When Okay Isn’t Really All That Okay: Pre-natal Depression

This week’s Mental Health Monday piece is from my archives – not my personal story, but a piece I wrote in conjunction with others for a magazine piece. It was eye opening for me to learn about prenatal depression and to speak to Madge and Rosey who have experience in the area. It’s something that is so rarely spoken about, which can lead to more feelings of isolation in pregnancy with women who do suffer with it. Hopefully you’ll find it insightful and a useful read.

Mental Health Monday : When Okay Isn't Okay - PreNatal Depression

The day you find out you’re pregnant is a life-changing day. Whether it is your first or your fourth, a planned new addition or an unexpected surprise, when that test changes to a positive sign, your heart will race and everything changes. For some it is a moment of absolute bliss, but for others, it can take a while for the news to sink in and to process whether or not this is a good thing. The image of a panicked woman and a pregnancy test in hand is not just reserved for the teenager terrified to tell her parents – even when you’ve got your life sorted out, that positive test can rock you to your core and make you think about what you really want in your life.

Having a baby is a big deal. Physically, that test turning into a plus sign is just the start of nine months of strain on your body leading up to childbirth. Mentally, your hormones are set to go all over the place. Even for the most planned of pregnancies, you’re still faced with moments of doubt. It’s human nature to fear the worst and for those fears to surface at 3.14am when everyone else is sound asleep. Having a baby calls for a massive change in lifestyle, and while some find this exciting, for others, it can lead to deep insecurity, doubts about whether or not they’re ready for this massive change, and questions over whether or not they do actually want this child or not. This doubt can be accompanied by strains of guilt, particularly if you feel like this is something you should want but you’re not so sure. These feelings are very common and it’s important to remember that it doesn’t mean you’re any less of a good parent for having these feelings.

But what if the feelings get too much? While it’s perfectly normal to feel overwhelmed and to need time to adjust to being pregnant, what if these worries become all-consuming and affect your mental state? Antenatal, or prenatal, depression affects around 10,000 Irish women every year during their pregnancy – and in reality, this number is probably much higher, when you take into account the number of women who might dismiss their feelings as hormones and therefore do not seek help.

“Antenatal depression is where the mum feels down in herself, anxious, not sleeping, not eating, crying at the drop of a hat, most commonly occurring in the final trimester although it can appear beforehand,” says Madge Fogarty, the chairperson of PND Ireland. “It usually goes away when baby is born but for some women can develop into postnatal depression.”

Those hormones can certainly be a cause of stress and upset, as can changes in your body shape, worries about work or other family members being affected by the pregnancy, anxiousness about childbirth or previous miscarriages. “Women who have gone through IVF to have their babies, or had miscarriages in the past have a higher risk too, as they may feel more pressure on their pregnancy,” Madge adds.

Extra issues such as relationship difficulties with the father of the child, or stressful circumstances during pregnancy (death of family member, loss of job, financial worries) can add to these low feelings. A personal or family history of depression can heighten the risk too. These are all things you’re likely to be asked about initially by your GP or midwives in the hospital as part of routine check-ups, but if you’re not, definitely mention any concerns that you do have to them so that if help of any kind is needed that you’ll be in the best place possible to get it.



Signs And Symptoms

It is important to recognise the signs and separate them from the normal emotional effects of pregnancy, which can be especially difficult to do if this is your first pregnancy. Being more emotional, change of appetite and feeling tired are part and parcel of being pregnant, but they can be exacerbated by antenatal depression. You may also feel more isolated, or you might not want to be around others.

Minor stresses can be heightened and you might feel very anxious about things that really don’t matter much. You may feel more emotional than usual, or you could be completely numb and feeling nothing. These are all signs that you may need to have a chat with your GP to see what they think could be the best course of action for you. Milder cases are most likely to go away naturally when the baby is born, but there are other options if your case is worse, for instance, your GP may put you on a mild antidepressant late in pregnancy if they consider it the best option for you and your baby. Again, the key is to get professional advice if you find yourself overwhelmed by negative feelings.

“Most cases are mild so reassurance is important,” advises Madge. “Get out and exercise. Try to stay positive. Talk to someone who understands, such as PND Support. Or talk to your GP, public health nurse or gynaecologist.”

There are a number of different support groups for antenatal and postnatal depression in Ireland. Your maternity hospital is likely to have one, or can make you aware of groups in the area during the antenatal classes. Talking about it with others who understand and can support you will help and hopefully ease any anxieties you are having. You can also find more information from PND Ireland at www.pnd.ie, emailing them at [email protected] or call them on 0214922083.

“I was exhausted all the time, irritable, and had mood swings going from happy to in tears within minutes”

Rosey Wren was compelled to start her own support group after suffering pre- and postnatal depression on all three of her pregnancies

I’m a 26-year-old mother of three – Kimble (7), Connor (5) and Harvey (2) – and I experienced antenatal and postnatal depression with all three pregnancies. It was a very lonely and isolating time because of the lack of the professional and peer support.

My third pregnancy was by far my worst experience of antenatal depression. I found the whole experience mentally, physically and emotionally draining. I was exhausted all the time, irritable and had mood swings going from happy to in tears within minutes sometimes. I didn’t bond with my bump and there were days where I just wanted to hide under the duvet, but with two small children to look after I had to get up and get through the day whilst battling the intrusive thoughts in my mind that made me feel worthless.

The isolation I felt was overwhelming and was definitely a big contribution to how low I felt and how long it took me to seek help. I didn’t realise how many other mums were feeling the same way, and I honestly think that if I’d had access to an accredited peer support group I would have sought help a lot sooner than I did.

Eventually I asked for help when I attended a routine midwife check at 28 weeks pregnant. The midwife encouraged me to see my GP, who prescribed me anti depressants. However, I was not offered help of any other kind.

My experiences prompted me to begin #PNDHour support. My Twitter page @PNDandMe began after writing a poem of the same name. After sharing it, I realised there was an opportunity to set up a dedicated hour to connect those affected by perinatal mental illness. In January 2014 I began #PNDHour, running every Wednesday from 8pm to 9pm, which discusses a different topic every week from symptoms to self-care. It has grown bigger than I ever expected and every week, the dedicated hour supports 30-60 women.

This piece was originally published in Maternity & Infant Magazine in 2015. 


If you would like to share your mental health story as part of the Mental Health Monday series, please do get in touch – drop me an email at [email protected], or contact me on Facebook or Twitter. I’d love to hear from you!