Prenatal Anxiety and Depression: The Importance of Identifying Issues Early and Tackling Them Head-On

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Pregnancy can be overwhelming. Everything is changing, hormones are fluctuating and you’re left wondering how to manage it all. You may find yourself crying in a corner one minute, and happy as a clam the next. While all of this is definitely normal to some degree, it’s important to listen to your body and your mind and to seek help when something doesn’t feel right. We hear an awful lot about postpartum depression, even less so about postpartum anxiety — but the issue that really does not get the credit it deserves is prenatal anxiety and depression. 

A study from 2011 shows that 9% of pregnant women and 10% of postpartum women met the criteria for major depressive disorders. I’d be willing to bet that number has increased since that time. The American College of Obstetrics and Gynecology (ACOG) recommends that OB/GYNs (or the nurse practitioners and physician assistants working with them) screen patients at least once during the perinatal period for depression and anxiety symptoms using a standardized, validated tool. There’s a lot to cover in those visits, and hopefully, your healthcare provider is proactive about assessing this issue.

Some common symptoms of prenatal anxiety and depression that may warrant a discussion with your healthcare provider include:

  • Persistent generalized fear or worry
  • Feeling tired and lacking energy
  • Losing interest in all the normal things that bring joy 
  • Sleep troubles
  • Mood swings
  • Difficulties with focus, concentration or memory

… sound familiar? This could probably be any one of us at any given time during parenthood. It’s tricky to know whether or not to seek treatment, but always err on the side of caution. Mental health is health, and if our minds are not straight we won’t be able to parent to our greatest potential. Additionally, it’s important to seek help in the prenatal period before baby comes, as women experiencing prenatal mental health issues are at an increased risk for postpartum depression. Consider it an investment in yourself — better to learn coping mechanisms now than to deal with this while also figuring out how a new baby works.  You owe it to yourself and to your family to put yourself first and be the best version of you.

Sure, all of that sounds great — but what can you do about it?  There are many resources out there to help. We are fortunate to live in an era where maternal mental health issues are being more widely talked about, the stigma is slipping away and resources are becoming more available. It’s not perfect yet, but it’s a start! Chances are, the mom sitting next to you right now has experienced some sort of perinatal mental health issue. You certainly are not alone. 

Talk to Your Healthcare Provider

First and foremost — talk about it! Talk with your partner, your best friend, your co-worker, and even better yet, your OB/GYN. The worst thing you can do is bottle it up inside you. It’s important for your healthcare provider to know about this and provide proper diagnosis so that you can receive the best care possible. Many healthcare groups can refer you to a maternal mental health specialist (shout out to Dr. Maria Ellswick at Kaiser San Marcos, who was life-changing for me) or support group that is covered by your insurance. It is possible that medication may be needed in addition to non-medication treatment, and there are relatively safe options out there to consider during pregnancy (note: this is generalized advice; all risks and benefits as they pertain to you should be discussed with your medical provider).

Consider Online Therapy

As we are in the midst of a pandemic, telehealth is having a moment like it’s never had before. A couple of great resources for online counseling:

  1. Talkspace Online Counseling (online chat with a licensed therapist; no insurance required) — http://www.talkspace.com/
  2. Brightside (online chat with a physician or therapist and option to consider medication) — https://www.brightside.com/

You can also see if your health insurance covers telehealth therapy visits with your healthcare coverage.

Utilize Local Resources

We are lucky in San Diego to have the Postpartum Health Alliance right here in our own backyard. Contrary to the name, they offer services for prenatal families as well. They offer screening tests, support groups and help getting you in contact with a local provider. 

Try Mindfulness & Meditation 

Mindfulness is “a mental state achieved by focusing one’s awareness on the present moment, while calmly acknowledging and accepting one’s feelings, thoughts, and bodily sensations, used as a therapeutic technique.” You can read more about mindfulness and how-to’s on our recent post.

San Diego has a lot of wonderful holistic practitioners to help with mindfulness, meditation and positive psychology around motherhood. Here are a few:

  1. Jenna Nascimiento of Feel Good Mama Hood 
  2. Denise Funfar of MomTribeSD 

PLEASE NOTE: If you ever have any thoughts of harming yourself, please utilize the following resources:

Sources: 
Optimizing postpartum care. ACOG Committee Opinion No. 736. American College of Obstetricians and Gynecologists. Obstet Gynecol 2018;131:e140–50.
Yonkers KA, Vigod S, Ross LE. Diagnosis, pathophysiology, and management of mood disorders in pregnant and postpartum women. Obstet Gynecol 2011;117:961–77.