The Impacts of Depression During Pregnancy and Early Parenthood

By Anne Gold | Oct. 14, 2016

 

Depression during pregnancy is a much more common problem than you might think. In fact, according to the American Congress of Obstetricians and Gynecologists (ACOG)  an estimated 14–23% of women are impacted by depression during their pregnancy, which is much higher than the 6% of women who will suffer from depression at some point during their lifetime. Given that pregnancy has a huge impact on your hormone levels, affects your brain chemicals and causes other physical and emotional changes to your body, it comes as no surprise that these massive changes might lead to depression as well.

What Are Common Symptoms of Depression During Pregnancy?

Depression tends to develop slowly, and the symptoms can differ from person-to-person. However, changes in your appetite and sleep habits; feelings of sadness, hopelessness or despair; lack of energy; taking no pleasure from your normal pastimes and hobbies; and crying for no reason are all pretty common with depression.

Untreated depression during pregnancy can lead to miscarriage or pre-term labor, so if you are experiencing symptoms of depression, make an appointment to see your physician as soon as possible. It’s important to remember that depression is nothing to be ashamed of and being diagnosed with depression will have no impact on your abilities as a mother or on the love that you have for your child.  

Could My Child Inherit My Depression?

Many women who live with depression and are contemplating motherhood worry about the impact that their depression might have on their children—particularly if they are taking medication while they are pregnant. There have been several studies conducted on the long term impact on children who are born to mothers with depression. Research conducted Dr. Anqi Qiu at the National University of Singapore and published in Biological Psychiatry found that babies born of women with high levels of depression symptoms had a slightly different brain structure to babies born of women presenting no signs or symptoms of depression.

However, the differences found were very slight. It is therefore unlikely that any child will definitely develop depression simply because their mother had the condition.

Can I Still Breastfeed My Baby?

It is a common misconception that women who take antidepressants should not breastfeed their babies. In fact, while small amounts of antidepressants will come through breast milk, extensive research has shown that children exposed to these drugs through breast milk consumption have not gone on to experience any problems or side effects. Doctors and midwives promote that “breast is best” for the health of the baby and for promoting a strong bond between mother and child, so if you would like to breastfeed your child then there’s really no reason why you shouldn’t.

Women, and particularly mothers, living with mental health problems are highly likely to be stigmatized and discriminated against. But the fact is that by acknowledging your depression and seeking medical and emotional support, you are actually putting yourself in a better position as a mother than if you were to pretend that the problem didn’t exist.

If you are thinking of becoming pregnant, discuss your desires with your physician. They may adjust your treatment plan, offer you additional emotional support or reduce your medication levels, depending on your unique needs. What’s important to remember is that if you feel physically and emotionally ready to have a child, do not let depression stop you.

 

Now a writer, Anne Gold worked previously in the mental health sector. She's someone who has battled her own problems with depression and anxiety and firmly believes that to be able to help others, you have to help yourself. Now she's a mother, she's more acutely aware of staying well and promoting good mental health to others.

 

Comments
Psych Pharmacist
Hi Terri. Yes, unfortunately bipolar disorder can start in the teen years, but is hard to diagnose at that stage. The symptoms can be a bit different. There are some good references if you search for "bipolar disorder teens". Here is one: http://kidshealth.org/en/teens/bipolar.html
The good news is that early diagnosis and treatment is very helpful, rather than having untreated symptoms that can get worse. I wish the best for her and you.
3/23/2017 2:20:52 PM

Terri Rimmer
In responsed to psych pharmacist's comment of March 10, I appreciate that. Monday, however, I found out that my birth daughter has been put on Zoloft for depression and anxiety. They have not officially diagnosed her as bipolar but have used the word bipolar. Zoloft was the first med I was put on at 27 but it wore off after 90 days. I'm very concerned for my daughter because she's always cared about school; etc. and now has gone the opposite way. I don't want her to go through what I have. Dr. Phil said a teenager can't be diagnosed bipolar because their brain isn't completely formed. Any thoughts on that?
3/16/2017 6:51:18 PM

Psych Pharmacist
Oh goodness no. The last thing I wanted to do was to try to make you feel guilty. In fact I was trying to say just the opposite. My belief is that she would have had feeding problems despite the Effexor and/or depression, neither of which was your fault. I'm trying to say that sometimes these things just happen and there is no identifiable reason why. I believe that taking Effexor was the right decision, as it has been shown to be much safer in pregnancy than depression. It sometimes isn't dosed properly in pregnancy, which means women can get breakthrough symptoms which can be harmful to mother and baby. And swaddling IS absolutely the right thing to do, as it helps with any withdrawal symptoms that might be there.
3/10/2017 6:30:51 PM

Terri Rimmer
In response to psych pharmacist response posted Feb. 23 concerning Effexor and tube feeding, I took Effexor because my dr. told me it was safe. I'm trying to discern from your post if you're trying to say I caused the problem because of my depression even though I was on medication for it. I spent years feeling guilty until I was told that Effexor was the cause of my birth daughter's food aversion. Now you're telling me I should have felt guilty after all because of my depression? What am I supposed to do with that? My baby was swaddled by her transitional parents she had for a week during my visits and by her adoptive parents. But her feeding problems started from the time she was placed in the hospital nursery. The hospital nurses swaddled her. I saw you had alluded to the fact that swaddling could've caused the problem.I am trying to make peace with this. Even though she no longer has to rely on the tube I need to know that I was not to blame. I followed dr's orders. This was not a planned pregnancy. For 34 years I didn't think I could get pregnant. But I love my daughter and if I thought for one minute that I could've caused this I couldn't live with myself.
3/3/2017 12:06:11 AM

Psych Pharmacist
Terri, it is great to hear that your birth daughter is feeding without the tube now. I know I'm not going to convince you, despite the fact that I have over 20 years experience researching and working with women with depression with or without antidepressants during pregnancy. I am also part of a listserve with reproductive psychiatry specialists from across North America. There has been more than 10 years of research on depression and/or antidepressants in pregnancy.

Depression in pregnancy can cause miscarriage, prematurity, low birth rate and pre-eclampsia. Women with depression are less likely to eat and sleep well, and malnutrition can cause a whole host of problems. Women with depression are more likely to smoke and abuse substances, which causes far more problems. Women with Post Partum Depression have a difficult time bonding with baby and breastfeeding. This can cause long term neurodevelopmental effects. Not all babies born to depressed mothers have problems. Just because adverse effects are correlated with a disorder such as depression, it doesn't mean it happens all the time.

3 to 5% of ALL babies in the general population will have birth defects and other problems even without depression and antidepressants. One study says that 80% of all babies in the neonatal intensive care unit are tube fed. As many as 35% of all infants exhibit food selectivity and refusal, as revealed by parent interviews in general population surveys. Yes there are infants born to mothers with depression and/or on antidepressants that have withdrawal and feeding problems. But the incidence has not been reported to be any higher than in the general population. The product information says babies born to mothers on Effexor may have to be tube fed, but there are no published case reports and the company does not release reports. They also tend to put negative information regarding their medication in pregnancy because they don't want their medication used and have to deal with lawsuits with no merit. Tube feeding is rare with babies exposed to antidepressants, and is not reported to be any higher than the general population of babies.

It is awful to have a baby with problems, and we always want to understand why. Yes, your daughter was exposed to Effexor and had to be tube fed. But anecdotal evidence, or one case, is not a scientific finding. We look to population studies and it was not found to be more common in babies exposed to Effexor than those who weren't. The same goes for other adverse effects in babies exposed to antidepressants. The only effect known to be higher in them is withdrawal effects, which are almost always mild enough to be treated by swaddling and go away within a week.

If you have scientific papers showing a link between tube feeding and Effexor, I would be pleased to read them.
2/23/2017 8:06:32 PM

Terri Rimmer
I responded to the psych pharmacist's comment of Dec. 1 but I don't know why it wasn't posted. Effexor was the cause of my birth daughter's feeding disorder and ten years of research shows this. According to your theory, if my depression and anxiety was the cause, then wouldn't everyone who is pregnant who suffers from those disorders have a child with a feeding disorder, too since you say anxiety and depression is that devastating to the fetus? That doesn't make sense. At any rate, as of December 2016, my birth daughter was able to get her g tube removed and no longer has to depend on feeding tubes any more.
2/15/2017 5:40:22 PM

Annemiek den Hollander
Thank you for giving a summary of such a difficult topic.
2/12/2017 10:09:51 AM

Psych Pharmacist
I'm sorry Terri but you are completely wrong. Effexor has never been found to have the feeding problems you describe. It absolutely has not been associated with heart defects whatsoever. I personally know very concerned researchers not affiliated with the drug company who have studied this for years and have found no link. I have done extensive research about the subject as I wrote a book on psychotropic drugs in pregnancy and lactation. I have known many women who have delivered very healthy babies on Effexor and other antidepressants. I have also known women whose babies had heart defects that were not on medication. Heart defects are very common unfortunately, and occur in 1-2% and some studies say even three percent of all babies born. I'm sorry for your daughters problems, but it is extremely unlikely they were due to Effexor. Antidepressants are by far the most studied medications in pregnancy, and other than a slight risk of 1st trimester miscarriage and a risk of withdrawal in the baby that is manageable, they have found no additional risk compared to the general population.

I would highly suspect the problems your daughter experienced were due to the hormonal (especially cortisol) effects of depression and/or anxiety on pregnancy. These effects are well documented and studied and can be devastating.
12/1/2016 5:12:52 PM

Terri Rimmer
In response to Psych Pharmacist's post of Nov. 3, my daughter was the one who had the problem with Effexor. After giving birth to her she experienced feeding problems because of it. It took me 10 years of research to find out that was the reason (the drug). There is much research on this. She has had to use a feeding tube since she was 2. She is now 16. It caused her to be born with food aversion. My dr. told me the drug was safe because the drug company, Wyeth said it was safe. It also causes heart defects. There is much research on this as well.
11/8/2016 4:08:53 PM

Psych Pharmacist
I don't understand why you had a problem with Effexor. The data in pregnancy is overwhelmingly positive other than some mild withdrawal in baby that can easily be managed. It is not safe for women to stop antidepressants in pregnancy. It is MUCH safer than depression and anxiety in depression! I know this from pregnant women I have worked with and the literature I re iewed while writing a book on psychotropics in pregnancy.

Your daughter is at risk for depression due to genetics which you can't help. Fortunately the study of epigenetics, or gene expression, shows that a positive environment and learning good coping skills can help prevent this.
11/3/2016 3:46:09 PM

Terri Rimmer
It is very important that pregnant women don't take Effexor when they are pregnant. My dr. told me it was safe and it wasn't. I have suffered from severe depression my entire life and still do. I do worry about my daughter inheriting it. She's 16 now and so far, so good.
10/30/2016 1:40:38 AM

Psych Pharmacist
Antidepressants are arguably the most studied medications in pregnancy. There is an extremely low risk of Persistent Pulmonary Hypertension, but this is true of some other medications too. The biggest risk is of some withdrawal in the baby, but this can be managed by the team. There are no known long term effects at this time. Stopping or lowering the dose in the third trimester is definitely NOT recommended as it greatly increases the risk of post partum depression. Here is a quick link that I hope helps. And of course speak to your physician and pharmacist!:
http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/antidepressants/art-20046420?pg=1
10/28/2016 1:19:24 PM

Andrea Mullins
Please expand on safety of antidepressants and/or other meds during pregnancy. I am 24 weeks pregnant and very depressed and anxious. thanks
10/27/2016 10:58:24 AM

Devin Brock
I want to learn more
10/26/2016 1:47:48 AM

Psych Pharmacist
Thank you for talking about antidepressants in these women using factual information. Too many women suffer from stigma, misinformation and well meaning but uninformed people. Depression in pregnancy has far more known I'll effects than antidepressants. And there is no question that a woman who is breastfeeding doesn't need to stop her antidepressants!
10/20/2016 1:25:09 AM

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