Psychology for Midwives
Depression and Pregnancy 2
For most women the period of growing bellies and growing anticipations is a joyful and exciting time and for others this time may harbor doubt, fear, and depression. “As many as 1 out of 5 women have symptoms of depression during pregnancy. For some women, those symptoms are severe. In pregnancy, women who have been depressed before are at higher risk of depression than other women” (“Pregnancy complication: depression,” 2009). “Depression during pregnancy, or antepartum depression, is a mood disorder just like clinical depression. Mood disorders are biological illnesses that involve changes in brain chemistry. During pregnancy, hormone changes can affect brain chemicals, which are directly related to depression and anxiety” (“Depression During Pregnancy,” 2008).
“Environmental factors, such as relational issues [history of depression and relationship difficulties], financial troubles, childhood sexual abuse (Klaus & Simkin 2004) and chronic illness [pregnancy complications and loss of pregnancy] can be contributing factors to the development or worsening of depression” (Sanders 2006). “Daily chronic stressors appear to be more powerful predictors of depression”. A study was done in Quebec in which the dependent variable, depressive symptomology, was measured using a validated revised form of the Beck Depression Inventory, commonly used during the perinatal period. The independent variables were women who were of both low and high socioeconomic status. “In this research, all indicators of depression in women of low socioeconomic status were elevated compared to other studies using the Beck Depression Inventory in the perinatal period”. The results showed that 49.6% of women from the low socioeconomic status suffered from depression where as only 20.0% of women from the higher socioeconomic status were depressed (Seguin, Potvin, St.-Denis, & Loiselle, 1995). This study shows that the epidemiology of depression is not strictly
Depression and Pregnancy 3
hormonal but also environmental. Any one of these factors mentioned above can increase the chances of a pregnant women having antepartum depression.
“The Diagnostic and Statistical Manual, 4th edition, text revised (DSM-IV-TR), published by the American Psychiatric Association, provides the diagnostic criteria for psychiatric disorders”. Five or more symptoms should be present with a depressed mood for a minimum of two weeks for the diagnosis of depression to be made (Sanders 2006). Signs and symptoms of Depression are: “trouble sleeping, sleeping too much, lack of interest, feelings of guilt, loss of energy, difficulty concentrating, changes in appetite, restlessness, agitation or slowed movement, thoughts or ideas about suicide” (“Pregnancy complication: depression,” 2009). The symptoms should be causing significant distress or impairment in social, occupational, or other relational areas. The symptoms should not be caused by medication, a medical condition, substance abuse, or be caused by bereavement (Sanders 2006).
Some women throughout their pregnancy may ask the question, “Can depression during pregnancy cause harm to me or my baby?” The answer to this question is Yes. According to an article written by the American Pregnancy Association, “Depression that is not treated can have potential dangerous risks to the mother and baby. Untreated depression can lead to poor nutrition, [poor prenatal care], drinking, smoking, and suicidal behavior, which can then cause premature birth, low birth weight, spontaneous abortions, [Preeclampsia], and developmental problems. A woman who is depressed often does not have the strength or desire to adequately care for herself or her developing baby” (“Pregnancy complication: depression,” 2009). “It appears that women with a history of depression are at greater risk for...