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The leading causes of prenatal depression and how to manage it best

The leading causes of prenatal depression and how to manage it best

Do you know that as many as 20 per cent of pregnant women can be depressed during their pregnancy? Often dismissed as pregnancy blues, prenatal depression is a form of clinical depression that needs much more serious attention than a temporary relief from pills to reduce anxiety.Just like any other form of depression, prenatal depression is a clinical depression that occurs during a woman’s pregnancy. Due to the hormonal changes that occur during pregnancy, there could be chemical changes in the brain that affect a woman’s mental health, leading to depression or anxiety.

Sometimes due to situational factors, the condition of the woman worsens.How would you know if what you are experiencing are normal pregnancy mood swings or if you need medical attention? The answer is that if you experience the following symptoms for a period of more than two weeks persistently, you need medical attention. The symptoms include a persistent state of sadness, difficulty in concentration, changes in sleep pattern, losing interest in things you otherwise enjoyed, doubting your parenting ability, having second thoughts about being pregnant, over anxiety, feeling guilty, or having morbid thoughts.One real concern for the treatment of mental problems is the stereotyped mindset of people who often disregard their existence.

Prenatal depression may not only affect the woman but can also harm the baby in her womb. A major repercussion of prenatal depression is premature birth. This in turn causes poor many problems for the baby, such as low birth weight, problems in development and an adverse impact on overall mental health.The best way to battle prenatal depression is to seek treatment for it. Do not try to self treat it by temporary reliefs. There are support groups, psychotherapists and medication that can help you deal with it effectively.
Prenatal Depression Causes

There are multiple factors that can cause Prenatal Depression. These include:

1. PMDD (Premenstrual dysphoric disorder):
A very common disorder now, this comes before the menses starts. This disorder gets with it the feeling of being moody, irritated, fatigued, depressed during the duration of the menses. This can be one of the primary causes of getting prenatal depression.

2. Severe PMS (Pre-menstrual syndrome): Severe PMS usually appears a week prior to when the actual menstrual cycle starts. Due to the hormonal changes in the body, which are vigorous at this point of the month, you may feel low and moody. If you have been getting this feeling too often, chances of getting prenatal depression are more likely.

3. History of depression: Many times, depression runs in our families and often ends up affecting us as well. Along with this, with the kind of lifestyle we have been leading in recent times, getting prenatal depression almost comes as a predisposition. However, this varies from one case to another and should not be considered a necessary condition.

4. Younger pregnancy:
Sometimes, our body is not ready for pregnancy. Over the years, the female body goes through various hormonal changes and this needs to be considered if going for pregnancy at a younger age. Consulting your doctor is a good option as prenatal depression in pregnancies at a younger age is high.

5. Lack of familial/social support: During the course of pregnancy, social support is of prime importance to help the mother-to-be deal with the new changes that she isn’t used to. At times, women who do not get this support end up being preys of depression and hence, hurting their health as well as their baby’s.

6. Marital conflicts:
Marital conflicts can bring with them stress that may lead to prenatal depression. This is because, during the course of a pregnancy, a woman’s body is going through a variety of changes, which may be difficult for her to understand. Hormonal changes are infinite, and the stress of a marital conflict only adds to the depression she may get into.

The leading causes of prenatal depression and how to manage it best

Prenatal Depression Symptoms

“Cases of Prenatal Depression have risen by 45% in the past four years. Since it is difficult to find out whether a woman is experiencing normal pregnancy-related mood changes or something serious, symptoms of Prenatal Depression have often been overlooked. Women who seek help are often told ‘it’s just your hormones’. This offers little help to the person,” says Seema Hingorrany, clinical psychologist. Symptoms include:

1. Severe anxiety, fears about delivery or a miscarriage

2.
Feeling guilty

3. Bouts of crying

4. Low self-confidence and apprehension about being a capable parent

5. Feeling lonely, irritable and misunderstood

6.
Sleeping and eating problems

7. Lack of concentration

8. Indifference to prenatal care

9. Resentment towards the baby, because it will be an overwhelming responsibility

Prenatal Depression Prevention

1. If the pregnancy is unplanned or unwanted, the stress increases all the more. In such cases, you must consult a psychotherapist who can help you deal with it smoothly.

2. Access professional health care services as they usually have specialized services to deal with pregnant women prone to depression.

3. Ask your doctor to recommend anti-depressants that are safe for you during pregnancy.

4. Talk to your doctor and a certified fitness expert to continue your fitness routine even while you’re pregnant. Exercise helps release happy hormones which will not only keep you de-stressed but will also help you divert your mind from things that don’t require much attention.

5. Get adequate amount of sleep. Sleeping less can bring with it uncalled-for stress and hence increases your chances of falling prey to prenatal depression.

6. Talk to an expert if you do not feel good about your pregnancy as prevention is better than cure.

In this Article

In this Article

In this Article

  • Risk Factors
  • Effects
  • Take Care of Yourself
  • Medication and Treatment
  • When to Talk to Your Doctor
  • Step-by-Step Care

Although many people consider pregnancy a time of happiness, about 10% to 20% of moms-to-be struggle with symptoms of depression.

Risk Factors

  • Having a history of depression or PMDD (premenstrual dysphoric disorder)
  • Age at time of pregnancy; the younger you are, the higher the risk.
  • Living alone or having limited familial support
  • Limited social support
  • Marital conflict or domestic violence
  • Uncertainty about the pregnancy

Effects

Hormonal changes or stress can make depression symptoms worse or make them return. Pregnancy symptoms such as morning sickness, fatigue, and mood swings can also contribute.

Depression can get in the way of being able to care for yourself during your pregnancy. You may be less able to follow medical recommendations, as well as sleep and eat properly.

The condition can also make you more likely to use tobacco, alcohol, and illegal drugs that can harm you and your developing baby.

Some studies suggest that depression during pregnancy may increase the risk for pre-term delivery and low infant birth weight. However, there are experts who debate this.

Depression may interfere with your ability to bond with your growing baby, too. Being depressed during pregnancy can place you at greater risk for having an episode of depression after delivery (postpartum depression).

Take Care of Yourself

Preparing for a new baby is a lot of hard work, but your health should come first. So resist the urge to get everything done: Cut down on your chores, and do things that will help you to relax. Taking care of yourself is a key part of taking care of your unborn child.

Open up to your partner, your family, or your friends about what concerns you. If you ask for support, you’ll find that you often get it.

Your OB-GYN or regular doctor may screen you for depression at a routine office visit. They can ask you a series of questions to check your risk for depression and can offer treatment if necessary.

Medication and Treatment

Studies on the effect of antidepressant medicines on your growing baby suggest they are safe for treating depression during pregnancy. However, there may be a very small risk of birth defects that include fetal heart and skull abnormalities with the use of SSRI antidepressants, which include fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft) early in a pregnancy. But remember that not treating depression may be more risky than taking medication.

Talk to your doctor about the possible risks and benefits of antidepressants. They can work with you to manage your symptoms and develop a treatment plan. They can also refer you to a mental health specialist, if you need it.

Continued

When to Talk to Your Doctor

  • You find out you’re pregnant and you’re taking antidepressants or other medications.
  • You have a history of depression and are worried about depression during or after pregnancy.
  • You have symptoms of depression.
  • You have thoughts of harming yourself or your baby.

Step-by-Step Care

  • Get support from your partner, family, and friends.
  • Tell your doctor. Ask for help.
  • Eat well. Depression can rob you of your appetite, but your baby still needs nourishment.
  • Get some exercise. A walk or swimming can help improve your mood and is good for your baby.
  • Don’t suddenly stop taking antidepressants. Talk to your doctor first.
  • Consider counseling or joining a support group.

Sources

American Pregnancy Association.

“Recommendations for Screening Depression in Adults.” Journal of the American Medical Association, January 26, 2016.

Reefhuis, J. BMJ, 2015.

American College of Obstetricians and Gynecologists. Your Pregnancy and Childbirth, Month to Month. 5th edition. 2010.

March of Dimes: “Pregnancy Complications: Depression.”

Adah Chung is a fact checker, writer, researcher, and occupational therapist.

The leading causes of prenatal depression and how to manage it best

In most cases, prenatal development occurs normally and follows the established patterns of development with little variation. However, a number of things, usually caused by genetics or environmental problems, can go wrong during this time.

Genetic Problems

Genetics plays a major role in development. In some cases, genetic problems can emerge that may impact both the current and future growth of the developing child in the womb.

  • Down Syndrome: Also known as trisomy 21, Down syndrome is the most common genetic anomaly during prenatal development.   Down syndrome is caused by an extra copy of the 21 chromosomes (meaning there are three chromosomes instead of the usual two) and impacts approximately 1 out of every 1,000 infants. Typical features of Down syndrome include flattened facial features, heart defects, and intellectual impairment. The risk of having a child with Down syndrome increases with maternal age.
  • Inherited diseases: A number of illnesses can be inherited if one or both parents carry a gene for the disease.   Examples of inherited diseases include sickle-cell anemia, cystic fibrosis, and Tay-Sachs disease. Genetic tests can often determine if a parent is a carrier of genes for a specific disease.
  • Sex-Chromosome Problems: The third type of genetic problem involves sex-chromosomes. These include conditions such as Klinefelter’s syndrome (an extra X-chromosome) and Turner syndrome (a single X-chromosome).  

Environmental Problems

Environmental variables can also play a major role in prenatal development. Harmful environmental elements that can affect the fetus are known as teratogens.   A number of teratogens can harm the fetus, including:

  • Maternal Drug Use: The use of substances by the mother can have devastating consequences to the fetus. Smoking is linked to low birth weight, which can result in a weakened immune system, poor respiration, and neurological impairment. Alcohol use can lead to fetal alcohol syndrome, which is linked to heart defects, body malformations, and intellectual disability.   The use of illicit psychoactive drugs such as cocaine and methamphetamine is also linked to low birth weight and neurological impairment.
  • Maternal Disease: A number of maternal diseases can negatively impact the fetus, including herpes, rubella, and AIDS. Herpes virus is one of the most common maternal diseases and can be transmitted to the fetus, leading to deafness, brain swelling, or intellectual disability.   Women with herpes virus are often encouraged to deliver via cesarean to avoid transmission of the virus.

The prenatal period is a time of tremendous growth and also great vulnerability. A number of dangers can pose a potential risk to the growing fetus. Some of these dangers, such as environmental risks from teratogens and drug use, can be prevented or minimized. In other instances, genetic problems may simply be unavoidable. In either case, early prenatal care can help new mothers and children cope with potential problems with prenatal development.

Speak with an experienced medical secretary

Book a prenatal or postnatal depression assessment and diagnosis and attend your appointment from the comfort of your home.

The leading causes of prenatal depression and how to manage it best

Why choose Psymplicity to treat your prenatal and postnatal depression?

    We’ve helped many clients both with prenatal and postnatal depression, helping them manage their challenging emotions during and after pregnancy. Clients love our warm, caring approach — and the transformative results that come from working with us We’re available7 days a week You will get your own dedicated therapeutic care coordinator We’re registered by the Care Quality Commission and members of the Royal College of Psychiatrists

The leading causes of prenatal depression and how to manage it best

A Quick Introduction to Pre and Postnatal Depression

Prenatal and postnatal depression can have a huge impact on your life, making you feel unhappy, distracted and anxious. But both are treatable, using our three-step process:

  • Get the right diagnosis and a holistic prenatal or postnatal depression treatment plan tailored to you
  • Receive cognitive behavioral therapy or counselling to help you deal with the symptoms of prenatal or postnatal depression. We can also prescribe medication before therapy to help alleviate symptoms
  • Enjoy and embrace parenthood and feel happy and confident wherever you are in your journey

We don’t just work with you to treat the symptoms; our holistic approach means you’ll have all the tools you need to manage your pre and postnatal depression.

Do you need support managing the symptoms dominating your life?

Not sure where to start?

Click the links below to jump directly to the section most relevant for you, or scroll down to see our prenatal and postnatal depression blogs, some of the other conditions we can help you with and more.

What are prenatal and postnatal depression?

Prenatal depression affects pregnant women, while postnatal depression occurs after childbirth. The mind and body both change during these periods, and these changes can overwhelm some mothers during and after their pregnancy.

How are prenatal and postnatal depression treated?

At Psymplicity, we adopt a holistic approach that puts your wellbeing first. We work to fight prenatal or postnatal depression with a combination of treatments depending on the patient’s situation. We’ll develop a tailored plan that takes your circumstances, medical history and any underlying conditions into account.

What are the symptoms of prenatal and postnatal depression?

Symptoms of both prenatal and postnatal depression can include lack of energy, chronic anxiety and the feeling of isolation. These symptoms can vary, and some women experience these forms of depression for much longer periods than others. Here, we cover the most common symptoms of prenatal and postnatal depression.

Meet our prenatal and postnatal depression specialists

Our specialists in this field have decades of combined experience in diagnosing and treating prenatal and postnatal depression and have practised in leading institutions in the UK and beyond. Our experts are dedicated to keeping up to date with all the latest developments in psychiatry to deliver the best care for you — because we know that the right treatment combination can be truly transformative.

Book an online appointment with our prenatal and postnatal depression specialists

Prefer to pay in flexible instalments? We also offer payment plans.

The leading causes of prenatal depression and how to manage it best

Call us today to find out if Psymplicity Healthcare is right for you.

About Psymplicity

Specialists in prenatal and postnatal depression

Clients who have trusted us with their treatment

Decades of combined experience

What is Prenatal Depression?

Having a child is a significant step for any parent, whether it’s their first time or their fifth. Women preparing to become mothers experience a completely new world as they learn more about their pregnancy, and sometimes, anxiety or insecurity can follow. Women must prepare to endure changes to not only their body but also their lifestyle and routine. This alone can be daunting for many and induce symptoms of prenatal depression.

Once a woman has given birth and is preparing for life with her new baby, there may then come worries surrounding responsibility — even if this is not their first child. New mothers are also likely to suffer from lack of sleep, significant weight gain or loss and general feelings of loneliness. These and other symptoms can lead to postnatal depression.

Prenatal and postnatal depression are more common than you might assume, no thanks to the media’s increased portrayal of “perfect” mothers and “easy” babies. In today’s society, it’s easy for new parents to feel isolated if they’re struggling during their pregnancy or the first few months of motherhood. Some may also have anxieties around reaching out and asking for help — the challenging emotions they are experiencing may cause them to feel embarrassed or alone when it comes to seeking guidance, particularly if they are single parents without a supportive partner who can offer rationalisation and comfort.

On top of this, the sleep deprivation that inevitably comes with bringing home a newborn can trigger complex emotions and leave women feeling depressed and alone, even if they have a supportive network around them. Women suffering from postnatal depression also tend to feel fear, anger and guilt. These emotions are usually a result of a new mother feeling pressured to live up to expectations, whether by those around them or the media.

But these feelings are nothing to be ashamed of. Both prenatal and postnatal depression can severely impact a woman’s ability to enjoy and embrace the challenging journey of becoming a mother. All pregnant women and new mothers are bound to feel overwhelmed during this new stage in their lives, but unfortunately, these powerful emotions and feelings of isolation can sometimes prove difficult to manage alongside having a child to care for.

Adah Chung is a fact checker, writer, researcher, and occupational therapist.

The leading causes of prenatal depression and how to manage it best

In most cases, prenatal development occurs normally and follows the established patterns of development with little variation. However, a number of things, usually caused by genetics or environmental problems, can go wrong during this time.

Genetic Problems

Genetics plays a major role in development. In some cases, genetic problems can emerge that may impact both the current and future growth of the developing child in the womb.

  • Down Syndrome: Also known as trisomy 21, Down syndrome is the most common genetic anomaly during prenatal development.   Down syndrome is caused by an extra copy of the 21 chromosomes (meaning there are three chromosomes instead of the usual two) and impacts approximately 1 out of every 1,000 infants. Typical features of Down syndrome include flattened facial features, heart defects, and intellectual impairment. The risk of having a child with Down syndrome increases with maternal age.
  • Inherited diseases: A number of illnesses can be inherited if one or both parents carry a gene for the disease.   Examples of inherited diseases include sickle-cell anemia, cystic fibrosis, and Tay-Sachs disease. Genetic tests can often determine if a parent is a carrier of genes for a specific disease.
  • Sex-Chromosome Problems: The third type of genetic problem involves sex-chromosomes. These include conditions such as Klinefelter’s syndrome (an extra X-chromosome) and Turner syndrome (a single X-chromosome).  

Environmental Problems

Environmental variables can also play a major role in prenatal development. Harmful environmental elements that can affect the fetus are known as teratogens.   A number of teratogens can harm the fetus, including:

  • Maternal Drug Use: The use of substances by the mother can have devastating consequences to the fetus. Smoking is linked to low birth weight, which can result in a weakened immune system, poor respiration, and neurological impairment. Alcohol use can lead to fetal alcohol syndrome, which is linked to heart defects, body malformations, and intellectual disability.   The use of illicit psychoactive drugs such as cocaine and methamphetamine is also linked to low birth weight and neurological impairment.
  • Maternal Disease: A number of maternal diseases can negatively impact the fetus, including herpes, rubella, and AIDS. Herpes virus is one of the most common maternal diseases and can be transmitted to the fetus, leading to deafness, brain swelling, or intellectual disability.   Women with herpes virus are often encouraged to deliver via cesarean to avoid transmission of the virus.

The prenatal period is a time of tremendous growth and also great vulnerability. A number of dangers can pose a potential risk to the growing fetus. Some of these dangers, such as environmental risks from teratogens and drug use, can be prevented or minimized. In other instances, genetic problems may simply be unavoidable. In either case, early prenatal care can help new mothers and children cope with potential problems with prenatal development.

Nancy Schimelpfening, MS is the administrator for the non-profit depression support group Depression Sanctuary. Nancy has a lifetime of experience with depression, experiencing firsthand how devastating this illness can be.

Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.

The leading causes of prenatal depression and how to manage it best

Everything feels more challenging when you’re dealing with depression. Going to work, socializing with friends, or even just getting out of bed can feel like a struggle.

But there are some things you can do to cope with your symptoms and improve your quality of life. Here are eight tips for living with depression.

Build a Support Network

One of the most important things you can do to help yourself with depression—other than medication and therapy—is to develop strong social support.

For some, this may mean forging stronger ties with friends or family. Knowing you can count on supportive loved ones to help can go a long way toward improving your depression.

For others, a depression support group can be key.   It may involve a community group that meets in your area or you might find an online support group who meets your needs.

Reduce Your Stress

When you’re under stress, your body produces more of a hormone called cortisol. In the short-term, this is a good thing because it helps you gear up to cope with whatever is causing the stress in your life.

Over the long run, however, it can cause many problems for you, including depression.   The more you use techniques to reduce stress, the better because it will reduce your risk of becoming depressed.

Improve Your Sleep Hygiene

Sleep and mood are intimately related. A 2014 study found that 80% of people with major depressive disorder experience sleep disturbances.  

But, you might feel like you just can’t fall asleep. Or perhaps you struggle to get out of bed because you feel exhausted all the time.

Good sleep hygiene could be key to improving the quality and quantity of your sleep.

Turn off electronics at least an hour before you go to bed. Use dim light to read a book or engage in another relaxing activity.

Only use your bed for sleep and sexual activity. Doing work in bed, or even in your bedroom, can cause you to associate your bed with stress, rather than relaxation.

Improve Your Eating Habits

Research continues to find clear links between diet and mental health. In fact, there have been so many studies that have shown improving nutrition can prevent and treat mental illness that nutritional psychiatry has become mainstream.  

There are many brain-essential nutrients that can affect depression. For example, a 2012 study found that zinc deficiency increases symptoms of depression.  

Improving your diet could be key to reducing your symptoms.

But before you make any major changes to your diet or begin taking vitamins or supplements, talk with your physician.

Learn How to Stop Negative Thoughts

Depression doesn’t just make you feel bad, it can also cause you to think more negatively. Changing those negative thoughts, however, can improve your mood.

Cognitive behavioral therapy (CBT) is a type of therapy that works to alter common patterns of negative thinking called cognitive distortions in order to eliminate depression.   There are also many self-help books, apps, and online courses that can help you learn how to change your unhealthy thinking patterns.

Beat Procrastination

The symptoms of depression, such as fatigue and difficulty concentrating, make procrastination tempting.

Putting things off fuels depression. It can lead to increased guilt, worry, and stress.

It’s important to set deadlines and manage your time well. Establish short-term goals and work hard to get the most important things done first. Each task you successfully complete will help you break through the habit of procrastination.

Get a Handle on Your Household Chores

Depression can make it difficult to complete household chores, such as doing the dishes or paying bills.

But a pile of paperwork, ​the stack of dirty dishes, and floor covered in dirty clothes will only magnify your feelings of worthlessness.

Take control of your daily chores. Start small and work on one project at a time. Getting up and moving can help you start to feel better in itself. But, seeing your progress in the home can be key to helping you feel better.

Create a Wellness Toolbox

A wellness toolbox is a set of tools that you can use to help soothe yourself when you are feeling down.  

The tools you find most helpful might not work for someone else so it’s important to carefully consider what things can help you feel your best.

Think of things you like to do when you’re happy. Then, when you’re feeling down, try one of those activities.

Cuddling your pet, listening to your favorite music, taking a warm bath, or reading a good book are just a few tools you might find helpful.

Create a list of the activities you might try when you’re feeling bad. Then, choose an activity to try when you’re having a particularly rough time.

If you or a loved one are struggling with depression, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

What Causes Postpartum Depression?

Postpartum depression is a mental and emotional health condition that affects women after childbirth. It has many different forms and symptoms, and it affects women in different ways. Therefore, it is difficult to attribute this condition to one unique cause.

Instead, it is believed that postpartum depression can have multiple causes. Each woman who develops postpartum depression has her own set of risk factors that made her more susceptible to its development.

In some cases, it’s unclear as to why and how a woman developed postpartum depression. This can make it even more confusing and challenging for those suffering from this crippling condition.

It is vital for women suffering from postpartum depression to understand that it is not the result of something she did or did not do. In other words, it is never the mother’s fault that postpartum depression develops.

Postpartum Depression Causes

There are many causes of postpartum depression in women. Potential causes include genetic predispositions, the mother’s health history and countless other environmental, physical and emotional factors.

Physical Causes of Postpartum Depression

It is most commonly believed that postpartum depression stems from the drastic hormonal changes that take place during and after childbirth. Decreased estrogen and progesterone levels place the body into a sudden hormonal shift. This is thought to trigger emotional repercussions.

However, many non-depressed women experience the same drop in hormones and have the same estrogen levels as women who do have PPD.

Sleep deprivation may also play a large role in causing postpartum depression. Following childbirth, women often do not get enough sleep due to their new responsibilities caring for their child. A lack of sleep can greatly impact how a woman functions, feels and handles situations. Without proper and consistent sleep, women may start to exhibit signs of postpartum depression.

Emotional Causes of Postpartum Depression

In addition to hormonal changes and sleep deprivation, there are other emotional triggers that can cause postpartum depression. These types of emotional situations may include complications faced during childbirth, as well as general feelings of being overwhelmed by new motherhood.

Postpartum Depression Risk Factors

Because it is difficult to identify any one particular cause of postpartum depression, it is better to isolate certain factors that put woman at a greater risk of developing PPD.

Risk factors that may contribute to postpartum depression include genetics and environmental, emotional and physical influences. Other risk factors include a combination of emotional, physical and psychological health issues.

Genetic and Medical History Risk Factors

Women with one or more family members who have suffered from postpartum depression have a greater risk of developing it as well.

Those who have struggled with mood disorders like depression or anxiety or more significant mental illnesses like bipolar disorder are 30% to 35% more likely to face postpartum depression in their lifetime. Women who have experienced postpartum depression in previous childbirths are also much more likely to experience it again.

Recent studies have shown that there is a possible genetic factor in developing postpartum depression. According to Johns Hopkins researchers, there are possibly two different genetic alterations that, when present during pregnancy, may predict whether a woman will develop postpartum depression. These genetic alterations were discovered through blood tests.

Environmental Risk Factors

A recent study from the Canadian Medical Association Journal revealed that women who live in big cities have the highest rates of PPD. This is largely due to the fact that many women living in larger cities have lower levels of social support.

The study surveyed 6,126 new mothers living in Canada’s metropolitan cities, suburbs, towns, farming communities and very remote areas.

The percentages of new mothers who had a risk of screening positive for postpartum depression are displayed below.

Urban Women and Postpartum Depression

This chart displays the percentage of new mothers in various types of locations who are at risk of developing postpartum depression.

The chart reveals that out of all women surveyed, there were more instances of postpartum depression among the women who lived in cities.

Emotional Risk Factors

Women who face emotional and mental stress before, during or right after pregnancy may be at a greater risk of developing postpartum depression. Stressors may include job loss, financial burdens, the death of a friend or family member, the end of a relationship or any other type of stressful life situation.

Women may also feel anxious and depressed after childbirth due to new responsibilities or the feeling that they have no time for themselves or social activities.

Additionally, women who lack the support of a partner, family members or friends during pregnancy may be more likely to experience symptoms of postpartum depression. Women in abusive domestic situations may also be at a greater risk of developing depression during and after pregnancy.

Other Risk Factors:

There are a variety of other possible risk factors that play a role in whether a woman will develop postpartum depression.

These other postpartum risk factors include:

  • Having an unplanned or unwanted pregnancy
  • Being under the age of 20 when pregnant
  • Current substance abuse such as drugs or alcohol
  • Abruptly stopping taking medications during or after pregnancy
  • Being single or without a partner to co-parent

Awareness of the potential causes and risk factors of postpartum depression allows women and their families to better prepare for this potential outcome. Then, they can take preventative measures to limit the debilitating effects of this condition.

Talk to your physician or mental health professional if you are concerned about postpartum depression risk factors that may affect you.

    Fact-Checked Editor

Kimberly Langdon is a Doctor of Medicine and graduated from The Ohio State University in 1991. She completed her residency in Obstetrics and Gynecology at The Ohio State University Hospitals, Department of OB/GYN. Board-Certified in 1997, she is now retired from clinical practice after a long and successful career. Currently, she is the Founder and Chief Medical Officer of a Medical Device Company that is introducing a patented products to treat vaginal microbial infections without the need for drugs. She is an expert in Vaginal Infections, Menstrual disorders, Menopause, and Contraception.

Abstract

Complications related to preterm birth (PTB) and low birth weight (LBW) are leading causes of infant morbidity and mortality. Prenatal depression is a hypothesized psychosocial risk factor for both birth outcomes. The purpose of this systematic review was to examine evidence published between 1977 and 2013 on prenatal depression and risks of these primary adverse birth outcomes. A systematic search of the PUBMED and PsycINFO databases was conducted to identify studies testing the associations between prenatal depressive symptoms, or diagnoses of depression, and risk of PTB or LBW. We systematically selected 50 published reports on PTB and length of gestation, and 33 reports on LBW and BW. Results were reviewed by two independent reviewers and we evaluated the quality of the evidence with an established systematic review method, the Newcastle Ottawa Scale. We then undertook a narrative synthesis of the results following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Less than a quarter of 50 published reports found that prenatal depression was significantly associated with PTB or gestational age. In contrast, slightly more than half of the 33 reports found that prenatal depression was associated with LBW or BW. When weighing methodological features, we determined that the effects of prenatal depression on LBW are more consistent than effects on length of gestation or PTB. Although the evidence may not be strong enough to support routine depression screening for risk of adverse outcomes, screening to enable detection and timely treatment to reduce risk of postpartum depression is warranted. Further rigorous research on prenatal depression and adverse birth outcomes is needed.

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Are you up or down? It’s not just your mood, but also your weight that can be affected by depression. These tips can help you regain balance.

The leading causes of prenatal depression and how to manage it best

Which comes first, obesity or depression? Just like “the chicken or the egg” scenario, the underlying problem with depression and weight gain (or weight loss) can be hard to tell. Symptoms of depression and weight management issues are linked, and the relationship is a two-way street. In fact, a study done in the Netherlands found that obesity increases the risk for depression in initially non-depressed people by 55 percent, and depression increases the risk for obesity in initially normal-weight people by 58 percent.

Why are depression and weight issues so intertwined? “The part of the brain responsible for emotion — the limbic system — also controls appetite,” explains Joseph Hullett, MD, senior medical director of clinical strategy for OptumHealth Behavioral Solutions in Golden Valley, Minn. “When this emotional part of the brain gets disturbed in someone who is depressed, appetite gets disturbed as well.”

Plus, weight management issues on their own can be depressing. “For some people, being overweight feeds into the self-deprecating ‘I don’t like myself’ thinking pattern, which gets tied into the depression,” says psychiatrist Marketa Wills, MD, MBA, medical director of the women’s behavioral program at St. Joseph Medical Center and an assistant professor in the department of psychiatry and behavioral science at the University of Texas Health Science Center in Houston. You may gain weight, which makes you depressed, and then you may use food to self-soothe. It’s a vicious cycle.

In addition, some of the medications used to treat depression can have weight-related side effects, either causing weight loss or weight gain.

Depression and Weight Gain Versus Weight Loss

When depression sets in, the appetite control center of the brain can get thrown off in either direction. “Some people have a problem with depression and weight gain, and other people have a problem with depression and weight loss,” Dr. Hullett says.

Whether you overeat or undereat has to do with your unique biology and underlying coping strategies, says Dr. Wills. “And it’s possible for depression and weight loss as well as depression and weight gain to happen in the same person in response to two different episodes of depression.”

The type of depression symptoms you experience may also play a role in whether you gain or shed pounds. “People with seasonal affective disorder, for example, may become sluggish and gain weight in the winter and lose weight in the spring, like a bear in hibernation,” Hullett says. “People with depression and anxiety, on the other hand, may wring their hands, pace a lot, and tremble more because their metabolisms are accelerated — as a result, they can lose weight.”

Hullett adds that depression and weight gain is a much more common and serious problem than depression and weight loss. “Generally, depressed people won’t lose so much weight that they are endangering their health, except in severe cases,” he says. “But depression and weight gain can escalate to the point that a person becomes obese and develops heart disease and diabetes, so it needs to be addressed regardless of the severity of depression.”

The Relationship Between Depression and Eating Disorders

Beyond weight gain and weight loss, binge-eating disorder (characterized by bingeing, meaning compulsive overeating used as a way to cope with unwanted emotions) and bulimia nervosa (characterized by bingeing and purging, meaning overeating and then attempting to get rid of it, such as by vomiting) are the two major eating disorders most often tied to depression.

“A high percentage of people with bulimia have depression — at least 50 percent are diagnosed with major depression,” Hullett says. “So treating the depression can often also help to stabilize weight in people with bulimia. Depression treatments are also often effective for binge-eating disorder, when people often eat to compensate for stress and depression, he says.

Anorexia nervosa, on the other hand, is much less likely to be tied to depression, Hullett says.

Tips for Healthy Weight Management

Because depression and weight are so closely linked, tackling both problems is important in order to move forward. “The same tactic to control weight applies if you have depression: You need to decrease calories and increase your physical activity,” Hullett says. “So finding a way to do this despite the effects of depression is critical.”

Here are some helpful weight-management strategies to try:

Examine the relationship between your depression symptoms and food. “Explore the feelings you have about your weight and be mindful of how and when you use food,” Wills says. “Unlike smoking, you can’t quit eating.” So find a new way to look at food — as a source of nutrition instead of a outlet for depression, for example.

Take it slow. “People with depression often feel overwhelmed with life, so having small, incremental weight-management goals is important,” Wills says. “If you drink sugary drinks, for example, make eliminating them your goal for one week. Then move on to cutting out fried foods the next week.”

Turn the TV off and get moving. “Most people with depression and weight gain have reduced their amount of physical activity,” Hullett says. “It may not be obvious, but if you sit for four hours a day watching TV when you’re feeling depressed instead of your usual three hours, your metabolic rate will drop,” he says. Every bit of physical activity helps; start an exercise regimen to boost yourself out of a rut.

Just as with changes to your diet, increase physical activity gradually. “The low energy associated with depression can be debilitating,” Wills says. “Start by stretching for a few minutes in the morning, and make that your goal for four or five days. Then add a walk around the block. If you make small incremental changes, over time you’ll feel more in control, have a more positive outlook, and become more motivated to exercise.”

Ask your doctor if your medications are interfering with your weight-management efforts. “Many of the medications used to treat depression symptoms can cause weight gain over time,” Hullett says. “If weight management is important to you, clearly communicate this to your doctor, because there are alternatives.” Your doctor may change your medication or add a medication to counteract the weight-gain effects.

Consult with a registered dietitian. “This is particularly important if your depression and weight gain or weight loss is significant,” Wills says. To find a qualified dietitian in your area, log on to Eat Right, the Web site of the Academy of Nutrition and Dietetics (formerly the American Dietetic Association).

As you try to make these changes, having a positive attitude is key. “Weight management changes can be challenging for all of us, especially for people with depression,” Wills says. “Stay focused and continue to communicate with your doctor to help reach your healthiest weight.”