by Hilary Planden
Depression is quite common both during pregnancy and after the baby’s birth. Up to half of all pregnant women have a period of depression during their pregnancies. About one in five women feels depressed in the first year after they give birth. Perinatal depression does not just affect women; some partners of women with perinatal depression also feel depressed so it can affect the entire family.
Two terms are used to describe depression in pregnancy and after the birth. The depression that occurs at any time between when the woman first becomes pregnant to when the baby is one year old is called “perinatal depression” while depression that occurs after the birth of the baby is called “postpartum depression.”
There are many reasons that women get perinatal depression. Changes in hormone levels can contribute to depression. A woman’s past history of depression can increase her chances of having perinatal depression. Stressful life events or a difficult relationship can increase the chances of having perinatal depression. Just the changes that a new baby brings to home life can also be a contributing factor.
The symptoms of perinatal depression are varied and each woman experiences it differently. The following is a list of symptoms that are often seen when women have perinatal depression:
• Feeling sad, empty and helpless.
• Extreme feelings of guilt, worthlessness, and hopelessness.
• Loss of interest and pleasure in activities enjoyed in the past, including sex.
• Decreased energy, feeling of fatigue.
• Changes in sleep or appetite.
• Restlessness and irritability.
• Difficulty concentrating or remembering.
• Having frightening thoughts about harming the baby.
• Thoughts of death or suicide.
Just as there are many symptoms of perinatal depression, there are also many things a woman and her family can do to decrease the symptoms. Many women know something is wrong but they do not ask for help, as they may feel ashamed or embarrassed. Sharing feelings and experiences with trusted loved ones, whether family or friends, does help.
Self-care is a very important goal when a woman has perinatal depression. Women suffering from perinatal depression must learn to be good to themselves. Postpone the laundry and have a quiet time instead. Sometimes just 10 minutes is enough to have a cup of tea and take a breather.
Keeping expectations realistic is also important. A list of chores that has more than one or two items is too long. Plan to do one task during the day and if that task is completed, celebrate that accomplishment. Do not feel badly if a task is not completed—there is always tomorrow.
Try to get as much rest as possible, eat well and get some exercise. All of this can be a challenge when you have the never-ending demands of a baby or the discomfort of pregnancy but it is very important. Rest is vital for your brain’s health. You may have to ask for help from family or friends so that you can nap while someone else is caring for your baby.
Eating well is particularly important for women who are pregnant or postpartum. Some women find that snacking on healthy food throughout the day is easier than sitting down to a large meal. Try to stock your cupboards and fridge with healthy ready-to-eat or easily prepared foods. Do not forget to take the multivitamin recommended by your health professional. Canada’s Food Guide makes excellent recommendations for pregnant and breastfeeding women and is available at most health units throughout Vancouver Island.
Regular physical activity is related to improved mental and physical well-being. Focus on exercise that you enjoy and keep in mind that regular short periods of exercise three or four times a week are better than irregular long periods. Even simple activities such as going for a walk can help you feel better.
Seeking professional help is vital. Family physicians and midwives can identify women who may be at risk of depression in pregnancy. They can give women who are between their twenty-eighth and thirty-second week of pregnancy a questionnaire called the Edinburgh Postnatal Depression Scale. This questionnaire helps to identify women who may be at risk for depression in pregnancy so that supports and treatment can be put in place. Physicians and midwives may prescribe anti-depressant medications, which have a role to play in treating perinatal depression. They are often most useful when offered in combination with counseling and attendance at a support group.
Child, Youth and Family Community Health also has a role to play in supporting perinatal women. Women who bring their infants into the Public Health Unit for their two and six month immunizations are offered the Edinburgh Postnatal Depression Scale again by Public Health Nurses. If a woman appears to be at risk for depression, referrals can be made to counselors and/or support groups throughout Vancouver Island.
If a women or her family feels that she is at risk of hurting either herself or her baby she needs immediate help and treatment. A call to the family physician or midwife should be made right away. Another good source of immediate help is the NEED Crisis Information Line at 250-386-6323. They will be able to make a referral to the Emergency Mental Health Services if necessary.
Perinatal depression is an illness that many women and their families experience. There is no need for women to suffer alone or in silence, as there are many sources of support and information. Physicians, Midwives and Public Health Nurses are very knowledgeable about this illness. Child, Youth and Family Community Health Unit contact information throughout Vancouver Island is listed in the ad on the facing page. Other sources of information and resources are:www.postpartum.orgwww.postpartum.netHilary Planden is a Clinical Coordinator at the Victoria Health Unit for Child, Youth and Family Community Health, VIHA.