Most people know that post partum depression can happen to moms after birth. But you can also have depression while you’re pregnant. This kind of depression is called antepartum depression — and it happens to about 7 percent of pregnant people overall. This rate may be as high as 15 percent in some countries.
Pregnancy can be an exciting time, but it may also bring a lot of stress and anxiety, along with a roller coaster of hormones. All of these can cause or worsen depression. And diagnosis can be tricky: Pregnancy symptoms can sometimes hide antepartum depression.
Catherine Birndorf, MD, cofounder and medical director of The Motherhood Center in New York, is working to educate pregnant and postpartum people about what’s going on with their mental health. She wants them to know there’s much more to it than baby blues and postpartum depression, which get the lion’s share of the attention: You might find yourself struggling with anxiety or obsessive-compulsive disorder or PTSD, and it can creep in during any trimester or after birth. She also wants people to know that there’s hope and that professional help can make a difference: “If you can figure out that you have a problem and find someone who can help you, you can get better,” Birndorf says. “Don’t let anyone tell you you’re fine if you know you’re not. Do not take no for an answer.”
What can partners and loved ones look out for as signs of struggle?
It’s hard to be pregnant at times. But if someone is socially isolating, uninterested in doing things, expressing negative thoughts, and not looking forward to much, it’s time to step in. Same goes if they seem abnormally scared, anxious, weepy, irritable, or generally not themselves. We are conditioned to think that these symptoms are just a result of pregnancy hormones, so it can be very hard to separate what’s what, and you may not fully be able to. One thing Birndorf always suggests: is to look someone in the eye, hold their gaze for a moment, and ask them, “How are you really doing?” Then cut through the politeness and insist on an honest answer if you don’t feel that you got one.
If they start crying, it will tell you volumes. Or they may very well blow you off or tell you that it’s just hormones. But feeling hopeless, regretting getting pregnant, or staying up all night with worry is not the same as being hormonal. You have to set up a situation for a pregnant person to feel safe to say these things out loud without feeling judged. Only then can they get the help they need to feel better again.
What are some resources for pregnant people struggling with depression?
We have a lot of data over many years looking at the safety profile of medications during pregnancy. People are often scared to introduce medication during pregnancy, but to not treat an illness like depression or anxiety during pregnancy is also risky. You have to weigh the risk of the symptoms versus the risk of medication.
The Motherhood Center offers an outpatient day program that meets virtually every day of the week to support pregnant and postpartum people who are experiencing moderate to severe symptoms of PMADs. The day program is the most intensive treatment outside of a hospital setting. We offer different kinds of individual, group, couples, and dyadic therapies on our virtual platform as well. If you think you are experiencing a PMAD and want to be evaluated, please email or call The Motherhood Center— for more information.
You can also research outpatient programs and support groups in your area.
Postpartum Support International is a great resource that helps connect people who are struggling with PMADS to local resources in their area.