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Recognizing and Treating Antepartum Depression

The Usual Ups and Downs of Pregnancy?

If you exhibit any of these symptoms for more than two weeks at a time, you probably can't blame your feelings on the normal mood fluctuations of pregnancy and should seek help, suggests the National Mental Health Association.

Peggy, a working mother from Austin, Texas, was miserable throughout the final weeks of her first pregnancy. She blamed her misery on everything from her job to the death of her mother. She finally started feeling better six months postpartum and put the experience out of her mind. But a few months after, she became pregnant with her second child. "I was a basket case and swore I'd see someone about it as soon as the baby came," she says. She suffered through the pregnancy and went on to suffer from postpartum depression as well. It was months before she finally sought help. "[My doctor] asked me the standard screening questions for depression, which, of course, fit me like a glove. Shortly after, I was seeing a therapist and trying Prozac. That was four years ago, and it changed my life."

Antepartum depression can be treated with medication, therapy or a combination of both. In the New England Journal of Medicine, Dr. Elisabeth Robert says drugs of any type should not be taken in pregnancy unless the risks to the mother and baby without the drug outweigh the risks of taking the drug. But if you consider that women suffering from antepartum depression are more likely to ignore the advice of their health care provider, eat poorly and abuse substances, sometimes medication to treat depression does make the most sense. Strkman says, "I may decide, in my professional opinion, that a woman needs a support group and/or may benefit from antidepressant or anti-anxiety medication. In [my] case, as a nurse who cannot prescribe medication, I either refer her to a psychiatrist or family doctor."

Want to see more?

• Pregnant and Depressed? Find the Support You Need
• Postpartum Depression: Preventing Tragedy
• Postpartum Depression: When Having a Baby Gives You More Than the Blues
• Talk about it!