously difficult parts of my labor and delivery: the emergency c-section and my recovery from that.

I remember during that time I saw a pregnant Facebook friend’s complaints about her wild mood swings during pregnancy. Immediately, I thought, Well, at least I didn’t have to deal with that.

But then I remembered, Yes, yes. I did. Why did I refuse to acknowledge — even to myself — this huge aspect of my pregnancy?

My Experience of Antepartum Depression

Somewhere around the middle of my second trimester I started to feel not myself. On the face of it, I was doing really well. After a debilitating period of morning sickness during my first trimester, I was feeling physically great. My dissertation research was progressing well. My husband and I were excited about our plans to buy a house and move to upstate New York.

Then I couldn’t sleep. Normally I’m not a good sleeper. I’ve occasionally struggled with sleep issues during certain periods of my life. But this was different. I literally could not sleep. I would lie awake at night for hours, all night.

I became anxious, teary, irrational even. I became even more upset when I didn’t understand what was wrong. Because there was nothing wrong. I was happy, healthy, and excited about the future. But I was a mess. I would cry for hours, writing in my journal about how I was too weak of a person to become a mother.

I couldn’t think about anything except how my own potential breakdown could be affecting my growing baby. I pictured my own stress hormones surging into my poor developing baby and would become even more upset.

Finally, I went to see my ob/gyn. I told her what was going on, that I couldn’t sleep, that I had never been so anxious and depressed for no reason in my life. We talked about medication, but I was appalled at first at the thought of beginning an anxiety medication or antidepressant during my pregnancy. She referred me to a psychiatrist at Mass General Hospital who specialized in women’s reproductive mental health, one of the top centers in the country.

When I showed up for my first appointment, I sat in the waiting room, holding back tears.

What was I doing in a psychiatrist’s waiting room? I had a wonderful husband and a great life. I could see that there were mentally unstable people all around me in the waiting room — the old woman with matted hair, the skinny and pale adolescent girl. Was I one of the crazy ones too? How would I ever be a good mother if I couldn’t get it together?

The psychiatrist was wonderful, an expert in her field. She was gentle, reassuring, and calmly, without judgment, told me about my options.

I was lucky because, with her help, the darkness and anxiety went away by my third trimester. I was back to being myself, admittedly a much larger, awkwardly moving, and bloated version of myself.

And now, thinking about my friend on Facebook and her mood swings, I wonder if she’s doing okay.

We’ve made tremendous strides in increasing awareness about postpartum depression. But depression during pregnancy — or antepartum depression — is not as widely recognized.

Pregnancy is supposed to be a joyous time, a period of some minor physical discomforts but mainly a time of anticipation and glowing, giddy maternal pride. Instead, during my pregnancy, I felt like I was taken over by a dark and silent force in my mind that caused me to feel hopeless, guilty, and inadequate. I never experienced anything like it before or since.

Depression During Pregnancy Is Not Uncommon

Now I know that I was never alone, even though it felt like that. About 10- 12% of women experience depression during their pregnancies. Yet it’s much less commonly screened for than postpartum depression.

The symptoms are the same as typical depression:

Anxiety, feelings of sadness and hopelessness, trouble with concentration, loss of interest in typical activities, changes in sleep patterns. If you feel sad, depressed, or hopeless during your pregnancy, tell your doctor about your feelings honestly and ask for help. There are a wide variety of treatments — not just medications — that are highly effective and can make you feel better.

No one knows exactly why some women experience depression during pregnancy, and others do not. Genetics, previous history of trauma, and prior mental health challenges may be risk factors.

Greater awareness and screening of this condition could lead to less suffering and better outcomes for both mothers and babies. Too many health care professionals do not ask about depression symptoms during this time.

If you are experiencing symptoms of depression during pregnancy, don’t suffer alone. Because you are not.

Did you experience depression or anxiety during your pregnancy? Did you seek treatment?

Resources:

Massachusetts General Hospital Center for Women’s Mental Health

Postpartum Progress’s Katherine Stone