Experiencing Depression While Pregnant
Far from being a time of relaxed contentment, pregnancy can be the first time that some women ever experience depression. The emotional turmoil, shame and embarrassment that accompany this is sometimes misunderstood or not recognized for what it is. Appropriate intervention can help women understand what is happening to them, reduce fears about their pregnancy and provide a structure for regaining control over their life.
A great deal of clinical literature exists in relation to the outcomes of maternal depression, but very little is known or understood about women’s own experiences of depression during pregnancy. Major depressive disorder is twice as prevalent in women. The average age of onset also coincides with the time that most women conceive, that is, between their early 20s and 30s. Women with a history of depression are at greater risk of a depressive episode during pregnancy and it is know that some women develop depression for the first time during pregnancy (e.g. Wisner et al, 1999).
In an attempt to illuminate women’s personal experiences of depression during pregnancy, a team of researchers led by Heather Bennett from the University of Toronto, worked with 19 women who were diagnosed with depression during their pregnancy (Bennett et al, 2007). The results revealed a sometimes complex journey starting from the depths of despair to a sense of arriving at a better place.
Using individual, in-depth interviews lasting between one and half and two hours, a number of questions were asked in order to gain comprehensive perspectives from the volunteers. Women volunteered a wide range views which included, “views about depression, labelling, stigma, incidents contributing to her depression, her symptoms, the influence of depression on her relationships, her coping strategies, her experience of help seeking and her feelings about counselling and the use of antidepressants” (p.3).
Being the Best Mom That I Can
The research team found that loss of control, an altered perception of self and doubts about maternal abilities were central issues. Trying to, ‘be the best mom I can’, revolved around attempts to control perceived threats to their pregnancy and their ability to care for the baby once born. This process, or journey, appears to consist of four major categories:
- Traveling into despair.
- Conceiving the threat.
- Confronting and confining the threat.
- Regrounding self and regaining control.
Traveling into despair is the woman’s experience of the symptoms of depression. All women in the study reached a point where they could not believe that things could get any worse as they withdrew socially, became more anxious, irrational, emotional and generally unable to function.
When women try to make sense of their feelings and are unable to do so they, ‘conceive the threat’. Women often try to tune out their feelings or intrusive thoughts by attempting to distract themselves. These distractions can be anything from comfort eating, to watching TV, to meditation. However, women also know that their attempts to cope with their feelings are ineffective and inadequate. Typically, they feared that their depression was a risk for themselves and their baby. In this study, all women felt a sense of urgency to deal with their depression prior to giving birth.
Seeking care from a psychiatrist experienced in reproductive health was the first step women in the study group took to, ‘confronting and confining the threat’. Some women had to initially overcome personal obstacles involving feelings of shame that they were being viewed as lazy and attention seeking. Having turned to professional help, the mere fact that they received a formal diagnosis was a huge sense of relief to some women. A diagnosis signified that their feelings were known about, understood, and that they were experiencing a known and manageable disorder. The most pressing question for women was whether antidepressants could or should be taken during pregnancy.
Finally, the process of ‘regrounding self and regaining control’ came about as a result of combing counselling and antidepressant medication, although some women elected not to take medication until after the birth, and one until she had stopped breast feeding. Most of the women in the study felt they were better than before, despite still having bad days. Many felt they were better equipped, “to recognize their own needs, what triggered their moods, and that they could identify ways and means to ensure those needs were met”(p.11).
This research provides an interesting insight into an area that has largely been overlooked. The idealised view of pregnancy does not stand up to much scrutiny when compared with the lived experiences of many women. In many ways this form of research represents a toe in the water of what is clearly a complex area that needs greater time and exploration. Meanwhile, health professionals can help by recognizing the signs of depression during the prenatal period and lobbying for greater awareness and action.
Bennett. H.A., Boon. H, S., Romans. S, E., Grootendorst, P. (2007) Becoming the best mom that I can: women’s experiences of managing depression during pregnancy – a qualitative study. BMC Women’s Health, 7: 13, 1-14.