Pregnancy and birth
When you discover you are pregnant, a certain degree of stress and anxiety is to be expected - whether the pregnancy was planned or unplanned, the implications of a positive pregnancy test can be overwhelming. While this is a normal experience for many, there can be times when these feelings build up to such a level that they cause antenatal depression and other mental health issues.
It can be easy to compare yourself to celebrity mothers who are portrayed as being able to cope with the emotional turmoil of pregnancy with ease, (and doing so while running a business, maintaining a happy marriage and raising four other children). Suffice to say, this isn't the case for most expectant mothers.
You may feel as though now is the time to prove yourself as a 'multitasking hero', but in reality this is the time when you need support the most. Getting support and developing coping mechanisms can help transform a time of stress and anxiety into one of excitement and joy.
Most of us are well aware of postnatal depression and the associated symptoms, but a lot of people are still unaware of the effects antenatal depression can have. When you fall pregnant your body is put under immense stress, causing your hormones to work overtime. Not only does this lead to a range of physical symptoms (including morning sickness) it can also lead to the amplification of certain emotions.
When you begin to feel stressed it's these hormones that can, in some cases, lead to antenatal depression. Currently it is thought that around 10% of women are affected by it. Studies also show that if antenatal depression is not acknowledged and treated, around 50% of sufferers will go on to develop postnatal depression.
By understanding the causes, symptoms and treatments of antenatal depression you will be better informed and able to reach out if necessary.
Causes of antenatal depression
What causes depression differs from person to person, and sadly there is rarely one single cause. The following list contains some of the more common causes of antenatal depression:
- Hormonal changes - sometimes the simple upset of your body's hormone balance is enough to trigger depression.
- Relationship issues - perhaps your partner isn't as supportive as you hoped, or maybe you're going through this alone, either way relationship problems can often spark feelings of depression.
- Financial worries - concerns over the amount of money you'll need to raise a baby is a common worry among expectant mothers.
- Despair over morning sickness - for some, this symptom of pregnancy is debilitating and can even lead to hospitalisation, leading to feelings of hopelessness and depression.
- Lack of sleep - pregnancy related insomnia and general exhaustion could lead you to overthink situations and magnify negative emotions.
- Family issues - when you become pregnant a spotlight is often shone on your own family life and previous rifts and tensions can become exaggerated.
Symptoms of antenatal depression
There are likely to be times during your pregnancy when you feel down and unable to cope. While this may be common, it does not mean you need to suffer in silence. For some, these periods pass after a good chat with your other half, but for others it can turn into more than a 'blue day' and become antenatal depression.
The following symptoms are common in those suffering from depression during pregnancy, if you are experiencing similar feelings it may be worth speaking to your GP who can advise you what to do next.
- Feeling tearful - your emotions will be running high due to your hormones during pregnancy regardless, but if you are feeling more tearful than expected, it may be a sign that you're not coping.
- Feeling numb/empty - for some the implications of pregnancy are too overwhelming and the mind switches off. This may lead you to feel a numbness or emptiness at a time when you are expected to be overcome with joy.
- Guilt/shame - there are a lot of expectations associated with pregnancy, and when you don't feel what you are expected to feel, it can lead to intense feelings of guilt and even shame for having negative thoughts.
- Isolation - this can be especially true if your friends have not had children or if you come from an emotionally closed family. Feeling alone in your pregnancy often evokes feelings of panic and depression.
- Insomnia - many women find it hard to sleep during pregnancy due to bodily changes, but for some it is a busy mind keeping them awake. This feeling of not being able to switch off and rest can lead to exhaustion, exaggerating negative emotions.
Feeling anxious about your baby's health, the birth and your ability as a parent are all perfectly natural. If these feelings begin to get in the way of your happiness however, it may be time to take action.
Common symptoms of anxiety include:
- Feeling on-edge all the time - it is natural to feel anxious occasionally throughout your pregnancy, but if you are starting to feel anxious constantly, or about non-specific things, it may be worth seeking help.
- Anxiety/panic attacks - in some cases, these feelings become overwhelming for both the body and mind, resulting in a panic attack.
- Avoiding people/situations - sometimes the very thought of being near to a person or place that instills feelings of anxiety means you avoid them at all costs. This can have a negative impact on your life.
- Difficulty concentrating - you may find yourself struggling to focus on one task at a time or you may become easily distracted.
Anxiety, stress and depression often go hand in hand, with one leading to another if not treated. For your best chance of avoiding this it is advised that you seek professional help from a qualified professional such as your GP or a counsellor.
Anxiety towards the birth
Giving birth is no longer an act shrouded in mystery - thanks to TV shows like One Born Every Minute we can watch the birthing experience in its entirety. For some this is helpful, for others it only confirms fears of complications. The media plays its part, relishing the chance to report about a celebrity's 'traumatic birth' and how it affected the mother, instilling fear into the nation.
Of course, if you are pregnant with your first child it is normal to have some anxiety about the birth. It is something you will have never experienced before and understandably you will be unsure of what to expect. Even if you have had children before, worrying about things going wrong in the delivery room is still common. This could be due to previous experiences, friends’ experiences or reading about long, painful births in the media. Whatever your reasons may be, for some the thought of giving birth becomes almost a phobia.
To cope with this type of anxiety it is recommended that you arm yourself with information. Speak to a medical professional with experience, they will be able to tell you about possible complications, how likely it is that they will happen and exactly what the midwife/doctors will do in that situation.
Reading up about the labour and listening to other peoples' experiences should also help to give you a good idea of what to expect. The important thing to remember is that every birth is different and just because your friend/cousin/sister had a difficult labour, it doesn’t mean you will too.
Try to learn some relaxation techniques such as deep breathing to control your anxiety. Reaching out about your fears before your due date will give you time to trace your concerns, gain information and develop a coping strategy before the birth. The sooner you speak out about your fears, the more time you will have to do this, so don't be afraid to voice your concerns to your GP, counsellor or support group.
Coping with a traumatic birth
For the majority of people childbirth is an extraordinary event, for others it can feel traumatic due to complications during labour, or unexpected deviations from the birthing plan. Sometimes even when everything goes according to plan, the experience can be such an overwhelming one that mothers are left feeling traumatised.
Coping with this can be difficult and may require the help of a therapist who can talk through these feelings with the mother. Being fully informed about exactly what happened is key to dealing with the event - for many mothers their emotions and feelings run so high during labour that memories of the birth get skewed. Getting a detailed account of the labour from your midwife or doctor can help you put things into perspective.
Gaining support from other mothers who have experienced similar births often helps - knowing you are not alone and hearing how others coped can be reassuring. Speaking to a qualified counsellor will also be helpful as they will be able to explain some of the panic-based reactions and over time, desensitise the trauma.
Tips to cope with depression and anxiety during pregnancy
If you are experiencing symptoms of depression and/or anxiety during your pregnancy it is recommended that you seek professional help from your local healthcare provider. The following tips should also help you to cope with symptoms of depression and anxiety.
- Exercise - when you have the all clear from your doctor, participating in light exercise such as antenatal yoga will increase your energy levels and boost production of 'feel-good' dopamine hormones.
- Communicate with your place of work - working throughout pregnancy can increase stress levels, so be sure to keep an open dialogue with your boss regarding your pregnancy. Be sure to inform them that you may have to take a lighter workload and that you may need to cut down your hours.
- Nap when you can - if you are struggling to sleep at night it can be helpful to take 20 minute cat-naps throughout the day to revive you.
- Take care of yourself - this is the time to put yourself and your health first. Treat yourself to long baths, massages and nutritious food.
- Get support wherever you can - this may come from your partner, friends, family, counsellor or support group. Ask for help when you are struggling - nursery decorating parties can be a fun way to make a time consuming job less stressful.
- Take notes - if you are suffering from 'pregnancy brain' it can be hard to keep track of things like appointments, errands and birthdays. To help you keep on top of things, try keeping a notepad with you at all times and jot down important dates and things to remember.
- Practice saying no - pregnancy is often a time when you come face to face with your physical and mental limitations. Even if you are known as the ever-helpful friend who says yes to everything, now is the time to start saying no and prioritise yourself over others.
- Learn relaxation techniques - this can simply be a case of breathing deeply when you feel anxious or taking it one step further with yoga or meditation. Find something you can incorporate into your daily life to help reduce stress levels.
How can a counsellor help with depression and anxiety during pregnancy?
If you feel you are suffering from antenatal depression or anxiety it is essential that you seek help. As tempting as it may be to bury your head in the sand and ignore these feelings, dealing with them now will save you a lot of time, energy and heartache later. It also means you will experience a happier, more relaxed pregnancy which can only benefit your child.
A qualified counsellor can provide space for you to vent your concerns or frustrations in a safe, non-judgmental environment. They will also be able to talk you through your feelings so you better understand why they are occurring, as well as offering coping mechanisms and relaxation techniques.
What should I be looking for in a counsellor or psychotherapist?
There are currently no laws in place stipulating what training and qualifications a counsellor must have in order to treat mental health issues during pregnancy. However, the National Institute for Health and Care Excellence (NICE) have developed a set of guidelines that provide advice about the recommended treatments regarding various mental health problems during pregnancy and after giving birth including:
- obsessive-compulsive disorder
- post-traumatic stress disorder
- eating disorders
- bipolar disorder
Read the NICE guidelines here:
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