Most people have heard about and are familiar with the term Postpartum Depression. There are articles everywhere offering warnings, advice, and support for women who find themselves deep in its trenches after giving birth. However, there isn’t a lot of information about another motherhood-related illness, Antenatal Depression (aka Prenatal Depression).
In fact, the signs of Antenatal Depression are so similar to normal pregnancy symptoms that it frequently goes undiagnosed. Anxiety, depression, and mood swings can be hard to distinguish from the normal worry, fatigue, mixed emotions, and hormone-induced crying spells that plague women during the third trimester.
Who may be affected by Antenatal Depression?
Anyone. The hormonal changes that take place during pregnancy and environmental stressors can make any woman susceptible. For me, Antenatal Depression came out of nowhere during my second pregnancy. I had no history of depression, postpartum or otherwise. However, I had struggled off and on with social anxiety throughout adulthood. So, when I started having severe anxiety in my third trimester, I did my best to ignore it and press on with life.
It started with episodes of extremely high heart rate and low blood pressure, which were noticeably worse at night when I was alone with my thoughts. At times, it was so bad I would feel like I was going to die. Sounds pleasant, right? I was having panic attacks. When I realized what was happening, I told myself I knew how to cope with anxiety. I started listening to soothing music, sleeping with headphones on, and meditating daily. It helped. A little.
However, as my pregnancy progressed, I started experiencing new symptoms. I would suddenly and irrationally feel sad that I was having a baby at all. I thought I’d made a huge mistake getting pregnant. I worried, illogically, that I was ruining our family. I was too ashamed to discuss it with anyone. I felt an enormous pressure to do everything perfectly and be perfectly happy. And I was incredibly happy. After years of trying to get pregnant, I was ecstatic. But these constantly conflicting emotions were disturbing and only compounded my anxiety and filled me with guilt. What was wrong with me? In the end, I decided it must be due to my past pregnancy loss, secondary infertility, and all of those lingering emotions. No doubt my past experiences certainly contributed, but I knew there was more to this anxiety. However, since I was still functioning, I decided I didn’t need to tell anyone. It must not be that serious. I was sure I would feel better once my baby arrived.
Antenatal Depression may be a precursor to Postpartum Depression.
I didn’t find out about Antenatal Depression until my son was 6 months old. Postpartum thyroiditis, isolation, and a demanding breastfed baby were taking a toll. I felt trapped in our home and had no family or friends nearby to give me a break. Any time I tried to talk about the stress and loneliness, I would revert to my usual sarcasm and self-depreciating humor. I didn’t want to admit just how weak I felt. I made light of it, and I don’t think anyone ever grasped the magnitude of what I was going through.
Postpartum, I experienced three emotions; sadness, anxiety, and (more often) rage for most of my waking hours. Thankfully, I never had thoughts of suicide or hurting my child. Instead, I directed most of these emotions toward my husband. The drastic mood swings were shocking even to me. I knew it wasn’t completely logical. No, he wasn’t perfect, and yes, his inability to know what he needed to help with would be really irritating to anyone. But we had experienced tougher financial and marital times during my first pregnancy and postpartum period, and I had never felt like this. I had never felt so much anger. Every emotion felt magnified and I knew things had to change.
I searched for two things online.
Can PPD start during pregnancy?
I found out that postpartum rage is actually a thing and it is a symptom of Postpartum Depression. And while “postpartum” depression obviously doesn’t start during pregnancy, Antenatal Depression may precede Postpartum Depression more often than we realize. As I read the list of symptoms and contributors, all of the pieces fell into place. Looking back, I realized the bouts of sadness and anxiety happened more often when my stress levels were high from other things (i.e., a small argument with my husband, financial stress, physical discomfort, work, juggling too many projects, lack of sleep, etc). I experienced a brief respite from symptoms after my son was born, but they eventually resurfaced as PPD as my stress levels rose once again, unchecked.
Knowledge really is power.
I started taking my emotional health more seriously. I demanded more help from my husband, was more specific about my needs, forced myself to get out more (even though it is an hour drive just to the grocery store), and talked about how I felt instead of bottling it up.
With this pregnancy, I was ready and more watchful of my emotions, especially as my third trimester approached. Just when I thought I was going to make it through unscathed, it hit me hard around 32 weeks. Fortunately, I was prepared and immediately adjusted my expectations of myself. I let my husband take over more household and parenting responsibilities. I asked grandparents if they could babysit more. I dropped anything that added to my anxiety. I slept when I needed sleep. I forgave myself if I got behind on the laundry. And just as quickly as the symptoms had overwhelmed me, they became more manageable.
It is important to be proactive in managing your anxiety and depression. This is not a time for the wait and see approach.
Ask for help. This might be the hardest thing you do, but the most necessary. Family, friends, coworkers, and anyone that is part of your daily life can be a valuable support. Let them know you are overwhelmed. When they ask how they can help, be honest and open. Maybe you aren’t sure. Say so. Confiding in those you trust may be helpful all on its own.
Decrease stress. Let go of the things that add to it. Whether it is breastfeeding a toddler, folding the laundry, cooking meals, watching the news, or career goals. Make like Elsa and Let It Go. You can pick those routines, responsibilities, and aspirations back up later. Let someone else handle them or find a way to get by without doing them for now. The laundry can sit in a pile. The grocery store has a frozen food section for a reason. Whatever path leads to less stress, take it. Just for now.
Take care of yourself. Be prepared to go on medication or get therapy if necessary. If you are like me and don’t even like taking Tylenol when pregnant, this can be scary. However, do not underestimate the importance of your emotional health during pregnancy. Taking care of yourself is taking care of your baby.
Speak to your doctor. Let them help you decide what steps to take. Don’t assume they’ll insist you do something you don’t want to do. It can be difficult to discern your own needs when you are deep in the trenches, so take their advice seriously. Bring a trusted family member or close friend with you, so you can feel confident you are making a decision with you and your baby’s best interests in mind.
Watch for PPD. There will probably be a “honeymoon” period after baby arrives. Relax and enjoy those endorphins, but still be aware that Postpartum Depression could sneak up on you slowly or hit you hard quite suddenly. Having Antenatal Depression doesn’t mean you will definitely have PPD. Many women find complete relief from Antenatal Depression after giving birth. Just keep tabs on your emotions, take care of yourself, and don’t hesitate to ask for help if you start feeling bogged down.
Antenatal Depression symptoms can look different for different women. So, if you have read this far and still aren’t sure if that is what you are experiencing, Panda.org.au is a great resource. You can learn more about symptoms, contributing factors, others’ experiences, and how to cope. Also, Postpartumprogress.com (which focuses more on PPD) is full of helpful resources and information.
Finally, if you are having thoughts of suicide, please do not hesitate to let someone know immediately. Anyone. The idea may only cross your mind briefly. Or you may think about it obsessively. Either way, talk to someone. You might feel like you are beyond help, but I promise you aren’t. You are valued, worthy, and very much needed in your baby’s life!
*Please note: This is my personal experience and the information contained in this article is not to be used in place of the advice of a medical professional.