HAE

Pregnancy-related depression and anxiety occurs during pregnancy or after giving birth, including after a pregnancy loss. Symptoms can present at anytime during pregnancy and up to a year after childbirth.

1 in 7 women suffer from pregnancy-related depression and anxiety making it the most common complication of pregnancy.  

Parents of every culture, age, income level and race can experience pregnancy-related depression and anxiety. Women are most frequently affected but it can also affect fathers, partners and close family members.

Symptoms can start anytime during pregnancy or the first year after giving birth. They differ for everyone and might include the
following:

  • Feelings of anger or irritability
  • Lack of interest in the baby
  • Loss of appetite and trouble sleeping
  • Crying and sadness
  • Feelings of guilt, shame or hopelessness
  • Loss of interest, joy or pleasure in things you used to enjoy
  • Possible thoughts of harming the baby or yourself

How is it different from the “baby blues”?
In the beginning, pregnancy-related depression and anxiety can look like the “baby blues” because they share similar symptoms such as worry, crying and fatigue. The difference is that with the “baby blues,” the feelings are somewhat mild, last a week or two and go away on their own.

  • Personal or family history of depression/anxiety
  • Premenstrual Dysphoric Disorder (PMDD or PMS)
  • Inadequate support in caring for baby
  • Child care issues and intention to return to work
  • Financial stress
  • Marital/relationship stress
  • Complications in pregnancy, birth or breastfeeding
  • Major recent life event: loss, house move, job loss
  • Mothers of multiples
  • Mother of infants in NICU
  • Infertility treatment
  • A history of trauma and/or abuse
  • Unintended pregnancy or a negative attitude toward the pregnancy
  • Sleep deprivation
  • Miscarriage or infant loss
  • Surrogate pregnancy/adoption or teen pregnancy

Treatment of Pregnancy Related Depression and Anxiety: Integrated Model of Support
Ideally a team approach should be taken when treating women with PRD which includes: healthcare and psychiatric providers, pharmacists, psychological services, and social support networks.

Non-pharmacologic treatment
Cognitive-behavioral therapies are the first-line choice for the treatment of mild to moderate pregnancy-related depression and perinatal GAD.

However, in moderate to severe cases, pharmacological treatment should be considered

  • Treatment of mild-to-moderate pregnancy related depression and anxiety may include psychological and behavioral therapies (individual or group counseling)
  • interpersonal psychotherapy (IPT),
  • and partner-assisted IPT

Additional Treatment:
Social and partner support. Types of social support include emotional, practical, informational and peer.  

Pharmacologic Treatment
For patients with more severe symptoms and those who do not respond to non-pharmacologic therapy, medication therapy may be appropriate.