signs of depression in pregnancy

Women, myself included, often tend to confuse true signs of depression with so-called 'pregnancy symptoms'. It is one of the difficulties I encounter in practice. Indeed this IS a slightly grey area since many women feel a bit low in mood when they have sickness in the early part of pregnancy, or they become tired more easily than usual during pregnancy. A diagnosis can be difficult for doctors to make and so they often make use of check lists.

The DSM-IV requires at least two weeks of daily low mood or loss of pleasure in activities, experienced for most of the day, to be able to make a clear-cut diagnosis of a depressive episode. This would theoretically distinguish clinical depression from a transitory 'funk'. However, it's important to bear in mind that the questionnaires used in the research studies mentioned on the 'statistics' and 'risks to baby' pages do not ask very specifically about length of time that symptoms have been experienced (if they do it would be to say 'in the last 7 days...' or 'in the past week....').

Important to note, too, is that low mood or loss of enjoyment of life is not the ONLY primary symptom of depression. Atypical depression, which is common presentation of pregnancy depression, is usually characterized by IRRITABILITY. In my case this meant blowing a fuse every five minutes, getting overwhelmingly angry and feeling like I wanted to be violent! If you feel this way then you may think that it's just hormone fluctuations, but if it goes on for a few weeks on a daily basis, perhaps consider that you have depression.

The additional DSM-IV requirement for diagnosis brings us to actual signs of depression. To qualify you are supposed have 5 of the following:

-poor sleep or over-sleeping

-poor appetite or over-eating

-loss of libido (sex-drive)

-impaired concentration

-excessive and unreasonable guilt

-loss of motiation

-very low energy

-feelings of hopelessness

-withdrawal from friends and family

-and, thoughts of wanting to die or wanting to harm yourself

IN ADDITION these symptoms must be causing significant 'functional impairment'.

Don't diminish the relevence of some of the signs by assuming that they are normal in pregnancy....don't assume that it's normal to feel like you have lead in your limbs or that you can't think clearly.

Some of you may have most or all of the signs and others may not. If you are like me you might be feeling really rock-bottom but still function enough to make it into work no matter what! It's important to remember that this is not really supposed to be about check lists but about individual experiences and looking for signs of depression. For more on what makes you more susceptible to pregnancy depression, click here.

Feeling low in pregnancy, whatever the 'level', is a big deal to cope with on top of all the hormone changes, body changes and physical challenges of carrying a baby. You certainly don't have to endure it without, at least, reaching for help.

If you think you have signs of depression in pregnancy, find suggestions about what might help by clicking here.