Pregnancy is supposed to be a happy time, full of excitement, anticipation, buying cute little baby clothes, taking bump pictures, and enjoying the experience of watching your body miraculously grow another person. I had wanted to be a mother for as long as I could remember. When I finally did get pregnant, by week 8, I was miserable. I assumed it was because of morning (read: all-day) sickness and crushing exhaustion. At my 20 week ultrasound, I couldn’t muster up the excitement that everyone else seemed to expect from me. So I faked it.
On Facebook and Instagram, I was happy, excited, updating everyone about Boo (my nickname for him) and I. The reality was quite different. Most nights, I cried and wondered what I was doing. I began to think that it was all a mistake, that I never should have done this, and that I would be a horrible mother. I had a therapist, and since week 10, she had suggested I talk with my provider about medication, but I told her I wasn’t interested, that I really wanted to do this without any drugs. By week 25, I realized that I was not enjoying pregnancy at all. The exhaustion was all-consuming and interfered with my work. I forced smiles when people asked me about the pregnancy. I felt like a fraud. I had waited my entire life for this experience, wanted it with every fiber of my being, and now that I was in it, I hated every day. That’s not how I wanted to be as a pregnant woman. Underneath everything, I knew I wanted to be able to enjoy Boo’s kicks. I wanted to enjoy watching my belly bloom and shopping for new clothes. I wanted to look forward to getting baby clothes and a baby shower. Prenatal depression was robbing me of all of that – I couldn’t find the joy or magic in pregnancy, and I was resentful and angry much of the time. I needed something else besides talk therapy.
In my 27th week, I talked with my provider, and she prescribed sertraline (Zoloft). I’d done my research, and knew that this was safe for pregnancy and breastfeeding. Medication is a personal choice, and it’s not for everyone. However, when the risks of untreated depression or anxiety outweigh any possible risks of medication, many providers will strongly suggest medication. For me, I realized that I could not spend every single night crying and hating the situation I was in – not when I had wanted this for so long. I wanted to be able to enjoy growing my son, and wanted to reduce the risk of postpartum depression, as well. For me, a happy and healthy mama meant a happy and healthy baby. I needed to do this for my son. By week 29, I noticed that I wasn’t crying every night – maybe only once or twice a week. For me, this was huge. I also stopped hating being pregnant, and started to enjoy feeling my baby move. My only regret was not going on medication sooner.
The American Pregnancy Association states that according to the American Congress of Obstetricians and Gynecologists (ACOG), between 14 and 23% of pregnant women will struggle with depression during pregnancy. An article from Parents magazine states that up to 33% of pregnant women will experience clinical depression or anxiety during pregnancy. There is still a stigma surrounding depression and anxiety, and especially during pregnancy, when the accepted (even expected) image is a glowing, happy woman, it can be especially hard to seek treatment, or even accept that help is needed.
Symptoms of prenatal depression include: persistent sadness, trouble concentrating, eating too much or too little, insomnia (or too much sleep), feelings of guilt, lack of interest in things you used to enjoy, and thoughts of harming yourself or hopelessness. If you experience these most days for two weeks or more, talk with your provider.
Prenatal anxiety symptoms can include: fatigue, trouble concentrating, muscle tension or aches, worry that is unable to be controlled, and irritability.
Risk factors for perinatal mood disorders include a history of anxiety or depression, a history of PMDD, lack of social support, being low income, having a history of infertility, pregnancy complications, experiencing marital conflict, being under the age of 20, and being a single parent. Hormones can wreak havoc on brain chemistry, causing depression and anxiety, as well. Looking back, the signs were there while TTC – when I would take progesterone, my mood would plummet. Since progesterone levels increase exponentially while pregnant, it’s no wonder that my depression got worse and worse.
While it’s normal to be ambivalent or have fears or some sadness during pregnancy, clinical depression and/or anxiety can be – and should be – treated. If you think you might have depression or anxiety, tell your provider. Talking with a therapist, finding a support group, and even medication might be necessary. There are medications that are considered safe during pregnancy and breastfeeding. Untreated depression and anxiety can be dangerous for both mom and baby. Some women who are depressed during pregnancy don’t get adequate nutrition, or turn to smoking, drinking, or using drugs. Others attempt suicide. Babies born to women who are depressed can show increased agitation and less activity. They may also lack self-soothing techniques.
Depression and/or anxiety are illnesses, and are not normal parts of pregnancy or the postpartum experience. They can be dangerous, and you don’t have to suffer through these feelings. I know the feeling of wanting to handle things without medication, or not wanting to tell anyone how bad you really feel, when everyone else expects you to be over the moon. But there are different ways to treat mood disorders during pregnancy, and that can look different for each woman. You deserve to enjoy this experience. You are worth it.
Resources for Mood Disorders During Pregnancy
Postpartum Progress (also great info on prenatal mood disorders!)