Has The Pandemic Increased Depression In Pregnant Women?

Introduction

Pregnancy is a wonderful time for a couple. It also brings with it a variety of new experiences not only because you become a parent but also because a woman’s body goes through a number of physical, emotional and mental changes as it tries to make room for another human in the body. It is a rollercoaster ride and can also be overwhelming and exhausting as you try to process so many new changes in your life.

It is a happy time as you start preparing your nest to bring home a new person. You need to stay positively healthy both in your mind and body so that the 9 months seem like a breeze. However, according to research, about 7% of women tend to feel depressed during pregnancy. And this number saw a surge during the pandemic as 47% of expectant mothers were found to feel depressed and about 60% of pregnant women reported feelings of anxiety.

In this article, let us quickly evaluate how depression is common during pregnancy, why it increased during the pandemic and what can you do to reduce it.

Studies had shown that the rate of anxiety and depression among pregnant women during the COVID-19 pandemic had raised (20). A review article reported that the anxiety and depressive symptoms were highly prevalent, effecting 58–72% of pregnant women during the COVID-19 pandemic.

Dr. M.G. Kartheeka, MBBS, MD(Pediatrics)

Depression During Pregnancy

Studies have revealed that women are twice as vulnerable to feeling depressed as opposed to men and this condition starts to peak during their reproductive years. The feelings of stress and anxiety are quite common for women during pregnancy. Hormonal changes, morning sickness, sudden increase or decrease in appetite all contribute to both emotional as well as bodily stress. So, how to recognize that you are going through depression? What are the signs?

Persistence of some or all of the following symptoms for more than 2 weeks-

• Excessive anxiety about the baby’s health and safe delivery
• Feelings of inadequacy about your role as a parent
• Loss of interest in activities that earlier brought you joy and happiness
• Fear arising due to societal expectations of you as a mother
• Inability to respond positively to reassurance
• Persistent sadness
• A feeling of loneliness, and hopelessness 
• Low in energy
• Difficulty concentrating on any task
• Suicidal thoughts

Because women experience hormonal fluctuations regularly, and because they go through more intense hormonal changes at specific times in life, their risk of depression is biologically greater, pregnancy and perimenopause are commonly associated with mood swings and depression.

Dr. Ashish Bajaj, M.B.B.S, M.D.  in Clinical Pharmacology and Toxicology

Post-Partum/ Peri Partum Depression

In addition to prenatal depression, most women also tend to experience post-partum depression (PPD) now called peripartum depression. During and after pregnancy women tend to go through a myriad of emotional, physical and behavioural changes. 

According to multiple surveys, almost 70 per cent of all new mothers undergo the ‘baby blues’. This is a short-lived condition that does not affect or impair daily activities and no medical treatment is required. 

Some of the most common symptoms of ‘baby blues’ include-

• Crying inexplicably
• Irritability
• Restlessness
• Anxiety

Such symptoms usually only last 7-14 days and recede on their own without medication.

Peripartum depression is not the same as ‘baby blues’. Like any form of depression, postpartum depression too wrecks a person emotionally and debilitates a new mother physically. It may continue for many months and medical treatment is highly recommended.

Signs of PPD

• Inability to sleep or excessive sleepiness
• Changes in appetite
• Chronic fatigue
• Irritability
• Sadness
• Loneliness
• Loss of interest in previously enjoyable activities
• Constant mood swings
• Difficulty to gain bonding with the newborn 
• Feeling of guilt

Postpartum/Peripartum depression can be treated over time with counselling and medication.

Spike in Depression in Pregnant Women During the Pandemic

A study conducted by the University of Essex in the UK found that the COVID-19 pandemic was responsible for increasing the rate of depression and anxiety in pregnant women. A peer review was carried out taking 150 women between April 2020 and January 2021 which is considered the peak time of the pandemic all around the world to come to these conclusions. Although depression as stated above is quite common in women during the prenatal stage and even after delivery, the paper highlighted the fact that the surge in depression rates was due to the fear and trauma experienced by women at the time of the lockdown during the first wave. It also mentioned that women who had a history of clinical depression or had past traumatic experiences were also at the risk of feeling detached from their newborn babies.

Dr. Rigato from the University of Essex thus came to the conclusion that a woman’s experience during pregnancy played a key role in influencing the nature of her bond with her newborn baby. It has also put forward that women who had a negative attitude or negative takeaway about the COVID-19 pandemic were at a higher propensity to feel greater anxiety, depression and mood changes.

Conclusion

The tendency of women to feel more anxious during and after pregnancy and the sudden surge in the rates as revealed by the study shows us that expectant mothers are going through a vulnerable time in terms of both mental and physical health during the pandemic. In this regard, the importance of positive social support from loved ones such as family and friends is crucial. Unaddressed mental health crises in women could severely affect the health of the mother, the nature of the delivery, the relationship between the mother and the child and lastly, the development of the infant in its later stages. These mental health issues that arise during or after pregnancy are collectively termed peripartum depression and can be managed well with proper treatment and counselling given on time.

The American College of Obstetricians and Gynaecologists recommends taking women for counselling at least once during their pregnancy to screen possibilities of undetected anxiety and depression. Pregnant women and new mothers need to be felt loved and supported by their loved ones to make their most special time healthy as much as possible.

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