Recently a 26 year old pregnant woman came to my
clinic with the symptoms of depression. She could not understand
why she was feeling low and felt like crying all the time. She said
everyone around her expected her to be extremely happy and jolly
since she was pregnant. Even she was confused about why this was
happening to her in her pregnancy. On further case-taking I found
out that there was tension between the husband and wife due to the
other family members even before the she got pregnant. Most people
know about how some mothers go through slight depression after they
have delivered their babies. However depression during pregnancy
or Antenatal depression is not something we hear about commonly.
This is because not enough women understand what
is going on and they feel embarrassed to seek treatment since everyone
thinks they should be happy. Antenatal or depression during pregnancy
is in fact very common and the research shows that 1 in every 10
pregnant woman experiences this problem. This is especially seen
during the first and third trimester of the pregnancy.
WHO IS MORE
LIKELY TO GET DEPRESSION DURING PREGNANCY?
In many cases the reason
for getting this depression is not apparent and the woman just cannot
understand why she is feeling this way. But there are certain underlying
causes that may be making her more vulnerable to getting depressed
which she may not even be aware of. In other cases the factors for
this mental state may be very apparent. Here are a few conditions
and factors that might make a woman more prone to developing depression
1. One of the most common condition is if the
pregnancy was unplanned or unwanted. That means if the woman has
got pregnant by accident and does not really want the baby. This
creates a conflicting situation within her because though she is
pregnant she was not prepared to have this child.
2. The relationship
between husband and wife may not be strong and there may be lots
of doubts in her mind. There may be lack of confidence in the relationship.
3. The woman herself may be very young or old
and lack confidence in her own self. She questions her own ability
to bring up a child.
4. The pregnancy may be a result of a rape or
unintended sexual encounter in an unmarried female.
5. The pregnancy
may be a result of pressure from family members or others.
problems and poor health during the pregnancy may give rise to depression.
7. If the pregnancy is a result of months of fertility
treatments, the woman may have constant fear of loosing the child.
8. Past negative events like miscarriages, abortions
or tubal pregnancy can play on her mind and cause anxiety.
important aspect is if the couple is facing financial difficulties.
The to be mother will worry about the well being and the care needed
for the child. These constant worries are known to cause depression.
10. If there is lack of emotional support from
the family or husband it can cause lot of stress on the pregnant
11. It is important to know whether the woman
has suffered from depression or any other psychological problems
in the past like eating disorders. All these factors and situations
can make an already vulnerable woman prone to develop Antenatal depression.
She feels helpless, confused and thinks that things are not in her
WHAT CAUSES THIS DEPRESSION?
All the points written
above make the pregnant woman more susceptible to getting depression
but they are the not cause. Also in some cases there is none of the
above factors and the woman may have a perfectly planned conception
and yet may be depressed. Till now no physician can say for sure
why pregnant woman get depressed but there are some theories. The
most convincing and possible theory is that of the hormonal changes.
Many physicians blame the depression on the hormonal
changes taking place in the woman’s
body during pregnancy. The levels of these hormones seem to affect
the levels of neurotransmitters in your brain. The brain is the main
center for mood regulation and hence the change in the levels of
the neurotransmitters causes disturbances in the mood leading to
These changes seem to be more pronounced during
the first 6 to 10 weeks of pregnancy and then in the last 3 months.
Also noticed by physicians is that the hormonal changes makes the
woman more anxious and even this may add to the depression.
ARE THE SYMPTOMS OF DEPRESSION?
How does a pregnant woman know that
she is feeling depressed? There are many signs and symptoms, which
can suggest this. Here are the most common ones observed in practice.
If you are pregnant and have more than 2 or 3 of the symptoms listed
below you need to consult your physician.
1. The most common symptom
felt in pregnant woman is anxiety. They seem to get anxious over
very small and insignificant things.
2. If you have trouble concentrating
or focusing on things then your might be going through depression.
3. There may be a continuous low feeling all the
time. Nothing seems to excite and the woman does not feel like doing
anything or going out anywhere.
4. The woman has lack of confidence
in herself and a low self esteem. Feels worthless and thinks she
cannot do anything.
5. There is a sense of lack of control over her
life and a numb empty feeling.
6. Some pregnant woman may become
extremely irritable and impatient unlike. This may be unlike their
actual nature before the pregnancy.
7. There may be frequent mood
swings with lots of highs and lows.
8. Sleeping may be a problem
for some woman. The sleep pattern gets very disturbed and causes
9. There may be a loss of appetite contrary to
what is expected in pregnancy.
10. A sense of tiredness and fatigue
all the time may worry the pregnant woman and relatives. There may
be no desire to do anything. These are some of the common signs and
symptoms which indicate that everything is not alright and there
may be underlying depression.
If you are experiencing more than 2
of the points written above and are pregnant you need to go to your
physician and seek help.
DOES THIS HAVE AN IMPACT ON THE BABY?
is one of the most common question I am asked when I get such a case
in my clinic. The effects of post natal depression have been documented
where the mother does not care for her child and the baby is neglected.
The child may develop certain insecurities and behavioural problems.
However the effect of Antenatal depression have not been documented.
Nobody knows for sure what exactly are the adverse effects of depression
in the mother during pregnancy on the baby. Some physicians say that
depression in the last few months of pregnancy can cause pre-term
delivery. Others believe that this affects the heart rate patterns
of the foetus. However these are all assumptions and theories, none
of this has been proven as yet. What has been proved is that a woman
suffering from depression during pregnancy is at a higher risk of
developing postnatal depression too, which is known to have an adverse
effect on the child.
TREATMENT FOR DEPRESSION DURING PREGNANCY
you are pregnant or you know of someone who is pregnant and going
through depression do not take it lightly and think that it will
pass off. If not addressed it can become progressively worse and
lead to bigger problems in the future. Please consult your physician
about the necessary treatment and counseling required. Counseling
is an important aspect of the treatment and the root cause of the
depression should be tackled.
The entire family must be supportive
of the pregnant woman and be there for her when she needs them. The
husband is the most important person and he must go with the pregnant
woman for counseling as well. He must take part in her daily activities
like go for walks together and to the Gynaecologist for check ups.
Depending on the severity of the depression the
treatment should be selected. It is best to avoid anti-depressant
drugs and mood elevators
prescribed normally in depression. The effect of these drugs on the
growing foetus is not good and can cause certain birth defects. It
is safest to resort to Homoeopathy in these cases. In our system
of medicine the remedy is selected based on the symptoms and constitution
of the patient. Therefore it is not possible to write about the remedies.
However here are a few medicines which have proven effective in some
I had a very interesting case
of a 30 year old woman who was pregnant for the third time. However
her earlier two conceptions ended in spontaneous abortions before
three months were over. This time after much difficulty and complete
bed rest she had passed her third month. Due to past experiences
she was all the time worried and anxious about losing this baby too.
She told me that she felt as if there was darkness surrounding her
and she felt confused all the time. Sleep was difficult as she kept
thinking negative thoughts as if something wrong was going to happen.
Her husband told me that her moods were constantly changing. She
kept sighing loudly without knowing this. I gave her Cimicifuga 200,
5 pills daily to help her throughout her pregnancy.
case of a pregnant woman going through depression was given this
remedy. This lady had been trying for a child for years and had tried
several fertility treatments without success. Then she conceived
naturally but started going through depression. The family could
not understand this because they thought she should be happy. She
told me that she just wanted to be alone by herself and felt like
crying all the time. Her mind would keep thinking about past negative
events that had happened to her. This lady described herself as being
sad but did not want sympathy from others. Natrum Mur 200, in constitutional
doses was give to this pregnant woman, which made her feel like her
normal self again.
This Homoeopathic remedy is well known
as a female remedy. Pulsatilla is often used in problems pertaining
to the female sexual system where the symptoms correspond. It is
also very useful in treating emotional problems like depression especially
during pregnancy where the woman is most vulnerable. This patient
will weep easily even while narrating her symptoms. She will not
like to be alone and will want someone around her all the time. Even
darkness causes uneasiness. This uneasiness and anxiety is better
when she is in open air and when consoled. This remedy is also often
used in post partum depression where the mother weeps every time
the child breast feeds. Give Pulsatilla 200, 5 pills 4 times a day
to help improve her emotional and mental state.
I have written this
article in order to make people aware of depression during pregnancy.
We think that this is rare and uncommon because most women feel to
ashamed and embarrassed to speak about it and express themselves.
This can cause harm both to the mother and the child inside her.
If you are suffering from this or know of someone
who is please consult your physician and do not try to self medicate.