When we talk about pregnancy, most of the conversation focuses on a pregnant person’s physical health. And, of course, that makes sense! You are literally growing a human inside your body, which is a crazy thing to check off of your daily to-do list. While it is essential to focus on a pregnant person’s physical health, it is equally as important for both parent and baby to focus on their mental health and wellbeing.
Pregnancy and new parenthood can be an extremely exciting time, but it’s important to make sure you are taking a holistic approach to your health.The combination of the biological, emotional and social changes can leave your feeling nauseous - and not just from morning sickness. The actual changes in your body and life during pregnancy, and anticipating the changes of parenthood, can cause mood irritability and feelings of anxiety or depression, of which many people experience.
Hanging on Through Mood Swings
During and after pregnancy your hormones are changing to help your body prepare for childbirth. Estrogen and progesterone are rapidly increasing, up 10 ten fold their original levels, which can be responsible for your changing mood. Estrogen is related to serotonin, the hormone known for making us happy. But it’s not quite clear exactly how serotonin, or what level of serotonin, is ideal for optimal happiness, and the dramatic fluctuations of estrogen during pregnancy impact a pregnant person’s mood considerably. While estrogen is associated with energy, progesterone is associated with relaxation, and the amount of progesterone increases in a pregnant person during the first three months. During pregnancy, progesterone tells the body and muscle to relax, as one way to prevent contractions. While relaxation may sound nice, it can leave some people feeling fatigued or sad. The combination of these two fluctuating hormones can definitely take a toll on someone’s mood. Finding support with other pregnant women, or making a mantra about your body doing what it can to protect yourself and your baby, may help wait out these changing moods.
What is Perinatal Anxiety and Depression?
Perinatal anxiety and depression is considered anxious or depressive feelings from the beginning of pregnancy through a year after birth. Because of the way data is collected and aggregated across different jurisdictions the exact burden of perinatal anxiety and depression is unclear. PANDA, an Australian organization dedicated to providing information and resources to combat perinatal anxiety and depression, predicts about one in five pregnant people are impacted.
One aspect of perinatal anxiety and depression is prepartum (or prenatal) depression, that is depression during pregnancy. Some estimates that about 7% of pregnant people experience an onset of depression during pregnancy, but this can be misunderstood. For example, a lot of symptoms of pregnancy, such as changes in sleep, libido and energy, are similar to those of depression, so sometimes it can be hard to tell the difference. Pay attention to how you feel during pregnancy, especially if you’re having feelings of doom due to impending parenthood, loss of joy in daily activities and low self esteem. Another sign of prepartum depression is neglecting to take care of yourself during your pregnancy. If you find yourself not gaining weight due to an improper diet, smoking or drinking, this could be a sign that the pregnancy has taken a larger than expected emotional toll. Untreated prepartum depression can place you at a higher risk of postpartum depression and inhibit bonding with your child. It is important that if you experience any of these symptoms to talk to your OBGYN or provider about what you are going through.
While postpartum depression is a bit more socially discussed than prepartum depression, it can still feel very isolating. Postpartum depression is layered and multifactoria, often due to the chemical, societal, physical and emotional changes experienced after giving birth. After a dramatic rise in estrogen and progesterone during pregnancy, these hormones drop to prepregnancy levels just 3 days after giving birth. This change, along with the new pressures and responsibility of parenthood, can leave someone who has recently given birth feeling overwhelmed or depressed. One in 10 women experience sadness after childbirth, but if that sadness persists for longer than a few weeks it’s important to seek mental health care.
What Can You Do?
Your best advocate, for both you and your fetus, is you. Be as diligent as possible about tracking your mood, anxieties and feelings, and try to find support from other people who have given birth or are pregnant. Have a frank conversation with your healthcare provider about postpartum depression, and talk to your friends, family and primary care physician about a plan or to mitigate potential depression, which can also include medication options. Your feelings are valid, and with proper support and medical advancements, pregnant people should be able to access the mental health support they need.
Pregnancy and new parenthood is marketed as a joy. Just because you aren’t feeling joy at every moment does not mean there’s something wrong with you. Appreciate the incredible feat your body is accomplishing, and seek support when you need it. The only way you are supposed to be feeling is the way you feel.