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Depression during pregnancy can feel very isolating, but you're far from alone: About 1 in 10 women have depression during and after pregnancy. And the actual number could be even higher because many women with depression are reluctant to ask for help.
Although you may worry now that you're expecting, depression during pregnancy is very treatable. Taking action to get help may be difficult, but it's the first step to recovery. Here's what you need to know.
How do I get help for depression during pregnancy?
If you're not yet being treated for depression, talk to your healthcare provider. She can screen you for depression and anxiety then refer you to a maternal-fetal medicine doctor or another specialist if necessary. A range of mental health professionals can help you, including:
- Social workers
- Psychiatric nurses
Which type of professional you see depends on your needs and preferences as well as the cost. Check your health plan to find out what's covered.
If you're already being treated for depression but still feel low, your provider may need to adjust your medication or change your treatment plan. Having a relapse during pregnancy is common, especially if you've stopped taking your medication. Managing depression effectively during pregnancy can help prevent postpartum depression.
Whatever your treatment, healthcare professionals will work with you to ensure you and your baby get the best care possible.
What's the treatment for depression during pregnancy?
Your options depend on how severe your depression is. Your treatment may include talk therapy, medication, or both. Talk therapy is usually tried before starting medication.
Talk therapy is regular meetings with a psychotherapist who will help you explore your thoughts, feelings, and behavior, and how they're connected to your symptoms of depression. You may talk with a therapist individually or participate in a group with other people going through a similar experience. Common types of talk therapy include:
- Cognitive behavior therapy (CBT). CBT alters patterns of negative thinking or behavior to change the way you feel. CBT teaches you to identify distorted thinking, recognize inaccurate beliefs, and help you see yourself and relate to others more positively. Some therapists use relaxation techniques, like mindful meditation, as part of the process.
- Couples and family therapy. These types of therapies help when relationships suffer because of depression, or if problems in relationships contribute to the condition. The therapist helps partners or families enhance communication, sort through conflict, and cope with crisis.
- Interpersonal therapy (IPT). IPT helps you explore the roots of your suffering using the therapeutic relationship with your therapist as a way to do so.
CBT and IPT are often effective for treating mild to moderate depression, but if talk therapy alone doesn't work, your provider may recommend medication as well.
There are a lot of medications available to treat depression, and many are considered safe to take during pregnancy. It takes between three to four weeks for antidepressants to take effect, though some people start to feel better after just a week or two.
Your provider may recommend antidepressant medication if depression stops you from functioning in your daily life and you're struggling to cope. Antidepressants might also be a good option if:
- You tried talk therapy and it didn't work.
- You tried stopping or lowering your dose of antidepressants and your symptoms returned.
- You have another mental health condition in addition to depression, such as bipolar disorder or panic disorder.
In extreme cases, if your depression is making you suicidal or psychotic (including delusions and hallucinations), you'll be referred to a psychiatrist for emergency medication.
The first time you take an antidepressant you may experience side effects, such as an upset stomach, nausea, or trouble sleeping, but these usually go away after a few weeks. To monitor your progress, your provider should check in with you often, either in person or by phone.
Deciding whether to take antidepressants during pregnancy can be difficult. Taking antidepressants during pregnancy isn't entirely risk-free, but the risk is fairly low. These drugs can cross the placenta and problems are possible, though rare. They may increase the likelihood that a baby will have problems such as being born early.
But not treating your depression effectively can be harmful too. Your depression could get worse and make it hard for you to care for yourself, which would also affect your baby.
Ask your provider to explain the pros and cons of your treatment options and answer any questions you have. Knowing more about the safety of taking antidepressants during pregnancy may help you decide what to do.
Electroconvulsive therapy (ECT) involves having an electric current passed through the brain to induce a controlled seizure. ECT is considered safe and effective for chronic depression, but isn't usually recommended during pregnancy unless a woman has a very severe case of depression or depression-related psychosis. There's limited research on the effects of ECT during pregnancy, so it's used only when other treatments don't work.
Do alternative therapies help depression?
It's hard to know. Most providers will tell you that there's not enough evidence to show that alternative therapies are effective for treating depression during pregnancy. Sometimes this just means that not enough research has been done to draw any definite conclusions about a particular therapy.
Safety is an issue, depending on the alternative therapy. This can be a real concern, especially if the therapy involves ingesting a substance that could be harmful to you and your baby. And some alternative therapies are expensive, so it may be good advice not to waste your money.
Still, some women swear that alternative therapies are helpful for managing depression during pregnancy, and some options are less risky than others. If you're interested in learning more about certain alternative therapies before trying one, you may want to talk to your provider about:
- Acupuncture. In this therapy, an acupuncturist gently places needles into your skin at specific points on your body that correspond to specific organs. Some studies suggest that acupuncture may be beneficial for treating depression, and acupuncture with a qualified therapist is safe during pregnancy.
- Light therapy. This involves sitting in front of a bright white light for a period of time each day. It's typically used to treat seasonal affective disorder, a type of depression that tends to occur in the fall and winter months when the days are shorter and there's less daylight.
- Massage. If you've ever had a massage, you know that it can help you feel relaxed. It's possible that getting a massage regularly, either from your partner or a massage therapist, could also help relieve depression.
- Meditation. Research suggests that mindfulness meditation can help you regulate your emotions, increase self-awareness, and reduce symptoms of anxiety and depression. Mindfulness meditation involves being present in the moment by focusing attention on your breath and your thoughts.
- Yoga. Yoga combines stretching poses, breathing, and meditation, and, like any type of exercise, can relieve stress and make you feel better. Learn how to do yoga safely during pregnancy.
What else can help me cope with depression?
In addition to following your treatment plan, taking care of yourself physically and emotionally is the best thing you can do. You may find it hard, but figuring out what makes you feel even a little bit better will ease your symptoms and help you cope. Here are some things to try:
- Get support. Sharing your feelings with your partner, friends, and family can help you feel better. They may be able to offer some perspective or practical help, and you may also find that simply talking about your emotions makes them seem more manageable. Ask your provider about local support groups.
- Take time to relax. Stress is a common trigger for depression, so try to take a break when you can. Having lunch with your partner, listening to music, or taking a calming bath can lift your mood. It can sometimes be difficult to find time to relax, especially if you already have children or work outside the home. So accept any help that allows you to take a little time to yourself.
- Protect your sleep. Pregnancy and depression can both disrupt your sleep. Give yourself the best odds of getting a good night's rest by cutting back on caffeine (especially in the afternoon and evening), being active during the day, and not eating a heavy meal just before bed.
- Eat healthy and stay hydrated. Eat regular meals with healthy snacks in between to boost your energy and give your baby the nutrition he needs to grow. Drink plenty of water or noncaffeinated drinks to stay hydrated.
- Exercise. Exercise can alleviate depression because the brain releases feel-good chemicals that boost your mood. Go for a leisurely stroll, take a swim, or try some pregnancy yoga. Talk to your provider first before starting any exercise regimen.
When should I call my healthcare provider?
If you feel like you can't cope, or if your symptoms are getting worse, call your provider. Also contact your provider immediately if:
- It's hard to perform tasks at work or at home.
- You're struggling to take care of yourself.
- You have thoughts of harming yourself or others.
If you're in crisis and feel as if you can't go on, call the National Suicide Prevention Lifeline at (800) 273-TALK (8255). It's a toll-free number and is available 24 hours a day, seven days a week.
The service is available to everyone. You'll be connected to a trained counselor in your area, and all calls are confidential.
What if I'm afraid to ask for help?
If you're not quite ready to talk to your provider, consider reaching out to moms in the our site Community. You can post anonymously and share how you feel with other women experiencing depression during pregnancy. Connecting with those who understand what you're going through might give you the courage to pick up the phone and call your provider.
Visit the Society for Maternal-Fetal Medicine's website for more information and to find an MFM specialist near you.