About
Perinatal depression refers to depression occurring during pregnancy or after childbirth. The use of the term perinatal recognizes that depression associated with having a baby often begins during pregnancy. (Postpartum depression refers to depression experienced after childbirth.)
Perinatal depression is a serious, but treatable medical illness involving feelings of extreme sadness, indifference and/or anxiety, as well as changes in energy, sleep, and appetite. It carries risks for the mother and child. An estimated one in seven women experiences perinatal depression (Dave, et al 2010).
For most pregnant and postpartum individuals, having a baby is a very exciting, joyous, and often anxious time. But for people with perinatal depression, it can become very distressing and difficult. Pregnancy and the period after delivery can be a particularly vulnerable time. Mothers often experience biological, emotional, financial, and social changes during this time. Some individuals can be at an increased risk for developing mental health problems, particularly depression and anxiety.
Not Just the ‘Baby Blues’
Up to 85% of all new mothers experience the “baby blues,” a short-lasting condition that does not interfere with daily activities and does not require medical attention (Johns Hopkins). Symptoms of this emotional condition may include crying for no reason, irritability, restlessness, and anxiety. These symptoms last a week or two and generally resolve on their own without treatment.
Perinatal depression is different from the “baby blues” in that it is emotionally and physically debilitating and may continue for months or more. Getting treatment is important for both the mother and the child.
An estimated 10-15% of white women experience postpartum depression and estimates for women of other racial/ethnic backgrounds are higher (Guintivano et al, 2018a; Robertson & Wells, 2023; Cannon & Nasrallah, 2019; Segre et al, 2006; Logsdon & Usui 2001). Some research has found that almost one in three Latina women experience depression during pregnancy and about one in three experience depression after childbirth (Guintivano et al, 2018b; Lara et al, 2009). Factors that may contribute to this increased risk among Hispanic women include socioeconomic status, community
of residence, experiences of discrimination in health care, and immigrant status (Ceballos 2017; Crawford 2022).
Symptoms of Perinatal Depression
Symptoms of perinatal depression include (APA2022):
· Feeling sad or having a depressed mood
· Loss of interest or pleasure in activities once enjoyed
· Changes in appetite
· Trouble sleeping or sleeping too much
· Loss of energy or increased fatigue
· Increase in purposeless physical activity (e.g., inability to still still, pacing, handwringing) or slowed movements or speech [these actions must be severe enough to be observable by others]
· Feeling worthless or guilty
· Difficulty thinking, concentrating, or making decisions
· Thoughts of death or suicide
· Crying for “no reason”
· Lack of interest in the baby, not feeling bonded to the baby, or feeling very anxious about/around the baby
· Feelings of being a bad mother
· Fear of harming the baby or oneself
A person experiencing perinatal depression usually has several of these symptoms, and the symptoms and their severity may change. These symptoms may cause a postpartum person to feel isolated, guilty, or ashamed. To be diagnosed with perinatal depression, symptoms must begin during pregnancy or within one year following delivery.
Many people with perinatal depression also experience symptoms of anxiety. One study found that nearly two-thirds of people with perinatal depression also had an anxiety disorder (Fairbrother et al 2016). In 2023, the U.S. Preventive Services Task Force recommended anxiety screening for adults under 65, including pregnant and postpartum persons.
While there is no specific diagnostic test for perinatal depression, it is a clinical medical condition that is diagnosed by medical professionals. It is a real illness that should be taken seriously. Any pregnant person or new parent who experiences the symptoms of perinatal depression should seek evaluation by a medical professional — a family medicine doctor or an OB-GYN — who can make referrals to a psychiatrist or other
mental health professional. Ask your doctor about their training and knowledge about perinatal mental health conditions. Although these conditions are common, not all doctors are trained in diagnosing and treating pregnant and postpartum people with mental health conditions. Your doctor can call national and state-specific consultation services to get access to specialized support.
Assessment should include a psychiatric evaluation and a medical evaluation to rule out physical problems that may have symptoms similar to depression (such as thyroid problems or vitamin deficiencies).
You should contact your doctor if:
· You are experiencing several of the symptoms above for more than two weeks.
· You have thoughts of suicide or thoughts of harming your child.
· Your depressed feelings are getting worse.
· You are having trouble with daily tasks or taking care of your baby.
American Psychiatric Association (2024, January 1). What is Peri-Partum Depression. Retrieved January 8, 2024, from https://www.psychiatry.org/patients-families/peripartum-depression/what-is-peripartum-depression