Perinatal depression is the diagnostic term used to encompass maternal depression both during pregnancy and within the first year after birth. Formerly known only as postpartum depression (occurring after birth), perinatal depression now encompasses the time during pregnancy.
What is Perinatal Depression and How Does it Differ from the “Baby Blues”?
Many women experience some variation of the “baby blues” after giving birth. According to Johns Hopkins, up to 85% of new mothers experience this short-lasting condition that may include anxiety, irritability, crying for no reason and restlessness. These symptoms typically resolve themselves within a week or two and are not interfering with daily activities.
Perinatal depression is a longer lasting, more severe version of the baby blues, often becoming overwhelming enough to interfere with daily life. Beyond the baby blues symptoms, those suffering from perinatal depression may have trouble bonding with the baby, feelings of being a bad mother, thoughts of harming themselves or their baby, difficulty concentrating, changes in sleep patterns and appetite, loss of interest in activities and more. Perinatal depression is a serious condition and should not be taken lightly.
Who is at Risk for Perinatal Depression?
A study by Guintivano et al estimates that 10-15% of white women experience perinatal depression. Another study by Guintivano et al found that almost one in three Latina women experienced depression while pregnant and about one in three experienced depression after giving birth. An analysis by Carlson et al found that the global incidence ranges from 6.5% to 20%. China had the highest rate at 21.4%, followed by Japan at 14% and the United States at 8.6%. The Carlson et al analysis also found that the average time of onset of depression postpartum is at 14 weeks, but overall Black and Hispanic women tended to report symptoms earlier, within two weeks of giving birth.
While anyone may experience perinatal depression, women who have experienced depression or psychiatric disorders in the past (or have a family history of them) are at higher risk. Those lacking social and emotional support are also at higher risk, as well as those going through additional stressful life situations. A history of trauma or adverse life events can also increase the risk of experiencing perinatal depression.
How Does it Affect Mother and Baby?
The emotional distress of perinatal depression can affect both mother and baby. If the depression begins during the pregnancy, it could lead to premature birth and/or low birth weight, which can lead to medical and developmental problems with the infant. A study by Field, Brand and Brennan found that in the longer term, children born to mothers with perinatal depression may experience impaired social skills and deficits in verbal, developmental, emotional and cognitive abilities.
According to the American Psychiatric Association, perinatal depression can also make it difficult for a mother to bond with her baby, which could lead to problems with the infant in eating and sleeping habits, particularly if the baby is breastfed.
The impact of perinatal depression on a mother is huge. While dealing with sometimes debilitating depression symptoms, she now has the added responsibility of caring for a new baby and adjusting to a new way of life. It can be overwhelming and disruptive.
Prevention and Treatment
The medical community is aware of the importance of identifying and treating perinatal depression for the best outcomes for mother and baby. Utilizing screening tools such as the Edinburgh Postnatal Depression Scale (EPDS) is common practice during both pre and post natal visits.
An article by Zauderer suggests that up to 50% of perinatal depression cases are undiagnosed because women are afraid of the stigma surrounding depression and fear they won’t have the support they need to deal with it.
The good news is that there is treatment for perinatal depression. The sooner a mother brings forth her concerns, the sooner she can start feeling better. The American Psychiatric Association suggests that psychotherapy (talking with a therapist), medications, a good support system and even potentially some lifestyle changes can all be part of the treatment protocol, depending on the needs of the mother. Help is available to help a mother through these difficult times. While it can be easy for a mother to dismiss her feelings or try to handle it all on her own, this is a time to call in the support forces and accept help.
If you are experiencing any symptoms, no matter how mild or severe, talk to your doctor about it. They are well-versed in how to handle perinatal depression and can connect you to the right resources. Be open and honest about everything you experience. There is no shame in this and the sooner you reach out for help, the sooner you can feel better. You are already Superwoman but even Superwoman needs a community of support for her empire!
Symptoms of perinatal depression include:
• Feeling sad or having a depressed mood
• Loss of interest or pleasure in activities once enjoyed
• Changes in appetite
• Trouble sleeping or sleeping too much
• Loss of energy or increased fatigue
• Increase in purposeless physical activity (e.g., inability to sit still, pacing, handwringing) or slowed movements or speech [these actions must be severe enough to be observable by others]
• Feeling worthless or guilty
• Difficulty thinking, concentrating or making decisions
• Thoughts of death or suicide
• Crying for “no reason”
• Lack of interest in the baby, not feeling bonded to the baby, or feeling very anxious about/around the baby
• Feelings of being a bad mother
• Fear of harming the baby or oneself
*Source: American Psychiatric Association
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