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The Leading Causes of Prenatal Depression and How to Manage it Best

The Leading Causes of Prenatal Depression and How to Manage it Best

Prenatal depression is defined as a form of clinical depression affecting women during pregnancy. It can also be a pre-cursor to post natal depression. It is estimated to affect 10% of women worldwide; with higher instances within third world countries.[1]

Evidence indicates that treating the depression of mothers leads to improved growth and development of the newborn and reduces the likelihood of diarrhea and malnutrition among them.

Awareness of prenatal mental health is important in order to be your best as a parent and improving the health of your child. Have you ever contemplated what the impact could be of potentially unrecognised prenatal depression?

Leading Causes of Prenatal Depression

Although antenatal depression is more likely to occur among women who have a history of depression, it is by no means inevitable. It is important, however, that women with a history of mental health issues tell their midwife and/or GP, so they can discuss how this might affect their pregnancy and birth, and plan the right care and support.

Other factors causing prenatal depression are previous difficulty conceiving, unplanned pregnancy, emotional and physical abuse as well as relationship and financial concerns.

In a recent article posted by The BabyCenter, the authors stated that:[2]

“For years, experts mistakenly believed that pregnancy hormones protected against depression, leaving women more vulnerable to the illness only after the baby was born and their hormone levels plunged.”

It is now understood that a potential contributing factor towards prenatal depression is actually an imbalance in hormones. More and more information is coming out as this myth has been debunked and more research is being funded. This also shows in the lack of information for parents to turn to in such cases.

Common concerns can include:

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  • How mum feels about going through such a major life-changing event.
  • How mum views herself including negative perceptions about physical changes, such as weight gain, swollen breasts, and other discomfort.
  • The restrictions to mum’s lifestyle that motherhood might incur.
  • How mum’s partner or family feel about the baby.
  • How depression during pregnancy could impact relationships.
  • Difficulties with previous pregnancies.

Whilst these concerns are common for all expecting parents, and have been understood to be expected concerns in the past. Since the change in understanding about the prevalence of prenatal depression, it is clear that obsessive and chronic focus on the above points is linked and a sign of prenatal depression.

Signs of Prenatal Depression

Antenatal depression can begin at any point during pregnancy and is characterized as having a higher than normal level of worry about the impending birth and parenthood.

Whilst the majority of the following symptoms are common ‘side effects’ of pregnancy. The important factor to highlight here is if they become extreme, without break and/or multiple.

There are many signs that can show prenatal depression; from the following list, if seeing or experiencing more than one symptom, I suggest you seek advice from a qualified medical professional.

  • Lack of energy and extreme fatigue
  • Feeling emotionally detached
  • Tearfulness
  • Chronic anxiety
  • Feeling isolated and guilty
  • Inability to concentrate and difficulty remembering
  • Feeling emotionally numb
  • Extreme irritability
  • Sleeping too much or not enough, or restless sleep
  • Desire to over eat, or not eat at all
  • Weight loss/gain unrelated to pregnancy
  • Loss of interest in sex
  • A sense of dread about everything, including the pregnancy
  • Persistent sadness
  • Inability to get excited about the impending birth
  • Inability to feel a bond with the growing baby
  • Thoughts of suicide, or death

As previously mentioned, some of these factors are more commonly understood as ‘symptoms’ of pregnancy. Others are obviously more concerning. It’s important to have an awareness, both by the mother to be and her partner, in order to halt any brewing depression in it’s track.

As with any mental illness, open communication about the matter is one of the most beneficial things that can be done to overcome it. That is a pre cursor to all of the following examples of how to manage prenatal depression to facilitate overcoming it.

How to Manage and Overcome Prenatal Depression

1. Speak out

Don’t try to be ‘superwoman’. Try to do less and make sure that you don’t get over-tired.

Find someone you can talk to. If you don’t have a close friend you can turn to, there are many online support groups and even networks through social media. Your local group can be very supportive both before and after childbirth.

Go to antenatal classes. If you have a partner, take them with you. If not, take a friend or relative.

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2. Ask for help from your peers

Peer support in the right environment can be of great benefit to mothers affected by antenatal depression and PND.

Speaking to someone who has been through what you’re going through, and who has recovered allows mums to see they can get better.

However, do check that these groups are properly safeguarded with well-trained staff and volunteers, who have access to clinical supervision and support for themselves.

3. Antidepressants

Your GP may prescribe antidepressants which can help to ease many of the symptoms of moderate or severe antenatal depression. It is generally considered safe to take certain types of antidepressants when pregnant or breastfeeding, though do discuss this with your doctor who will ensure the ones selected for you are compatible.

Don’t stop (or change) antidepressant medication during pregnancy without medical advice. Around seven in 10 women who stop antidepressants in pregnancy relapse if they stop their medication.

You need to discuss the risks and benefits of continuing treatment in pregnancy and while breastfeeding.

4. Counselling and therapy

Talking treatments, such as counselling and psychotherapy, offer you the opportunity to look at the underlying factors that have contributed to depression, as well as helping you to change the way you feel.

If a friend or someone you know recommends a therapist, this can be a great way to find someone. If you don’t feel that the method of therapy or the therapist isn’t working for you, you can always change and try someone else. Private practitioners will charge a fee for their services, so this will probably be another factor in your decision.

Whoever you choose, make sure your therapist is registered with an accredited body, such as the American Counseling Association (ACA) and the British Association for Counselling and Psychotherapy (BACP). You could also contact your Community Mental Health Team.

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5. Spend time with your partner

Experiencing depression – particularly during pregnancy – can feel isolating and confusing, but you’re not alone.

Try to talk about how you’re feeling and be positive about seeking help. It’s the best thing you can do.

With the right help and support, particularly early on, things can get better.

6. Reduce inflammation

One traditional hypothesis of any type depression is that people who are depressed have a deficiency in monoamine neurotransmitters in the body, which leads to low levels of neurotransmitters like serotonin and norephinephrine in the brain.

But growing evidence supports that at least some forms of depression may also be linked to ongoing low-grade inflammation in the body. Pregnancy causes amounts of inflammation as the body changes.

Working to manage this inflammation can therefore be assumed to assist in reducing prenatal depression. Simple things such as spending time outside, meditation, hydration, eating plenty of green vegetables and regular gentle exercise have been shown to reduce inflammation.

7. Improve gut health

Continuing from the previous post, long term low level inflammation has a negative effect on gut health.

The intestinal wall is our border with the outside world. Because the gut is where things from the outside (like food) are absorbed inside our bodies, the intestinal wall is designed to handle a many types of interactions with foreign matter. Considering the functions of our gut, it makes sense that most of our immune cells are located in the gut.

Further, the gut is home to our microbiome, the trillions of beneficial microbes that live inside our gastrointestinal tract. When a potential threat is sensed in the gut, large, far-reaching inflammation occurs. This inflammation can travel directly from your gut to your brain, especially through the vagus nerve.

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One of the most direct and quick ways to calm the vagus nerve is through dietary change. Just as emotions send messages to your gut, food sends messages to your brain. Spend time focussing on nutrition containing plenty of fibre from vegetable sources as well as including fermented foods to replenish your gut bacteria.

Myths About Pre & Post Natal Depression

Pre and post natal depression is often misunderstood and there are many myths surrounding it. These include:

  • Postnatal depression is less severe than other types of depression?
    In fact, it’s as serious as other types of depression.
  • Prenatal depression is not possible due to hormonal changes?
    In fact, those hormonal changes can contribute.
  • Postnatal depression is entirely caused by hormonal changes?
    It’s actually caused by many different factors.
  • Postnatal depression will soon pass?
    Unlike the “baby blues”, postnatal depression can persist for months if left untreated. In a minority of cases, it can become a long-term problem.
  • Postnatal depression only affects women?
    Research has actually found that up to 1 in 10 new fathers become depressed after having a baby.

Conclusion

Virtually all women can develop mental disorders during pregnancy and in the first year after delivery. But poverty, migration, extreme stress, exposure to violence (domestic, sexual and gender-based), emergency and conflict situations, natural disasters, and low social support generally increase risks for specific disorders.

Prenatal depression can be extremely dangerous for the health of the mother, and the baby, if not properly treated. If you feel you might be suffering from antenatal depression, it is highly recommended to speak with your health care provider about it. Together you can discuss ways to help treat and cope with this mental illness.

It’s becoming more prevalent and more widely understood as more medical studies are being done. Antenatal depression was once thought to simply be the normal stress associated with any pregnancy, and was waved off as a common ailment.

It can be caused by many factors, usually though involving aspects of the mothers personal life such as, family, economic standing, relationship status, etc. It can also be caused by hormonal and physical changes that are associated with pregnancy.

Most important advice – if you believe you are at risk or may be developing symptoms, reach out for advice and speak to someone.

Featured photo credit: Suhyeon Choi via unsplash.com

Reference

[1] World Health Organization: Maternal Mental Health
[2] The Baby Center: Depression during pregnancy

More by this author

Camilla Dempster

A prenatal/postnatal and health expert who teaches women to ditch the binge/restrict/guilt cycle around their body, food and exercise.

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Last Updated on October 13, 2020

How to Spot a Burnout And Overcome It Fast

How to Spot a Burnout And Overcome It Fast

Burnout at work is an issue that most people who suffer from it, suffer unknowingly.

Have you ever felt that you can’t start an assignment, have an immense urge to Netflix binge, or couldn’t get yourself to wake up on time even though you have a lot on your plate? The cause for these might be burnout.

According to Deloitte’s report, “many companies may not be doing enough to minimize burnout.” This is to say that the responsibility is not only on the employee. According to that report, nearly 70 percent of professionals feel their employers are not doing enough to prevent or alleviate burnout within their organization, and they definitely should.[1]

Too many companies don’t invest enough in creating a positive environment. One out of five (21%) said that their company does not offer any programs or initiatives to prevent or alleviate burnout. It is the culture, not the fancy well-being programs that would probably do the best work.

This is a significant problem for individuals and companies, and it’s also an issue on a macro level. A Stanford University research found that more than 120,000 deaths per year, and approximately 5%–8% of annual healthcare costs, are associated with the way U.S. companies manage their workforces.[2]

It is both the employee and the employer’s responsibility—and the latter can certainly take more responsibility.

In this article, I’ll guide you on how to know if you suffer from burnout and, more importantly, what you can do about it.

Who Are Prone to Burning Out?

For starters, it is a good thing to know that you’re in good company. According to a Gallup poll, 23% (of 7,500 surveyed) expressed burnout more often than not. Additionally, 44% felt it sometimes. Nearly 50% of social entrepreneurs who attended the World Economic Forum’s Annual Meeting in 2018 reported having struggled with burnout and depression at some point.[3]

According to Statista (2017), 13% of adults reported having problems unwinding in the evenings and weekends. According to a Deloitte survey (consisting of 1,000 full-time U.S. employees), 77% of respondents said that they have experienced employee burnout at their current job.[4]

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Burnout is not only an issue of the spoiled first-world. Rather, it is a serious matter that must be taken care of appropriately. It affects so many people, and its impacts are just too significant to be ignored.

Some occupations are more prone to burnout, such as people who deeply care about their jobs more than others. According to the Harvard Business Review, “Passion-driven and caregiving roles such as doctors and nurses are some of the most susceptible to burnout.”

The consequences can have life or death ramifications as “suicide rates among caregivers are dramatically higher than that of the general public—40% higher for men and 130% higher for women”. It is also the case for teachers, non-profit workers, and leaders of all kinds.[5]

Deloitte’s survey also found that 91% say that they have an unmanageable amount of stress or frustration. Heck, 83% even say that it can negatively impact their relationships. Millennials are slightly more impacted by burnout (84% of Gen Y vs. 77% in other generations).

What Is Burnout Syndrome?

So, what is it, exactly? Burnout was officially included in the International Classification of Diseases (ICD-11) and is an occupational phenomenon.

According to the World Health Organization, burnout includes three dimensions:[6]

  1. Feelings of energy depletion or exhaustion;
  2. Increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job;
  3. Reduced professional efficacy.

The 5 Stages of Burnout

At this point, you must have a clue if you’re at risk of burnout. There are different methods for understanding where you are on the burnout syndrome scale, and one of the most common ones is the “five stages method.”

1. Honeymoon Phase

As you may remember If you’ve gotten married, there’s always the honeymoon phase. You’re so happy and feel almost invincible. You love your spouse and at this stage, you’re very excited about everything. It’s the same when it comes to taking on a new job or role or starting a new business.

At first, most of the time, you’re hyper-motivated. Although you might be able to notice signs of potential future burnout, in most cases, you might ignore them. You’re highly productive, super motivated, creative, and accept (and take) responsibility.

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The honeymoon phase is critical because if you plant the seeds of good mental health and coping strategies, you can stay at this phase for extended periods.

2. Onset of Stress

Let’s continue with the wedding metaphor. Now that you’re happily married for some time, you might start noticing certain issues with your spouse that you don’t like. You might have seen them before, but now they take up more space in your life.

You might be less optimistic and feel signs of stress or minor symptoms of physical or emotional fatigue at work. Your productivity reduces, and you think that your motivation is lower.

3. Chronic Stress

Let’s hope you don’t get there in your marriage, but unfortunately, some people get there. At this stage, your stress level is consistently high, and the other symptoms of stage 2 persist.

At this point, you start missing deadlines, your sleep quality is low, and you’re resentful and cynical. Your caffeine consumption might be higher, and you’re increasingly unsatisfied.

4. Burnout

This is the point where you can’t go on unless there is a significant change in your workspace environment. You have a strong desire to move to another place, and clinical intervention is sometimes required.

You feel neglected, your physical symptoms are increasing, and you get to a place where your stomach hurts daily. You might obsess over problems in your life or work and, generally speaking, you should treat yourself.

5. Habitual Burnout

This is the phase in which burnout is embedded in your life. You might experience chest pains or difficulty breathing, outbursts of anger or apathy, and physical symptoms of chronic fatigue.

The Causes of Burnout

So, now that we know how to identify our stage of burnout, we can move on to tackling its leading causes. According to the Gallup survey, the top burnout reasons are:[7]

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  1. Getting unfair treatment at work – This is not always something that you can fully control. At the same time, you should remember that even if you’re not calling the shots, it doesn’t mean that you have to accept unfair treatment. The consequences mentioned above are just not worth it in most cases.
  2. Workload – Another leading cause of stress according to dozens of interviews conducted before writing the article. According to Statista, in 2017, 39% of workers said a heavy workload was their leading cause of stress. We live in a busy work environment, and we will share some tips on how to manage that.
  3. Not knowing your role – While not something you can fully control, you can, and probably should, take action to better define it with your boss.
  4. Inadequate communication and support from your manager – Like the others above, you can’t fully control that, but as we’ll soon share, you can take action to be in better control.
  5. Time pressure – As mentioned, motivated, passionate workers are more in danger of experiencing burnout. One of the reasons is that they’re pressuring themselves to do more, sometimes at the expense of their mental health. We’ll address how to work on that as well.

How to Overcome a Burnout

After going over the stages of burnout and the leading causes of becoming burned out, it might be a good time to let you know that there is a lot you can do to fight it head-on.

However, let’s start with what you should not do. Burnout cannot be fixed by going on a vacation. It should be a long-term solution, implemented daily.

According to Clockify (2019), these are the popular ways to avoid burnout:

  1. Focus on your family life – 60% of adults said that stable family life is key to avoiding burnout. Maintaining meaningful relationships in your life is proven to reduce stress (instead of having many unmeaningful relationships).
  2. Exercising comes in second, with 58% reporting that jogging, running, or doing any exercise significantly relieves stress. Even a relatively short walk might improve your body’s resilience to stress.
  3. Seek professional advice – 55% say they would turn to a professional. There are online websites where you can speak with professionals at reduced costs.

Aside from the three most popular ways of avoiding burnout, you can also try the following:

1. Improve Time Management

Try understanding how you can use your time better and leave more time for relaxation. That’s easy to say (or write) but more challenging to implement. It would help if you started by prioritizing yourself. Understanding the connection between your values and your everyday tasks is a tremendous help. You can use proven methods to improve the relationship between your vision and goals to your daily life tasks’ lists. Check out the Horizons of Focus or V2MOM methods to get started.

2. Use the P.L.E.A.S.E. Method

The P.L.E.A.S.E. is a combination of things you should do to be at your best physically. It means Physical Illness (P.L.) prevention, Eat healthy (E), Avoid mood-altering drugs (A), Sleep well (S), and Exercise (E).

3. Prioritize

You don’t have to say yes to everything that comes across your way at work (or in other aspects of life). You’d be surprised how easy it can become once you start saying no. Some might even describe it as exhilarating.

4. Let Your Brain rest

Culturally, most of us are already wired to think that hard work is essential, and while that’s true in most cases, we sometimes forget that our brain needs to rest for it to recharge. Seven hours of sleep are essential (depending on your age). Meditation might be helpful, too.

5. Pay Attention to Positive Events

According to Therapistaid.com, we tend to focus on the bad things in our lives. However, by focusing on positive things, we can change our mindset. One way to practice this daily is by writing three good things about your life every morning or evening. It’s been scientifically proven that doing so for a few months can help rewire your brain.

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6. Take Some “You” Time

A Netflix binge is not always good for you, but it might be in some cases. The better the leisure time is, the better you’ll feel in the long term. It’s usually better to read a book or start a new hobby that requires more cognitive skills than just lying on the couch. But as long as you feel good watching a movie, that might be a good start.

7. New Technologies Might Be Helpful

There are tons of self-help apps such as Fabulous, Headspace (meditation), Noom (diet and exercise), and others. They’re good to use, but you should also be careful not to run away from your problems only to watch social media for hours. It’s not real, and no one’s life is perfect (even if their Facebook or Instagram feeds might seem so). You should also be aware not to be in an “always-on” mindset.

Bottom Line

Whether you’re at the first or the fifth stage of the burnout phases, the goal of this article is to show you that there are always ways to fight it. The first thing is self-awareness—knowing that there’s a problem. The second step is to decide what to do about it.

You can also consider using Lifehack’s community. You’re more than welcome to share your burnout story on our Facebook page.

Bonus: Rebound from Burnout in 8 Hours

Watch what you can do to rebound from burnout quickly in this episode of The Lifehack Show:

https://youtu.be/MNnyqQWK_zg

Featured photo credit: Lechon Kirb via unsplash.com

Reference

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