What is depression in pregnancy?

Pregnancy can be an emotional time. You might feel excited and elated one moment and stressed and unsure the next. This is completely normal. As your body goes through physical changes, it's common for your mood to go up and down.

But if your low moods or negative thoughts persist and interrupt your daily life, you may be developing depression. Up to 1 in 10 people have depression during pregnancy.

You might hear the terms antenatal, postnatal and perinatal depression and wonder what the difference is between them:

• Antenatal depression is depression that starts during pregnancy.
• Postnatal depression is depression that develops up to a year after childbirth.
• Perinatal depression is depression during pregnancy and up to a year after birth.

Mental health problems are common during pregnancy and after birth. They can affect you if you are the pregnant and birthing parent, as well as your partner.

What are the symptoms of depression in pregnancy?

The symptoms of depression during pregnancy are the same as those when depression happens at any other time in your life.

Symptoms can include:

• feeling low or numb
• having no interest or pleasure in things you normally enjoy
• changes in your sleep or appetite
• tiredness and loss of energy
• feeling helpless, hopeless or worthless
• problems with concentration and making decisions
• having thoughts of harming yourself

If you have depression, you are probably also having problems with your usual activities, including:

• work
• socialising
• parenting any older children

People who have depression may also have anxiety during pregnancy.

It's important to see your doctor if you have any symptoms of depression or anxiety.

What causes depression in pregnancy?

While depression can affect anyone during pregnancy, it may be more likely if you have:

• a history or family history of mental health problems
• a lack of support
• experienced any type of trauma or abuse
• current or recent stressful life events
• a history of alcohol or drug abuse
• experienced pregnancy loss or childbirth-related trauma
• pregnancy complications

How is depression in pregnancy diagnosed?

Your doctor or midwife will ask about your mood and feelings during your antenatal check-ups. They will ask even if you don't report any symptoms. This is called screening, and it's important so that depression can be diagnosed early.

If you do have symptoms, it's important to see your doctor as soon as possible. Your doctor will want to know how you are feeling and about your general health.

There are some tests available that can help detect depression in pregnancy. These are questionnaires, and include the:

• Edinburgh Postnatal Depression Scale
• Antenatal Risk Questionnaire

If you have depression during pregnancy, your GP, midwife or obstetrician may refer you to a:

• psychologist
• psychiatrist
• social worker

How is depression in pregnancy treated?

There are treatments available for depression during pregnancy.

Psychological therapy

Psychological therapy or counselling can help in the treatment of depression. Therapy aims to give you support, education and information on how to understand and cope with depression.

Therapies may include:

• cognitive behavioural therapy (CBT)
• interpersonal psychotherapy (IPT)

CBT can help you identify negative, unrealistic thoughts. It then encourages you to challenge those thoughts by approaching your thinking in a different way.

IPT can help you resolve things that may be contributing to your depression, such as past losses or conflicts.

Medicines

In some cases, your doctor may prescribe antidepressant medicines to help treat depression.

Remember to check with your doctor or pharmacist before taking any medicine while you are pregnant or breastfeeding. This includes over-the-counter medicine and supplements. They will be able to tell you what medicines are safe for you and your baby.

Self-care

If you are experiencing depression during your pregnancy, there are some things that may help. These can include:

• exercise or an enjoyable physical activity
• eating healthily
• getting enough sleep
• getting emotional and practical support from loved ones
• practising mindfulness, relaxation and meditation

Some types of exercise are not recommended during pregnancy. If you're not sure, talk to your doctor. It's important to get the care you need if you have depression during pregnancy. Untreated depression and anxiety during this time can affect your health and relationships.

It's okay to ask for help.

Resources and support

If you or someone you know is showing signs of depression in pregnancy, see your doctor. It's important to seek help early.

PANDA (Perinatal Anxiety & Depression Australia) has information on mental health problems during and after pregnancy:

• Phone their National Helpline on 1300 726 306.
• Find support in different languages and support for Aboriginal and/or Torres Strait Islander people.

COPE (Centre of Perinatal Excellence) provides support for the emotional challenges of becoming a parent. They also have information in different languages.

Beyond Blue offers support online, or you can phone 1300 22 4636.

For advice and to get connected to local mental health services, call Medicare Mental Health on 1800 595 212. Check the operating times.