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Last Updated on January 12, 2021

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

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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 October 15, 2021

Does Anxiety Make You Tired And Why?

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Does Anxiety Make You Tired And Why?

When you think of anxiety, several scenarios may come to mind: the endless tossing and turning of a restless night, dread over potential future events, pandemic-related overwhelm, or full-blown panic attacks. Even if you’re not diagnosed with an anxiety disorder, you’ve likely experienced anxiety symptoms at some point in your life. In these situations, you might feel a queasiness in your stomach, racing heartbeat, excessive sweating, chest tightness, some tension in your jaw/neck/shoulders, or worrisome thoughts as you prepare for the worst possible scenario. But does anxiety also make you tired?

After experiencing these symptoms, you may indeed feel fatigued. The sensation could fall anywhere on the exhaustion spectrum, from feeling like you just ran a marathon and need to sleep for two days, to just a little worn down and wanting a quick nap to recover.

Below are 7 ways anxiety zaps your energy and how to restore it.

1. Stress Hormone Overload

Anxiety can make you tired via overloading your body with stress hormones. The “fight or flight” response is a key connection between anxiety and fatigue. In fact, this process is made up of three stages: Alarm, Resistance, and Exhaustion. Anxiety triggers our body systems to go into high alert. This is a natural, involuntary reaction that developed in the human brain for survival.

When humans lived with the real, imminent threat of being attacked by a predator, it made sense for our bodies to spring into action without much preparatory thought. Such dangers are rare in modern times, but our brains continue to respond in the same way they did thousands of years ago.

The hormones and chemicals that flood our bodies to prepare us for safety can both affect and be affected by several body systems, and this interaction itself contributes to exhaustion. Adrenaline and cortisol are the two most notable hormones to address here. First, adrenaline is sent out, tensing the muscles and increasing heart rate and blood pressure in preparation to run. Later in the stress response, cortisol is released, enhancing the brain’s use of glucose. This is one of our main fuel sources, so it’s no wonder this contributes to fatigue (see #2).

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You can regulate baseline levels of these stress hormones by regularly practicing yoga, breathwork, meditation, and/or engaging in aerobic exercise.[1] It’s easier to lean into these routines for relief during stress when you’ve already mastered using them during times when you feel calm.

2. Elevated Blood Sugar Levels

Fatigue is one of the most common symptoms of hyperglycemia (high blood sugar), which is shown to be associated with anxiety in diabetic patients.[2] Many people who experience hyperglycemia report feeling tired all the time regardless of their quantity or quality of sleep, nutrition, or exercise.

Although this connection has shown more prevalent and prolonged effects in diabetics, it also occurs with nondiabetics exposed to psychiatric stress.[3] In fact, for all people, the natural stress response elevates blood pressure and heart rate as well as cortisol levels, all of which increase blood sugar levels.[4] This means that anxiety causes a double-hit of exhaustion related to blood sugar fluctuations.

Instead of reaching for comfort foods like chocolate during times of stress, take a calming walk around the block. Gentle movement alone is a great stress reliever that incidentally also helps to regulate blood sugars.[5]

3. Negative Mindset

Anxiety can also make you tired because of repetitive negative thinking (RNT), which is a common symptom of anxiety. RNT involves continuous thoughts via rumination (dwelling on sad or dark thoughts focused on the past) and worry (angst regarding the future). Some researchers argue that having a longtime habit of RNT can harm the brain’s capacity to think, reason, and form memories.[6] While the brain is busy using its energy stores to fuel negative thought patterns, the energy available for these other more productive endeavors is thereby reduced.

Negative thoughts can also disrupt or prevent healthy sleep patterns, keeping our minds racing at night and effectively wreaking havoc on daytime energy. (See #7)

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Reduce these patterns by reframing your feelings over anxious thoughts. Instead of staying stuck on “what if,” focus on what you can do in the here and now. What activity can you engage in for five minutes (or more) that brings you joy? What are you grateful for, no matter what’s going on around you?

4. Digestive Issues

It’s common for people to experience both intestinal and mental issues simultaneously. This suggests a strong connection between the central nervous system and the gastrointestinal (GI) tract, which is known as the gut-brain axis.[7] Simply put, what happens in our digestive tract (and as a result of what we eat) affects the brain and vice versa.

The gut microbiota is a complex population of GI tract microorganisms. When its balance is altered, the body can develop conditions that affect the gut-brain-endocrine relationship. The endocrine system produces and manages adrenaline, for starters. And the gut bacteria’s production of feel-good hormones (serotonin and dopamine—see #5) ties into this relationship as well.

GABA (gamma-aminobutyric acid) receptors are also found in gut bacteria. GABA is a natural brain relaxant that makes us feel good by helping the body to unwind after a stress-induced neurotransmitter release (e.g., cortisol and adrenaline). When GABA activity is low, it leads to anxiety, depression, insomnia, and mood disorders. These are just a few of the manifestations that demonstrate how gut bacteria influences behavior. All of these contribute to feeling both physically and mentally tired.

You can minimize the symptoms of depression and anxiety by keeping your gut microbiota balanced with probiotic-rich fermented foods. Yogurt with live cultures, sauerkraut, kombucha, kefir, kimchi, miso soup, and tempeh are great foods to include in your diet.[8]

5. Depression

Anxiety and depression often go hand in hand. Research continues to indicate a complex relationship between depression and decreased serotonin—a key neurotransmitter for regulating mood and feelings of wellbeing and happiness. Anxiety is also a direct symptom of serotonin deficiency. Serotonin helps with healthy sleep, mood, and digestion.

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Serotonin is produced in the gut, almost exclusively, at an estimated 90 percent. However, a small quantity is also produced in the hypothalamus, an area of the brain that is pivotal for transmitting energy balance signals. This small cone-shaped structure receives and relays signals transmitted via the vagus nerve from the gastrointestinal tract. It has a central role in mediating stress responses, regulating sleep, and establishing circadian rhythms. It senses and responds to a myriad of circulating hormones and nutrients, directly affecting our mood and energy.[9]

Dopamine is another mood-boosting neurochemical that is depleted in depression. It creates feelings of alertness and wakefulness and, when the body is operating normally, is released in higher amounts in the morning (allowing for daytime energy) and lower at night (preparing for healthy sleep). Stress is one factor that can deplete dopamine, thereby leading to depression, sleep disorders, and fatigue.

Studies show that dopamine levels in the brain can be elevated by increasing dietary intake of tyrosine and phenylalanine.[10] Both of these amino acids are naturally found in protein-rich foods like turkey, beef, eggs, dairy, soy, peas, lentils, and beans.

6. Breathing Problems

Breathlessness and anxiety are closely linked, and this is one of the ways anxiety can make you feel tired. Anxiety can lead to shallow breathing, which can cause shortness of breath while feeling breathless can exacerbate anxiety.[11] It’s a vicious cycle that often leads people to take rapid and shallow breaths, breathing into their upper chest and shoulders.

This type of breathing minimizes oxygen intake and usability. Despite comprising only two percent of the body, our brains consume 20 percent of the body’s oxygen supply. Oxygen is fuel for both mental and physical tasks. When breathing patterns compromise healthy oxygen levels, this can cause considerable fatigue.[12]

End the anxiety-fatigue cycle with focused breathing exercises. It’s important to practice this regularly while you’re not experiencing anxiety or stress, as this will help you to be prepared should a moment of breathless anxiety hit unexpectedly.

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There are several different styles of breathing exercises. There’s an easy one to try, called “Resonant Breathing.” Simply breathe in slowly through your nose as you count to five, then exhale for a count of five. Repeat this for a few minutes. It’s helpful to bring your awareness to any tension, deliberately relaxing your neck, shoulders, and jaw in particular.

7. Sleep Issues

Most of the elements we’ve already discussed inherently tie into sleep issues, which is often the reason why anxiety can make you feel tired. But it’s important to note that this is not always a directly linear cause-and-effect process. Much of it is cyclic. If we don’t get enough quality sleep, we increase our risk of excessive cortisol production, elevated blood pressure and blood sugar levels, depressed mood and mindset disorders, and dysregulation of appetite/craving hormones that affect our digestive health.

Sleep is obviously the number one antidote to feeling tired as a result of anxiety. But at the same time, many of these elements—including anxiety itself—lead to less-than-restorative sleep. We can improve our energy levels by addressing each element discussed here, as well as taking a proactive approach to our sleep health.

One simple habit to help recalibrate your circadian rhythm for healthy sleep patterns is to get outside in the morning. Sunlight exposure in the early hours of the day regulates melatonin production, helping us to feel sleepy at night.

You Don’t Have to Live Your Life Anxious and Exhausted

Times of extreme stress, like driving in heavy traffic or nerve-wracking situations like public speaking, can easily induce an anxiety response. Even “normal” everyday stressors, like feeling overwhelmed with work and home responsibilities, can build up to anxious feelings over time.

Our bodies’ response to stress and anxiety affects many of its functions in complex ways. When we unravel the interconnections of these processes, we can see how each part plays an intrinsic role in contributing to fatigue. By addressing each element individually, we can make simple lifestyle changes that resolve anxiety and diminish the ways it makes us tired as a result.

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More Tips on Coping With Anxiety

Featured photo credit: Joice Kelly via unsplash.com

Reference

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