I am 20 weeks pregnant with my third child and I am experiencing numerous occasions where I am overwhelmed with sadness and it seems that nothing in the world is right. Can being pregnant make you depressed?
There really isn’t a clear-cut syndrome called prepartum depression, not in the same way that we talk about postpartum depression, which is a mood change that occurs in many women (some say up to 50 percent) after they give birth.
For most women who experience it, postpartum depression is on the mild side, with sudden unexplained feelings of tearfulness and even sadness, usually occurring during the first few weeks to first couple of months after delivery. It then resolves on its own. For a significant portion of women, however (about 20 percent), it can be much more severe, with uncontrollable feelings of depression and hopelessness and a decreased ability to function. In a minority of cases, there can be postpartum psychosis, where the woman’s mood and behavior become so severely disturbed she loses touch with reality. In these very severe cases, this is a time of risk of self-harm, or of harm to the baby. These postpartum mood states are due to the very rapid and severe changes in hormones that occur in a woman’s body after she gives birth.
Of course, pregnancy is a time of great physicial changes for the female body as well, and there are a lot of hormonal changes that occur in a woman’s body as her pregnancy progresses. Many women experience a sense of psychological well-being while they are pregnant, but some women — especially those who may already be vulnerable to depression or mood changes due to hormonal influences — can experience severe depressive symptoms while they are pregnant.
You do not say whether you have had depressions before or not, or whether these feelings are something entirely new for you. You do mention that you have twin toddlers, which means you have a lot going on at home and are probably working very hard (and may be chronically fatigued and perhaps even stressed, which would definitely contribute to the risk for depression). You don’t mention how you feel about this pregnancy, which is coming while your twins are less than two years old and which means you’ve got more going on physiologically and psychologically than simply being the mother of two toddlers (which is itself exciting, challenging, and exhausting!). You do not mention whether you are also working outside of the home, and what your partner’s role and attitude is. All of these factors could play into how you are experiencing the pregnancy at both a physical and a psychological level. This can then, of course, influence your mood.
You do describe some things which are of concern to me: feeling overwhelmed with sadness, and feeling as if nothing in the world is right. We all have those feelings from time to time, but your description suggests that you are having these on an ongoing basis. If so, these are not normal symptoms of pregnancy. They could possibly be symptoms of a depressive episode, and they should be evaluated by a professional as soon as possible. If you have a good relationship with your ob-gyn, talk to her first. Some ob-gyn physicians have a strong background in understanding the mood symptoms of their patients and in offering treatment. Others will know of a psychiatrist colleague who can evaluate you. You should speak with a physician (ob-gyn or psychiatrist) because you are pregnant, and because of the potential seriousness of your depression if it is left untreated.
If you are having a clinical depression, what kind of treatment might be helpful? Although no one likes to have a pregnant woman take medications, it is an option for more severe situations (expecially after the first trimester has passed). Talking therapy may also provide effective treament. Also, even if you do not opt for any treatment while you are pregnant, your physician (ob-gyn or psychiatrist) will want to follow you closely after you give birth because you may be at increased risk for a true postpartum depression.
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