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    Default Postnatal Depression Awareness Week 2011 - Antenatal Depression (AND)

    Antenatal depression refers to depression that starts during pregnancy. Between 10‐15 percent of pregnant women experience mood swings during pregnancy that last more than two weeks at a time and interfere with normal day‐to‐day functioning. These can be a reaction to the pregnancy itself, for example if the baby is unplanned or unwanted, or due to health issues the mother has such as persistent nausea, or due to other major life stresses such as serious relationship problems. Medical assessment is necessary in such circumstances. (Factsheet; Depression during pregnancy and the postnatal period, The Blackdog Institute)

    Around 40% of women who experience symptoms of depression during pregnancy will go on to experience postnatal depression if they do not receive treatment. If you experience such symptoms it is recommended that you seek early assessment by a health care professional so that steps can be taken to provide you with appropriate support or treatment. (Factsheet; Depression during pregnancy and the postnatal period, The Blackdog Institute) Therapy during pregnancy can reduce your chance of developing postnatal depression dramatically. Putting in place a support network of family, friends, doctor, counsellor and support groups before the birth will make the period following birth much easier.
    (Factsheet: Antenatal Depression, PANDA)

    Emotions During Pregnancy
    Pregnancy is a time when there are many expectations about how you should feel, “you must be so happy” “how exciting for you”. The physical changes of pregnancy are accompanied by many emotional changes and for some people emotional distress. You may be experiencing some uncertainty about the timing of the pregnancy, it may mean that career or long-term goals will be delayed or create financial problems.

    Feeling uncertain about your new role as a mother, fears about the pregnancy or how you will cope with labor and delivery, may add to feeling guilty about being unhappy, because everyone expects you to be content and blooming. These emotions are not unusual, and are part of the common changes in emotion associated with each trimester.
    (Factsheet: Antenatal Depression, PANDA)

    First Trimester
    Mood swings tend to be most pronounced in the first 12 weeks of pregnancy, alongside the many physical changes such as fatigue, nausea, vomiting, and breast tenderness. Emotions can be unstable, and feelings of low mood are not uncommon. These mood swings can range from great joy to deep despair. Sometimes you may become tearful without knowing the cause. It is commonly believed that changes in the hormones oestrogen and progesterone contribute to the mood changes early in pregnancy.

    Second Trimester
    The second trimester is generally less turbulent. Morning sickness generally passes and worries about miscarriage tend to lessen. From about the twentieth week of pregnancy you might be able to feel the baby move and this realization that the baby is real can bring about excitement about the pregnancy. There is often an increase in energy and wellbeing in the second trimester.

    Third Trimester
    The third trimester often brings anxiety about the birth, especially if there has been a difficult birth previously or if this is your first child and you don’t know what to expect. During the final weeks of pregnancy these anxieties and fears may increase. You might also be concerned about the reality of becoming a mother and changes in relationships with your partner and family. You may experience sleeplessness, and it may be difficult to find a comfortable position. You may feel particularly vulnerable to rejection, loss or insult at this time. There will also be warm sensual feelings that can be very uplifting. (Factsheet: Antenatal Depression, PANDA)

    Symptoms of Antenatal Depression
    For about 10% of pregnant women these emotions experienced during pregnancy can become overwhelming and hard to shift. They are different from the usual emotional changes if they last longer than two weeks and interfere with the pregnant woman’s ability to function in everyday life. Antenatal depression is often overlooked because it is hard to identify and it is less well understood than postnatal depression.

    You may be experiencing antenatal depression if you experience:
    · Inability to concentrate and difficulty remembering.
    · Difficulty making decisions or achieving everyday tasks.
    · Anxiety and panic attacks.
    · Feeling emotionally numb.
    · Extreme irritability.
    · Avoiding family and friends.
    · Sleep problems.
    · Extreme or unending fatigue.
    · A desire to eat all the time or not wanting to eat at all .
    · Weight loss or weight gain not related to pregnancy.
    · Loss of interest in sex.
    · A sense that nothing feels enjoyable or fun any more.
    · Feeling like a failure, feelings of guilt
    · Persistent sadness.
    · Thoughts of death or suicide.
    (Factsheet: Antenatal Depression, PANDA)

    Factors that Can Contribute to Antenatal Depression
    • Pregnancy hormones may contribute to the emotional ups and downs that affect all pregnant women. Other factors can contribute to the development of depression during pregnancy.
    • Family or personal history of depression. If depression runs in your family, or if you have had past episodes yourself, you may be more likely to become depressed.
    • Discontinuing prescribed medication. There can be a worsening of symptoms if you discontinue taking medication for pre-existing mental illness because of the pregnancy, especially if stopped suddenly.
    • relationship difficulties. Difficulties between you and your partner or you fear a lack of support when your baby is born, can have a major impact on your emotional wellbeing
    • Stressful life events. Any major life change, such as a move to a bigger home in anticipation of your baby’s arrival, divorce, job loss or death in your family can contribute to depression.
    • Problems with the pregnancy.
    • A troubled pregnancy with a lot of medical monitoring or illness such as severe morning sickness or pain can take its emotional toll.
    • Infertility or previous pregnancy loss. If you experienced difficulties getting pregnant, or have had a miscarriage or stillbirth in the past, you may find yourself worrying about the safety of this pregnancy.
    • Unplanned or unwanted pregnancy. The timing of the pregnancy may cause significant stress if not part of the plan or relationship with the father.
    • Past history of abuse. Pregnancy can trigger painful memories in women who have survived emotional, sexual, physical, or verbal abuse.
    • Lack of social support. Feeling unsupported when you are facing the changes that parenthood will bring and social isolation can contribute to depression.
    • Financial difficulties. Financial problems can significantly increase the amount of stress you feel during pregnancy. (Factsheet: Antenatal Depression, PANDA)
    Effects on the Baby
    There is a growing body of research which indicates that a stressed, anxious or depressed woman is not ideal for her baby during pregnancy. Changes to the baby’s heart rate and it’s responses to stress are thought to result from severe and untreated antenatal depression, however more research is needed. Consideration for the wellbeing of the baby needs to be given when making decisions about the treatment of antenatal depression to avoid these impacts. (Factsheet: Antenatal Depression, PANDA)

    Treatment
    Early treatment of depression and anxiety is the most effective path to recovery. Don’t put up with your feelings for too long as it can get harder to shift them the closer the day of delivery approaches.
    • Take it easy. You don’t need to need to set up the nursery, clean the house, or work as much as you can before you go on maternity leave. Make some time for yourself, read a book, have breakfast in bed, or go for a walk. If you already have children, arrange for family or friends to look after them and have some time to yourself.
    • Eat well and exercise. Taking care of yourself is an essential part of taking care of your baby. It can be hard to eat well or exercise when you feel sick and uncomfortable. Try small frequent meals throughout the day and regular walking, swimming or antenatal yoga or Pilates.
    • Include your partner if possible. Your partner might be able to detect that you have changed, even before you realise or admit that something is wrong. He is likely to be worried about the pregnancy and how life will be for him, alongside his concern for you. Communicate with him, you need his support, and he can only provide support if you’re open with him. Encourage him to find out about antenatal depression and involve him in supporting you.
    • Talk about how you are feeling. Give your friends and family the opportunity to be supportive by talking to them about your fears and worries. Once you start talking you will be surprised how many people have had similar experiences. Involve them in planning your supports for after the baby is born.
    • Inform your midwife and doctor. Tell the people who are caring for you during your pregnancy about your thoughts and emotions as they can help you to understand what is happening and monitor and support you.
    • Seek counselling. If you’ve tried to work through things on your own but nothing seems to work, seeing a counsellor will help. You need to find someone you feel safe with, and whom you can trust.
    • Antidepressants. You may benefit from antidepressant medication especially if the wellbeing of you and the baby is at risk. It is understandable that you would be hesitant to take medication during your pregnancy but there are some antidepressants which are safe for pregnant women. Talk to your doctor or midwife about the possibilities.
    • Find out about postnatal depression. It is not automatic that you will develop postnatal depression but it can happen, and it is important to know what to look for if your emotions continue after the birth of your baby. Your midwife and doctor need to be aware of how you are feeling so they can help you find the supports you need.
    • When you need to seek help quickly. If you are feeling suicidal, disoriented, unable to handle daily life or if you’re having panic attacks, talk to your doctor or midwife immediately. Seeing a counsellor or psychiatrist is not a sign of weakness. It’s a sign that you are taking the steps necessary to keep yourself and your baby safe and healthy.
    (Factsheet: Antenatal Depression, PANDA)

    For further information, please see separate post/thread, on Resources and Further Reading.

    (With many thanks to MuminMind for researching and compiling this information)
    Last edited by BH-community; 16-11-2011 at 11:59.

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    MuminMind  (16-11-2011)

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    MuminMind is offline Bubhub Award Winner - 2011- Most Helpful Member, Member I'd Most Like To Meet, Most Community Minded Thread, Best Potential Moderator and Newbie of the Year Awards
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  4. #3
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    For me, everything blew up in the third trimester. And I mean bang.

    I note the information above mentions nothing about sleep deprivation or panic. These features are also prevalent in PND and left untreated caused havoc...as they did in my house. Also, I have found that not every practitioner subscribes anti-depressants either. The people who are treating me refuse point blank to provide me with anti-depressants until after I have given birth. What is presently helping me is a strictly controlled drug regimen that I take at the same times every day. These reduce anxiety and prevent my throughts from racing out of control as well as doing things I normally don't do or don't want to do.

    I also found that people are quick to hand you the Edinburgh Scale for you to fill out. My situation did not relate to that in any way and misled me to think I did not have depression. In fact, it made me think I was quietly going mad. So my advice there would be not to vest your faith in so called scales and guidelines as people tend to use them as though they were set in stone. They're not.

    Again, my situation doesn't relate to the above factors listed. However, factors that can contribute to PND can also be physical illness. I had a very sore throat constantly throughout my treatment which wouldn't go away and a short (thank god) but sharp dose of vaginal thrush. I note that when I balanced these out my brain started to as well and the anti-psychotic medication worked a lot better.

    My emotions throughout pregnancy have been those of apathy. I don't have doubts about my ability to mother or fears about motherhood. No guilt or unhappiness, just noticing that the bump was growing and thinking benignly, oh I'm pregnant. Now that I am on the cusp of giving birth, those thoughts have changed (obviously the meds are working) to great, I'm having a baby! I'm petrified of induction, can't they just rip him out with a general?

    The anxiety is a crippler. I can't up the benzodiazepenes due to pregnancy so what little of them I take pushes it to one side so that it's bearable. I intend to swallow a shower of them once the baby is born. (No, not really but it tickles me to think that).

    You may be experiencing antenatal depression if you experience:
    · Inability to concentrate and difficulty remembering.
    · Difficulty making decisions or achieving everyday tasks.
    · Anxiety and panic attacks.
    · Feeling emotionally numb.
    · Extreme irritability.
    · Avoiding family and friends.
    · Sleep problems.
    · Extreme or unending fatigue.
    · A desire to eat all the time or not wanting to eat at all .
    · Weight loss or weight gain not related to pregnancy.
    · Loss of interest in sex.
    . Finding fault in everything.
    · A sense that nothing feels enjoyable or fun any more.
    · Feeling like a failure, feelings of guilt
    · Persistent sadness.
    · Thoughts of hurting yourself.
    I can honestly say that the above were certainly features of my illness. One major difference with me was that suicidal feelings were replaced by wanting to do non fatal harm to myself so I could feel something. This meant standing out in the garden naked so I could get really cold, drawing little pictures on my skin with a boning knife, etc. Sleep problems were insomnia, deprivation and then mania.

    I'm not mentioning my differences to stand out from the crowd. I'm mentioning it because PND (in fact, mood disorders in general) don't always have a specific pattern they follow nor is the treatment prescribed for it necessarily the same.

    My DH is receiving counselling for my illness too because this experience has adversely affected him. Often the men are forgotten in this and it's really important to acknowledge them, their feelings, their need for time out and for someone in the medical profession to ensure that he's not being left behind in the whirlwind that is PND.
    Last edited by Caviar; 26-03-2012 at 16:55.


 

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