Depression in Pregnancy

Depression in Pregnancy A Mothers’ Mental Health Toolkit Project Learning Video with Dr. Joanne MacDonald Reproductive Mental Health Service IWK Health Centre Halifax, NS

Depression in Pregnancy • Pregnancy is a time of change. • Physical change. • Emotional change. • Role change. • Relationship change. • Depression can be an unexpected experience for the pregnant woman and her family.

What is the Rate of Depression in Pregnancy? a. 3.5 % b. 10 % c. 25 % d. 48 %

Fast Facts • Answer: 10% of pregnant women can have depressive symptoms of moderate to severe intensity – what is called Major Depression • Take Home Point: Pregnancy doesn’t prevent or protect mothers from a depressive illness. • Rates of Depression in pregnancy are similar to non-pregnant women of the same age

Depression in Pregnancy Typical symptoms of Major Depression include: • Changes in sleep patterns • Appetite • Energy • Mood • Capacity to cope with stresses • Speed of thinking • Daily thoughts more negative, fearful or guilty • Sense of connection to people or roles

Depression in Pregnancy • How do we recognize depression from the usual changes in pregnancy?

Depression in Pregnancy • Fatigue, speed of thinking or response & increased intensity or expression of emotion can come with the hormonal & physical changes of pregnancy. • But, they should improve with rest & support, not last long and not interfere with function.

Depression in Pregnancy Depression is more likely if: • the symptoms persist and are getting worse • the emotions and thinking are increasingly negative • the experience is not typical for this woman • the feelings don’t fit with her situation

Depression in Pregnancy

Depression in Pregnancy Risk factors? • Depressive episodes in past • Sensitivity to mood change with hormonal change, for example pre-menstrually • High levels of current stress • Loss of supports • Physical pain and complications in the pregnancy

Depression in Pregnancy Protective Factors: • Stresses have been recent, not ongoing • Good coping in difficulty in the past • Strong support systems • Capacity to increase self-care strategies • Psychological insight and skills for resilience • High desire and motivation to parent

Depression in Pregnancy Approaches to Intervention: • Interpersonal and cognitive-behavioral psychotherapies can be very effective for mild to moderate symptoms • Untreated severe depression is associated with poor outcomes for mothers and infants • Medications can be used for severe symptoms with relative safety and monitoring • Family and friends are important supports

Depression in Pregnancy What is the outcome for the pregnant woman with a depressed mood? • Not all women go on to have Postpartum Depression. • Some cases improve around delivery • Successful and safe treatments in pregnancy can limit the depressive illness • Treatment enhances function in labour and attachment postpartum

Depression in Pregnancy Considerations in Treatment & Intervention: 1. Reduce stressors when possible. 2. Increase rest, moderate exercise & nutrition. 3. Bring in practical & emotional supports. 4. Seek out mental health assessment . 5. Consider psychotherapy where possible. 6. Discuss benefits & risks of any medication recommended. Key Resource: www.motherisk.org (Sick Kids Hospital-Toronto)

Points to Remember • Pregnancy doesn’t protect from depression • Self-care and psychological strategies are key • Medications can be used in severe cases with safety and monitoring • Successful treatment of depression in pregnancy is critical to the new mother’s function when the infant comes

Depression in Pregnancy • A learning module in a series developed from the Mothers’ Mental Health Toolkit Project • To promote knowledge and advocacy in mothers’ mental health through front line support & service providers • A project of the Reproductive Mental Health Service, IWK Health Centre & Dalhousie University, Halifax NS

Thank You!

Depression in Pregnancy