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Pregnancy blues may signal depression

Arundhati Undurti, MD, PhD

Sadness and irritability. Fatigue. Guilt. You may recognize the signs of post-partum depression, but did you know that depression can begin before your baby is even born?

According to one study, half of women diagnosed with postpartum depression felt unhappy during their pregnancies.

A mother’s body undergoes huge changes while growing a baby, and feeling hopeless or overwhelmed is more common than you think. Getting support early can help women enjoy this special time in their lives.

It’s also healthier. Left untreated, depression and anxiety increase the risk of premature delivery, may result in a lower birth weight, and can prevent a mother from connecting with her infant.

I often treat mothers who have been struggling for months because they think it’s “just hormones” or because they’re afraid to take something. In fact, there are a wide variety of options within reach:

  • Medications with a safety record
    One of the first options is antidepressants—name brands Prozac and Zoloft are examples. The data on these drugs show that they are safe to use during pregnancy and while breastfeeding, which means mothers can easily continue with treatment. As with any medication, however, you have to balance the risks with the benefits. Drugs generally take four to eight weeks to work well. It’s not an overnight solution, but it can be an effective one.
  • Short-term therapy
    Women can also choose therapy, either on its own or with an antidepressant. Therapy can help women learn how to approach problems in a more positive way, which helps them feel better overall. It can also improve their relationships with other people. Therapy is designed to help women reach specific goals and requires weekly appointments for several months.
  • Being good to yourself
    Lifestyle changes may also help pregnant women manage depression and anxiety. Going outside for a walk or sitting in front of a light box is a huge mood booster. Taking omega-3 fatty acids and folic acid can also help. Some women find relief with massage therapy and acupuncture.

I believe the best treatment plans are those that the patient and doctor build together, and I enjoy collaborating with each individual to come up with the right solution. No matter what combination of therapies we land on, I encourage women I see to spend 10 to 20 minutes every day on an activity they enjoy. Even if they don’t feel like it. Doing something that you enjoy helps you feel better overall. It’s a good habit for anyone—pregnant or not.

Depression and anxiety can take a huge toll on how a woman feels about her pregnancy and her family, but things can and do get better with treatment. Helping a woman enjoy her pregnancy and baby is one of the most satisfying things I do.

If you are pregnant and depressed, talked to your primary care doctor or your OBGYN about treatment and referral options.

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Dr. Aru Undurti is a psychiatrist at Vancouver Clinic’s Salmon Creek location. She believes that physical health and mental health are intertwined, and collaborates with each patient to choose a unique, evidence-based treatment.