Signs of Prenatal Depression and What to Do About It
Ah, pregnancy. Such a magical time, right? Or is it? You are growing a new life, looking forward to expanding your family, and planning for the changes that parenthood will bring. Perhaps this pregnancy is the culmination of years of trying, or perhaps you were surprised by how quickly things happened.
Maybe it’s your first child, maybe it’s your fifth! While some may assume pregnancy is a wonderful time in every woman’s life, there are many factors that can make it a very difficult time. For example, some women really struggle with prenatal depression.
Depression: Not Just a Postpartum IssuePublic knowledge of postpartum depression has increased significantly in the last several decades. Most people are aware that there’s a difference between baby blues and more serious postpartum mood disorders, and screening practices have increased during the postpartum period.
However, many people are still not aware that it is possible to struggle with prenatal depression (prenatal meaning “before birth”). Being aware that depression is possible during pregnancy and recognizing when certain risk factors may predispose you to struggle with prenatal depression can be the difference between suffering silently and being able to get effective help.
Predisposing Factors for Prenatal Depression
A past history of mental health struggles, lack of social support, history of abuse, high perceived stress, previous pregnancy loss, unplanned pregnancy, and experiencing a high-risk pregnancy are some of the most prevalent risk factors for developing prenatal depression or anxiety.
Experts estimate that 7-20% of women struggle with prenatal mood disorders. While this is by no means a majority of pregnant women, it’s also not a small number, and because doctors don’t always screen during pregnancy, it may be underdiagnosed. Untreated prenatal depression can also increase your risk of struggling with postpartum depression.
Just because you have one or more of these risk factors does not mean you will struggle during your pregnancy, but it’s wise to be aware and to know that support is available if you need it. Especially if your path to pregnancy has been difficult or complicated by factors like infertility or loss, it’s good to expect that you may need support to be able to cope well with the massive social, emotional, and physical changes that pregnancy and birth bring about.
Physiological Effects of Stress
Maternal levels of cortisol can affect your unborn child. Research now shows that even after controlling for other risk factors, high levels of maternal stress while pregnant increase the likelihood of children later having neurobehavioral challenges.
This is not a point made to add to an expectant mother’s guilt or anxiety, but rather to underscore the importance of seeking support if you are struggling. As more research is done, we continue to learn just how important it is for mothers to be cared for well, before and after pregnancy.
Everyone knows that nutrition and diet play a pivotal role in prenatal health, but the “diet” of our thoughts and mental state also have important impacts on a developing child.
As scientists continue to study epigenetics, the science of how environment and genetics work together to result in expressed traits, more and more research comes to the fore that shows how connected our experience is to that of our parents and even our grandparents!
When you think about the fact that your grandmother’s body once held your beginnings (since a baby girl is born with all the eggs she will have at birth) it starts to make sense that taking care of yourself when pregnant has a lasting impact.
A Biblical Perspective
Part of being a loving parent and a good steward of the life God is knitting together in your womb is learning to manage your own stress levels and seek support. God recognizes that pregnancy is a precarious time and speaks of His gentle care for mothers in Isaiah 40:11:
“He will tend his flock like a shepherd; he will gather the lambs in his arms; he will carry them in his bosom, and gently lead those that are with young.” – Isaiah 40:11 ESV
As you begin to travel on the journey of pregnancy, this first step in becoming a parent, do not doubt for a moment that God will provide you with the resources you need to continue traversing through this new life terrain.
God is not an impersonal judge, looking for ways to censure you for failure, but rather a kind and loving high priest who is able to empathize with your struggles.
In Hebrews 4:15 we are presented with this picture:
For we do not have a high priest who is unable to sympathize with our weaknesses, but one who in every respect has been tempted as we are, yet without sin. (ESV)
God took human form, Himself coming to be with us, through pregnancy and birth no less! He was sad, wept, and experienced a full spectrum of human emotions. You can be confident that God understands the depths of whatever you might be feeling and that He is capable of walking with you through it.
How to Overcome Prenatal Depression
One of the most distressing aspects of prenatal depression is that you may feel guilty for feelings of depression during what “should” be a happy time in your life.
Rather than try to think your way out of feeling the way you feel, an approach which research has found to be largely ineffective when dealing with negative emotions, an approach called ACT (Acceptance and Commitment Therapy) can be helpful. ACT focuses on mindful behavior, attention to personal values, and commitment to action. While this might be a new name for this type of therapy, we actually see this approach modeled in the psalms quite often.
As an example of how to move through feelings of depression honestly, let us look at Psalm 13. David begins the psalm by saying,
How long, O Lord? Will you forget me forever? How long will you hide your face from me? (v.1)
He feels alone, like God is far away and there is no relationship to be had. He honestly expresses his frustration with God. Next, he moves into making requests of God and asking Him to change his present situation.
Consider and answer me, O Lord my God; Enlighten my eyes, or I will sleep the sleep of death, (v.3)
Lastly, the psalmist returns to that which he knows to be true, even in the midst of his current feelings.
But I have trusted in your steadfast love; my heart shall rejoice in your salvation. I will sing to the Lord, because he has dealt bountifully with me. (vv. 5-6)
We see three things here: 1) Acknowledgement of how the psalmist really feels (no sugar coating); 2) A request and petition to move into a healthier place; and 3) Affirmation of what continues to be true, despite negative feelings.
Christian Counseling During Pregnancy and Beyond
A healthy way of handling depression acknowledges the reality of tough feelings but also continues to seek the truth, without accepting negative emotions as absolute reality. Too often people err on the side of accepting their feelings as absolute truth or denying that the feelings exist in the first place.
There is a way to move through difficult emotions without denying them. Denying the feeling will often only strengthen its force, so instead, it can be more helpful to seek support to deal with what you are experiencing. This support could take many forms, but counseling can be a great place to start.
If you are struggling with prenatal depression, it may be helpful to name that reality, even if it feels scary. You are not the only one who has struggled with difficult feelings, and there is help!
Feel free to contact me to schedule an appointment or browse the counselor directory to find the best counselor to meet your needs.
Biaggi, Alessandra, et al. “Identifying the Women at Risk of Antenatal Anxiety and Depression: A Systematic Review.” Journal of Affective Disorders, Elsevier/North-Holland Biomedical Press, Feb. 2016, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4879174/.
Kinsella, Michael T, and Catherine Monk. “Impact of Maternal Stress, Depression and Anxiety on Fetal Neurobehavioral Development.” Clinical Obstetrics and Gynecology, U.S. National Library of Medicine, Sept. 2009, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3710585/.