Guest blogger Sara William is a digital marketing consultant, writer, freelancer, WordPress enthusiast, and coffee lover.
Depression and anxiety during pregnancy are often trivialized, and many women are embarrassed to admit their true feelings. Societies’ expectations of mothers-to-be are largely unrealistic and paint an inaccurate picture of pregnancy. Newspapers and magazines print pictures of expectant women glowing with happiness. The truth is that many pregnant women feel apprehensive and fearful, and can become easily tearful and irritable. There is nothing “wrong” with you for feeling this way, and rest assured, the vast majority of expectant women do not feel happy all of the time. The American Psychological Association suggests that 1 in 5 women experience depression and/or anxiety before, during, and after their pregnancy. The stigma surrounding mental illness often creates a sense of unwarranted guilt and shame which often leads women to keep their conditions secret.
The goal of holistic management is to encourage overall health and wellness by addressing biological, psychological, social, spiritual, and environmental factors. The focus of this approach is to balance and unify the factors listed above, and is not an alternative to traditional medication and therapy. Usually the best management plans include and integrate traditional medicine with other alternative therapies and practices.
This article provides a panel of preferences for anxiety and depression during pregnancy and the postpartum period, and gives information about each trimester and ways to be proactive during pregnancy and the postpartum period. There is always something that can be done during each trimester.
Depression and Anxiety during Your Pregnancy
No two pregnancies are identical, but many of the same challenges arise in each. Anticipating potential challenges of pregnancy can help individuals understand their emotions and behaviors and can allow for timely intervention.
First Trimester
The first trimester brings a roller coaster of hormonal changes and symptoms that range from nausea and fatigue to emotional lability. During this time many women choose to keep their pregnancy a private matter, if they choose to share the news at all. Many women find themselves obsessing about potential miscarriage and look for physical symptoms of a miscarriage. Some women experience an overall ambivalence toward their pregnancy.
It is important to recognize that these feelings do not always indicate depression, but rather may reflect the symptoms of anxiety and normal hormonal changes of early pregnancy.
The Second and Third Trimesters
In the second trimester, many women report having more energy and feeling better. This can lead women to believe that their symptoms have gone away. For some women this may lead them to ignore their emotional symptoms. Women may also become anxious for follow-up tests due to worrying about abnormal results. Women may also
become worried and anxious as their body begins to change and they may become distressed if they have issues concerning their body image. As the body changes this can also cause stress if women are having issues at work or at home.
Women who have had issues in the past with depression and anxiety may become distress if they stop taking medication and/or other coping mechanisms that may have been helpful for them in the past.
As women near the end of their pregnancy, they also become anxious and worried about the delivery and the child. They may become anxious about changing their life and the lives of others and about their ability to take care of a child. Women also become anxious about many of the unknowns concerning having a child. The combination of anxiety and worries about many things can also lead women to have depressed feelings.
Many women experience symptoms of depression and anxiety throughout their pregnancy. Women may also experience symptoms of depression and anxiety for a long time if they go untreated. Some women may experience symptoms of depression and anxiety if they stop taking medication that they have been taking for a long time.
Women may also experience symptoms for long time if they stop doing other activities that have also been helpful for them in the past. Some women may also experience symptoms of depression and anxiety if they stop seeing a therapist.
Importance of Nutrition, Movement and Sleep
Nutrition, activity level, and sleep play an important role in caring for your mental health. While they are not psychiatric interventions, they provide a foundation to your mental health care plan.
Food and Mood
You’ve probably heard that certain foods impact your brain. Nutrition is especially important during pregnancy. For the following nutrients, be sure to fill any gaps in your diet.
Omega 3. Omega 3s are important for brain health and can be found in fatty fish, walnuts and flax seeds. A decrease in omega 3s has been correlated with an increase in depressive symptoms.
Folate and B Vitamins. Folate is important for the production of red blood cells and can be found in green leafy vegetables and legumes. Other B vitamins can be found in animal and plant products, and help in the production of neurotransmitters.
Iron and Vitamin D. Iron can also play a role in depression, as can Vitamin D. A simple blood panel can be ordered by your provider to help assess your status.
Other nutrients important for hormone health include essential amino acids and essential fatty acids.
Anxiety can be triggered by low blood sugar and can also be exacerbated by caffeine. To help stabilize your blood sugar, be sure to consume a well balanced meal or snack.
Eating is tough when you have nausea, and the thought of trying to eat healthfully during a time when eating, in general, is a struggle, is unrealistic. If you can’t eat everything you need to eat to get the proper nutrients, that’s okay. When your appetite comes back, that’s when you focus on eating healthy again.
Moving Your Body Gently
A healthy diet isn’t the only thing that improves your health and well-being during your pregnancy. Being active and exercising has many benefits. The Department of Health and Human Services recommends that, during a pregnancy, you get at least 150 minutes of moderate exercise a week. Be sure to check with your doctor to see what is safest and healthiest for you.
Things that count as moderate exercise include swimming, walking, and yoga. You don’t have to workout for long hours to get the benefits. A short, 15-20 minute walk can help your mood and give you a boost of energy.
Practicing good sleep habits can also benefit your mental health. Mental illness can also increase the likelihood of having a poor quality of sleep. Creating good habits and rituals before bed, like taking a warm shower or bath, can help you relax and prepare your mind and body for bedtime.
It’s also important to move your body and be active during the day so that you don’t feel tired and worn out at the end of the day. If you have symptoms of heartburn, try not to eat 3-4 hours before going to bed and keep yourself extra hydrated during the day so you don’t feel as bloated and uncomfortable when going to bed.
Write your worries down. Taking just a few minutes to put your worries on paper before bed may help slow your mind and improve the quality of your sleep. If insomnia lasts for more than a couple of weeks, it may help to contact your health care professional. It may be a symptom of a condition that should be treated on its own. Some practices to help relax and calm your mind are listed above.
Most people find the practice of mindfulness to be simple but effective. This may be accomplished by either focusing on your breath or simply observing your thoughts and surrounding environment. This may help to reduce symptoms of depression and anxiety. If you find that you are unable to quiet your mind for an extended period of time, don’t be discouraged, setting aside even a few minutes a day may still be of benefit.
You may also try deep breathing. To do this, simply inhale through your nose for a count of four, hold the breath for a count of two, and exhale for a count of six. Repeat this as many times as needed until you feel calm. You may also try other practices such as progressive muscle relaxation, guided imagery, and journaling.
Prenatal Yoga, Massage and Acupuncture
Prenatal yoga utilizes yoga poses, breathing techniques, and relaxation to help expecting mothers during pregnancy. The practice builds community among mothers-to-be. The practice can help expecting mothers release physical and emotional tension. Expecting mothers should consult with their obstetrician before receiving a pregnancy massage since it can help ease tension and pain in the back and legs. There are studies showing the use of acupuncture eases symptoms of mild to moderate depression.
Psychotherapy and Depression
Many mothers-to-be find the use of psychotherapy and counseling to be very helpful and easy to incorporate in their already busy schedules. The use of the internet and video conferencing allows expectant mothers to engage in psychotherapy from the convenience of their home. The two most recognized and effective psychotherapies for
depression during pregnancy are cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT). Some expectant mothers find CBT to be very helpful in learning ways to cope with their fears and anxiety about giving birth and raising children. IPT helps expectant mothers with role transition and interpersonal relationship changes.
Herbal Remedies
Mood-related problems during pregnancy often lead women to seek out non-traditional methods for relaxation and stress reduction. They may turn to herbal remedies and dietary supplements in the belief that these “natural” products are safer to use during pregnancy. There is limited information regarding the safety of most herbal products and dietary supplements during pregnancy. Some herbal products may interact with medications or affect hormones and blood pressure. Before using any herbal product or dietary supplement during pregnancy, it is important to consult with your health care provider.
Connection, Support, and Knowing When to Get Help
There are a lot of different ways to ease anxiety and depression; for many pregnant women, medication is not one of them. Despite popular belief, yoga and salmon can’t completely alleviate anxiety and depression during pregnancy. In fact, pregnancy can be very depressing and anxiety provoking if your friends and/or family do not live near you or if they do not share your current life stage.
Building Your Support System
You need to start by telling at least one person your true feelings, the real, unedited version. This can be a partner, sibling, parent, or friend. Once they understand what is going on they can help in a variety of ways.
Tell them what you need, and give specific examples. People can’t read your mind. It’s better to say, “I need you to drive me to the grocery store,” or “I need you to sit with me while I do this” than to just say, “I need help.”
Being a parent is extremely challenging, but the support systems available to expectant mothers can help. Take advantage of peer support groups and prenatal classes. Many mothers find it more useful when other mothers simply validate their feelings rather than giving them advice. If your partner attends these meetings with you they can get support for their mental health as well. They can also get a better understanding of what is going on, and in turn help the family more.
You deserve a support system, and you need to protect your peace. This means you can set boundaries, and you can skip over anything that is negative or draining. Try not to compare your pregnancy to others, and try not to be grateful for everything. You deserve peace.
Additional Treatments
Not all women respond to changes in lifestyle and behavioral therapies. Women who do not experience improvement, or worsen, and particularly if their symptoms reach the level of severe, then the balance shifts toward the need for pharmacological treatment to manage the symptoms. There are genuine anxieties about any potential
consequences of using medication during pregnancy. However, women need to be fully informed of the potential adverse consequences of unmanaged mental conditions during pregnancy. Some conditions may become chronic and severe if left untreated.
The ultimate decision on treatment is best made by the pregnant woman after consultation with a mental health professional experienced with the range of psychiatric conditions, the effects of various treatments, and the courses of action available. This should include the risks of discontinuing treatment versus the effects of continuing
treatment.
It is of utmost importance that women be fully informed of the potential emotional and mental conditions that may require further psychiatric evaluations and treatments. They should feel secure about approaching professionals for assistance and should understand that they are not putting their children at risk by seeking help for psychological issues. They should also be aware that certain mental conditions may be life threatening to them or their child. Reaching out for help is a sign of courage and strength. Immediate professional help should be sought in cases where women feel that life is not worth living, have thoughts of harming themselves, their child, or others, feel
extremely panicky and anxious, and/or feel disconnected from reality.
Anticipate Needs During the Postpartum Period
During your last trimester, you can make a plan for postpartum care. You can arrange for meals and plan for help during the evenings and for the weeks following the birth. Identify your mental health counselor and/or psychiatrist, if you do not already have them. Choose a provider who will address your postpartum mental health. Share your plan with your ob/gyn so that they, too, will address your mental health during your postpartum appointments.
Many women feel anxious during their pregnancy and worry that they are not doing enough to manage their symptoms. Women can feel comforted knowing that they can do many things during their pregnancy to manage their mental health symptoms. You can use mental health resources, maintain a healthy lifestyle, and engage in other activities to enhance your emotional and mental well-being. Having a plan to address your mental health during your pregnancy can relieve some anxiety you may feel. You should not feel guilty for having mental health symptoms during pregnancy. If you are ready for guidance from a clinician who understands perinatal mental health, consider reaching out to Mind Align Psychiatry to discuss a personalized plan. You do not have to wait until symptoms feel unbearable. Book a consultation today, take the first step, and give yourself the same compassion you are already preparing to give your child.
