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Last Updated on January 12, 2021

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

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Camilla Dempster

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

The Leading Causes of Prenatal Depression and How to Manage it Best Working in the Third Trimester (The Complete Survival Guide) The Most Critical Do’s and Don’ts of Working Out While Pregnant

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Published on April 9, 2021

What Is Mindfulness And How It Helps Your Mental Wellness

What Is Mindfulness And How It Helps Your Mental Wellness

Mindfulness has become a popular buzzword in the health and wellness industry. However, few people truly understand what it is. My aim here is to teach you what mindfulness is and how it helps your mental wellness. By the end of this article, you will understand the meaning and benefits of mindfulness. Additionally, you will develop the ability to integrate mindfulness into your daily life.

What Is Mindfulness?

Mindfulness is approximately 2500-years-old with deep roots in the Eastern world as a spiritual, ethical, and philosophical practice. These roots are intimately connected to the Buddhist practice of vipassana meditation.[1]

Mindfulness continues to be practiced as a cultural and spiritual tradition in many parts of the world. For Buddhists, it offers an ethical and moral code of conduct. For many, mindfulness is more than a practice—it is a way of life.[2]

However, mindfulness has evolved in the Western world and has become a non-religious practice for wellbeing. The evolution began around 1979 when Jon-Kabat Zinn developed Mindfulness-Based Stress Reduction (MBSR).[3] Since then, mindfulness has emerged in the health and wellness industry and continues to evolve.

It is important to recognize the distinctions between mindfulness as a clinical practice and mindfulness as a cultural practice. The focus of this article is on the clinical model of mindfulness developed in the West.

Many researchers have integrated aspects of Buddhism and mindfulness into clinical psychiatry and psychology. Buddhism has helped to inform many mental health theories and therapies. However, the ethical and moral codes of conduct that drive Buddhist practices are no longer integrated into the mindfulness practices most-often taught in the Western world.[4] Therefore, Western mindfulness is often a non-spiritual practice for mental wellness.

Mindfulness aims to cultivate present moment awareness both within the body and the environment.[5] However, awareness is only the first element. Non-judgmental acceptance of the present moment is essential for true mindfulness to occur. Thoughts and feelings are explored without an emphasis on right, wrong, past, or future.

The only necessary condition for mindfulness to occur is non-judgmental acceptance and awareness of the present moment. Mindfulness can be practiced by anyone, anywhere, and at any time. It does not need to be complex even though structured programs exist.

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How Mindfulness Helps Your Mental Wellness

Along with MBSR, other models have been developed and adapted for use by clinical counselors, psychologists, and therapists. These include Mindfulness-Based Cognitive Therapy (MBCT), Acceptance and Commitment Therapy (ACT), and Dialectical Behavior Therapy (DBT).[6]

Structured models of mindfulness allow researchers to study its benefits. Research has uncovered an abundance of benefits including mental, physical, cognitive, and spiritual. The following is not a comprehensive list of all its benefits, but it will begin to uncover how mindfulness helps mental wellness.

Benefits on Your Mental Health

Practicing mindfulness can have positive impacts on mental health. It has been positively associated with desirable traits, such as:

  • Autonomy
  • Agreeableness
  • Conscientiousness
  • Competence
  • Empathy
  • Optimism

Mindfulness helps to improve self-esteem, increase life satisfaction and enhance self-compassion. It is associated with pleasant emotions and mood. Overall, people who practice this appear to be happier and experience more joy in life. Not only does it increase happiness but it may also ward off negativity.

Mindfulness helps individuals to let go of negative thoughts and regulate emotions. For example, it may decrease fear, stress, worry, anger, and anxiety. It also helps to reduce rumination, which is a repetition of negative thoughts in the mind.

MBSR was originally designed to treat chronic pain. It has since evolved to include the treatment of anxiety and depression. Clinical studies have shown that MBSR is linked with:

  • Reduced chronic pain and improved quality of life
  • Decreased risk of relapse in depression
  • Reduced negative thinking in anxiety disorders
  • Prevention of major depressive disorders
  • Reducing substance-use frequency and cravings

However, more research is needed before these clinical studies can be generalized to the public. Nevertheless, there is promising evidence to suggest MBSR may be beneficial for mental health.[7]

Benefits on Your Cognitive Health

Mindfulness has many important benefits for cognitive health as well. In a study of college students, mindfulness increased performance in attention and persistence. Another study found that individuals who practice it have increased cognitive flexibility. A brain scan found increased thickness in areas of the brain related to attention, interception, and sensory processing.[8]

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To explain this another way, practicing mindfulness can improve the ability to shift from one task to the next, increase attention span and increase awareness of bodily sensations and the environment. Therefore, it has the potential to literally change your brain for the better.

Harvard researchers are also interested in studies of the brain and mindfulness. One researcher studied how brain changes are sustained even when individuals are not engaged in mindfulness. Their research suggests that its benefits extend beyond the moments of mindfulness.[9]

Another study found that the benefits of mindfulness training lasted up to five years. In this particular case, individuals participating in mindfulness activities showed increased attention-span. Mindfulness has also been shown to increase problem-solving and decrease mind wandering.[10]

What Is Mindfulness Meditation?

Mindfulness can be practiced in many different ways. However, most practices include these elements:

  • An object to focus awareness on (breath, body, thoughts, sounds)
  • Awareness of the present moment
  • Openness to experience whatever comes up
  • Acceptance that the mind will wander
  • The intention to return awareness to the object of focus whenever the mind wanders

A practice that encompasses these elements is typically called mindfulness meditation. Most mindfulness meditations will be practiced between 5 to 50 minutes, per day.[11]

There is truly no right or wrong way to practice mindfulness. Most mindfulness meditations are done seated with an object of focus related to the breath, body, thoughts, emotions, or sounds. However, daily activities such as walking or eating can be practiced as a form of mindfulness meditation, as long as the aforementioned elements are in place.

Four Mindfulness Meditations and Their Benefits

Not all forms of mindfulness are created equal. Each practice has unique goals, structure, and benefits. The following four mindfulness meditations are linked with improved mental wellness related to vitality, happiness, and attention.

The results come from a study designed to explore the benefits of these four practices. All of these stem from traditional Buddhist practices.[12]

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1. Loving-Kindness Meditation

Loving-kindness is a form of meditation that focuses on sending love and compassion to others. It may begin with kindness for the self and extend outward towards close family and friends, communities, nations, and the world. Loving-kindness may even involve sending love and compassion towards enemies.

The study found that eight-weeks of loving-kindness meditation increased feelings of closeness to others. However, it did not reduce negative feelings towards enemies. Additionally, one week of loving-kindness mixed with compassion training increased the amount of positive feelings participants experienced.[13]

2. Breathing Meditation

Breathing meditation is a practice where the focus remains on the breath. Whenever the mind begins to wander, the attention is brought back to the breath.

In many different mindfulness and yoga practices, specific breathing (pranayama) practices are taught. However, for beginners, simple diaphragmatic breathing that focuses on each inhale and exhale is sufficient.

The effects of breathing meditation relate to attention. Breathing meditation is linked to changes in the way information is processed. Buddhist monks who practiced breathing meditation were able to process a greater amount of information than monks who practiced compassion meditation.

3. Body Scan Meditation

A body scan is as simple as it sounds. Attention is brought to each part of the body. Participants can choose to start from the top of the head or the bottom of the feet. It can be helpful to imagine a warmth or a color spreading from one body part to the next as each part begins to relax.

When body scan and breathing are combined, there are many benefits. Interoceptive sensitivity is the mind’s ability to focus on bodily cues. It is strengthened by body scanning. Body scanning also helps with attention and focus.[14]

4. Observing Thoughts Meditation

In observing thoughts meditation, the focus is on the thoughts. This is an opportunity to practice non-judgmental observation. It is also a practice of non-attachment.

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Within the study, participants practiced structured observation of thoughts. First, they brought their attention to their thoughts and labeled them within several categories: past, present, future, self, or others. Then, they practiced observing their thoughts without an emotional reaction.[15]

The benefits of this practice were robust. First, participants showed great improvement in the ability to observe their thoughts without judgment. Second, the practice greatly reduced rumination. As a result, participants had fewer emotional reactions to their thoughts and developed greater self-awareness around their thinking patterns.

In summary, there are many different ways to practice mindfulness meditation. The choice may be determined by the benefits each practice offers. For example, body scanning can increase bodily awareness. Thought-observation can increase self-awareness and decrease rumination. Regardless, every practice may increase positivity, energy, and focus.[16]

Considerations Before You Begin Practicing Mindfulness

Mindfulness is still a relatively new concept in clinical research. Critics worry that its benefits have been overstated. There is also concern that the Western world has changed it into something most Buddhists would not recognize.[17]

Mindfulness is a state of mind that builds self-awareness. As a result, it may force individuals to face difficult emotions, memories, and thoughts. In a study of long-term, intense mindfulness practices, 60% of participants reported at least one negative outcome. Some cases are related to depression, anxiety, and psychosis.[18]

There is no one-size-fits-all approach to mental wellness. Mindfulness offering promising results but there are also risks involved. Working with a therapist may be a great way to start a mindfulness practice while monitoring for risk.

Final Thoughts

Mindfulness is a powerful practice that has deep roots in Buddhism. It is a practice of present-moment awareness, acceptance of the present moment, and non-judgment of thoughts, emotions, or circumstances.

It has many benefits that may increase mental wellness. However, there are also some risks to consider. Overall, you should consider your unique profile before beginning a practice or consider working with a therapist at the start.

More About Practicing Mindfulness

Featured photo credit: Simon Migaj via unsplash.com

Reference

[1] NCBI: A Perspective on the Similarities and Differences Between Mindfulness and Relaxation
[2] Sage Journals: Mindfulness in Cultural Context
[3] Greater Good Magazine: What is Mindfulness?
[4] Sage Journals: Mindfulness in Cultural Context
[5] Greater Good Magazine: The State of Mindfulness Science
[6] NCBI: Effects of Mindfulness on Psychological Health: A Review of Empirical Studies
[7] NCBI: Mindfulness Meditation and Psychopathology
[8] NCBI: Effects of Mindfulness on Psychological Health: A Review of Empirical Studies
[9] The Harvard Gazette: When Science Meets Mindfulness
[10] Greater Good Magazine: The State of Mindfulness Science
[11] NCBI: A Perspective on the Similarities and Differences Between Mindfulness and Relaxation
[12] ResearchGate: Phenomenological Fingerprints of Four Meditations: Differential State Changes in Affect, Mind-Wandering, Meta-Cognition, and Interoception Before and After Daily Practice Across Nine Months of Training
[13] ResearchGate: Phenomenological Fingerprints of Four Meditations: Differential State Changes in Affect, Mind-Wandering, Meta-Cognition, and Interoception Before and After Daily Practice Across Nine Months of Training
[14] ResearchGate: Phenomenological Fingerprints of Four Meditations: Differential State Changes in Affect, Mind-Wandering, Meta-Cognition, and Interoception Before and After Daily Practice Across Nine Months of Training
[15] ResearchGate: Phenomenological Fingerprints of Four Meditations: Differential State Changes in Affect, Mind-Wandering, Meta-Cognition, and Interoception Before and After Daily Practice Across Nine Months of Training
[16] Greater Good Magazine: How to Choose a Type of Mindfulness Meditation
[17] NCBI: Has the Science of Mindfulness Lost Its Mind?
[18] NCBI: Has the Science of Mindfulness Lost Its Mind?

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