Sadness is a basic human emotion that usually occurs in response to emotionally or psychologically painful situations. Sadness may be associated with feelings of sorrow, disappointment, helplessness, grief, and despair. Everyone feels sadness at some point in their lives.
Sadness can lead to depression, which is a mental illness that causes significant feelings of sadness and a loss of interest in daily life. Perinatal depression occurs during pregnancy or in the first year following delivery, and it affects about 15% of pregnant women. It includes postpartum depression, which is depression that occurs after pregnancy.
Some differences between sadness and depression:
- Sadness is temporary and depression lasts longer
- There is usually a trigger for sadness, while depression often has no specific cause
- When a person is sad, they usually are able to experience moments of joy, but depression is often all-encompassing
Being sad occasionally during pregnancy is normal and probably won’t affect an unborn baby, but if sadness leads to perinatal depression, it may affect the unborn baby. If you are pregnant and experiencing symptoms of depression, tell your doctor right away. Prompt treatment for depression can help an expectant mother feel better and be prepared to care for her baby after birth.
Depression during pregnancy can affect the unborn baby with an increased risk of:
- Premature birth: birth that occurs before 37 weeks of pregnancy
- Being small for gestational age, when a baby doesn’t weigh what he should before birth
- Low birth weight: weighing less than 5 pounds, 8 ounces at birth
- Being more irritable, less active, less attentive, and having fewer facial expressions
- Learning, behavioral, and developmental problems
- Mental health problems later in life
Depression during pregnancy can increase the mother’s risk for:
- Neglecting to care for herself
- A depressed pregnant woman may not eat healthy foods or gain sufficient weight
- She may miss prenatal care checkups
- Smoking, drinking alcohol, or using harmful drugs
- Having postpartum depression after pregnancy which can make it hard for a mother to care for and bond with her baby
- Suicide, suicidal thoughts, or thoughts of harming her baby (rare)
- If you or someone you know are in crisis, call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255), available 24 hours a day, 7 days a week. The service is available to anyone. All calls are confidential. You may also find more information online at http://www.suicidepreventionlifeline.org
What Are Symptoms of Depression During Pregnancy?
Depression is more than just feeling sad for a short time. You may have depression if you have signs or symptoms of depression that last for more than two weeks.
Symptoms of depression last for more than two weeks and may include:
- Changes in feelings
- Sadness
- Hopelessness
- Feeling overwhelmed
- Feeling restless
- Mood swings
- Crying a lot
- Feelings of worthlessness or guilt
- Thoughts of death or suicide
- Changes in behavior
- Eating more or less than usual
- Difficulty remembering things, concentrating, or making decisions
- Insomnia or sleeping too much
- Withdrawing from friends and family
- Loss of interest in things
- Body changes
- Lack of energy
- Feeling tired all the time
- Headaches
- Stomach problems
- Aches and pains that don’t go away
If you’re pregnant and you have any of these symptoms, tell your doctor right away.
What Causes Depression During Pregnancy?
It is unknown what causes depression during pregnancy but it may be due to a combination of changing chemicals in the brain or changing hormones.
Risk factors for depression during pregnancy include:
- Family history of depression or other mental health conditions
- Having major depression or another mental health condition in the past prior to pregnancy
- Past physical or sexual abuse
- Problems with your partner, including domestic violence
- An unplanned or unwanted pregnancy
- Being single while pregnant or being pregnant as a teenager
- Life stress such as being separated from your partner, death of a loved one, illness in the family, being unemployed or having low income, low education levels, or lack of support
- Having diabetes
- Pregnancy complications such as being pregnant with multiples (twins, triplets, etc.), birth defects, and pregnancy loss
- Smoking
- Drinking alcohol
- Using harmful drugs
How Is Depression During Pregnancy Diagnosed?
To be diagnosed with depression, symptoms of depression (as listed above) must last at least two weeks and be a change in a person’s previous level of functioning.
What Is the Treatment for Depression During Pregnancy?
Depression during pregnancy may involve a combination of modalities.
Treatment for depression during pregnancy may include:
- Counseling
- Cognitive behavioral therapy (CBT)
- Interpersonal psychotherapy (IPT)
- Support groups
- Antidepressants
- Certain antidepressants taken during pregnancy may cause miscarriage, low birthweight, premature birth, birth defects (including heart defects) or a lung condition called persistent pulmonary hypertension (PPHN)
- Serotonin reuptake inhibitors (also called SSRIs) such as citalopram (Celexa), fluoxetine (Prozac), and sertraline (Zoloft)
- Serotonin and norepinephrine reuptake inhibitors (also called SNRIs), such as duloxetine (Cymbalta) and venlafaxine (Effexor XR)
- Tricyclic antidepressants (also called TCAs) such as nortriptyline (Pamelor)
- Bupropion (Wellbutrin)
- Certain antidepressants taken during pregnancy may cause miscarriage, low birthweight, premature birth, birth defects (including heart defects) or a lung condition called persistent pulmonary hypertension (PPHN)
- Electroconvulsive therapy (also called ECT) for severe depression
- ECT is considered safe for use during pregnancy
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