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New Research Finds Depression During Pregnancy is Common
Depression, a very treatable condition, is at least as common for women during pregnancy as it is after childbirth, according to new research, and should be diagnosed promptly because it can be harmful to the baby. Although doctors are careful to detect and treat postpartum depression, they are typically not so vigilant about looking for depression during pregnancy because they don’t expect to see it, said the study’s lead investigator Jonathan Evans, a senior lecturer in psychiatry at Bristol University in England.
A common assumption has been that pregnancy is predominantly a time of emotional well-being, and that women are protected from depression during those months--but this newest study indicates that over 10% of women suffer from depression during pregnancy, the same as at any point in their lives.
Previous studies have suggested that depression and anxiety during pregnancy are linked to such potential danger for the baby as reduced blood flow in the womb, low birth weight, and premature birth. Evans called for urgent research to clarify the potential consequences to the baby of a mother’s depression during pregnancy. Experts say that, in the end, it will come down to whether the depression itself, or the drugs that are often used to treat it, are worse for the developing fetus.
Postpartum Depression
Postpartum depression is different from what is often called the “baby blues,” a transient tearfulness that afflicts many women in the first few days following childbirth. Instead of feeling "just a little down," 1 in 10 new mothers feel uncontrollably miserable, become tearful daily, have problems sleeping (not just because the baby wants to feed or is crying), lose interest in doing anything, feel listless, lose their appetite, and feel overall hopelessness. Postpartum depression is indicated when such symptoms last for more than a week or two.
Postpartum psychosis, a more severe mental disturbance following childbirth, affects about 1 in 1,000 women. It usually strikes in the first two weeks to one month after delivery and can, in extreme cases, lead to mothers harming their children.
Details of the Study
In the just-published study (British Medical Journal), more than 9,000 British women responded to a series of questionnaires and recorded their moods throughout pregnancy and in the months following childbirth. The women were assessed for depression at 18 and 32 weeks of pregnancy, and 8 weeks and 8 months after giving birth. The researchers found that 13.5% of the women passed the threshold for depression when they were 32 weeks pregnant and 9.1% scored at that same level 8 weeks after delivery.
Normally, depression occurs in the similar proportions for women--approximately 10 to 15% of them--at other times of life.
Evans believes these findings show that postpartum depression is not a special type of depression, nor does it occur any more frequently than occurrences of depression at any other time of a woman’s life. “It’s actually a popular myth that postnatal depression is a specific syndrome,” he said. “Clearly people do get depressed postnatally. But it has entered public consciousness as a sort of condition somehow separate from the rest of depression and what we are saying is that it is depression like depression at any other time and it occurs no more frequently than at any other time in a woman’s life.”
Other Interpretations of the Study’s Findings
Although the study found that rates of depression were slightly higher during pregnancy than immediately after, some experts say that some cases of postpartum depression may have been missed because the study’s first postnatal measure occurred at 8 weeks after birth.
“I think there is a syndrome that they’ve missed, that happens much more immediately after childbirth and gets resolved by 8 weeks,” said Dr. David Mrazek, chairman of psychiatry and psychology at the Mayo Clinic in Rochester, Minnesota. Mrazek added that some of the depressed women dropped out toward the end of the study and didn’t complete the postnatal questionnaires—and so the postpartum figure is an underestimate. “How important an underestimate,” he said, “remains unclear.”
Staying Aware
“The single most striking thing is this unremitting level of between 8 and 11% of young women who come up seriously depressed,” Mrazek said. Efforts need to be focused on treating such women to prevent complications, including the risk of suicide, and to ensure the health and safety of in-utero and just-born infants
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