After the birth of my first child, I white-knuckled my way through postpartum depression (PPD) by convincing myself it was just a bad case of the "baby blues" that would eventually disappear. As a result, it took months before I was properly diagnosed and able to start treatment. Years later, when I found out I was pregnant with my son, I assumed I'd be better equipped to handle any mental health difficulties during those 40 weeks of change, growth, and discomfort. I was wrong. So, please, can we start taking pregnancy depression seriously? Because contrary to a dismissive popular belief, it's not just hormones.
According to the American Pregnancy Association (APA), between 14 and 23 percent of women will struggle with symptoms of depression throughout their pregnancies. Since depression affects 1 in 4 women, it shouldn't be a surprise that pregnant women can get depressed, too. In fact, according to the American Congress of Obstetricians and Gynecologists (ACOG), one in seven pregnant women will be diagnosed with prenatal depression.
But thanks to an often filtered version of pregnancy (happy, glowing mother who smiles constantly and loves to discusses the joy of impending motherhood), many women feel uncomfortable talking about their less-than-stellar feelings. I, personally, didn't pay attention to the accumulating signs of my deteriorating mental health when I was pregnant. Instead, I convinced myself that it was an influx of relentless hormones and that, eventually, I would feel "back to normal" again.
I was also afraid that despite how incredibly common depression and postnatal depression are, I wouldn't be taken seriously or, perhaps even worse, I would be judged for not being that picture-perfect, happy pregnant person. What if someone assumed I'd be a bad mother because I was depressed? What if people would start thinking I didn't love my unborn baby? What if people thought I had made a mistake getting pregnant in the first place?
According to Healthline, estrogen and progesterone are the two "main" pregnancy hormones. These hormones allow the uterus and placenta to "improve vascularization, transfer nutrients, and support the developing baby." There's a surge of estrogen levels in the first trimester, which causes morning sickness and nausea, and by the second trimester the hormones help a pregnant woman's often enlarged breasts develop milk ducts. The hormones also help your body loosen ligaments and joints to prepare for childbirth, and assist in transforming the uterus from "the size of a small pear" to a size that'll accommodate a full-term fetus.
While most people assume pregnancy is the "happiest time in a woman's life," I was left feeling alone, isolated, and guilty.
According to the AMA, a surge in hormones can also affect the chemicals in you brain that are directly related to depression and anxiety. However, blaming hormones for clinical prenatal depression and dismissing a woman's depression altogether does nothing but exacerbate the problem. And hormones alone are not to blame. The APA goes on to say that triggers for depression during pregnancy can include relationship problems, family and personal history of depression, infertility treatments, previous pregnancy loss, stressful life events, pregnancy complications, and a history of abuse and/or trauma.
As a pregnant woman, I felt like I shouldn't, and couldn't be anything other than happy during those 40 (more or less) weeks. It was as if carrying a fetus should've magically shut down the parts of my brain that contributed to my depression and anxiety. But that's not how science works. That's now how brains work. That's not how depression works. So while most people assume pregnancy is the "happiest time in a woman's life," I was left feeling alone, isolated, and guilty. I chose to close off completely instead of open myself up to untold levels of shame and stigma.
I knew that my pregnancy would trump my humanity, especially when discussing my declining mental health.
That shame and stigma was overwhelming when I was postpartum depression after my daughter was born. It was damn-near impossible to stomach when I became pregnant a year later and suffered through a miscarriage. It was disheartening when I suffered through months of infertility and a surprise diagnoses if polycystic ovarian syndrome (PCOS). It threatened to derail my life when I suffered yet another pregnancy loss. And still, when I found out I was pregnant with my son, I was too afraid to come forward and discuss my symptoms. I knew it would be dismissed as an irrational fear or some oversensitivity or hysterics. I knew I wouldn't be taken seriously and that people would tell me I should just be grateful. I knew that my pregnancy would trump my humanity, especially when discussing my declining mental health.
Dr. Gabby Farkas, a New York-based therapist specializing in reproductive mental health issues, tells Healthline that patients often confess to those they care about and receive an overwhelming lack of understanding and support. "Family members tell them to ‘shake it off’ and get themselves together," she says. Farkas stresses the importance of normalizing these discussions as a way to combat these unhelpful responses, and I couldn't agree more. If my loved ones would've stopped dismissing the signs of prenatal depression, or took it upon themselves to bring it up to me first, maybe my pregnancy would've been a more joyous time. Maybe I wouldn't have felt so alone. Maybe I would have put more value into my own mental health and wellness.
Luckily, in 2015, ACOG issued new guidelines suggesting all pregnant women have a depression screening — particularly if you have a history of anxiety and/or depression like me. Luckily, as more and more people open up and discuss their mental health without shame, the stigma of mental health related diagnoses and treatments is slowly, but surely, being chipped away.
Luckily, more and more of us are realizing that we're not alone.
Check out Romper's new video series, Bearing The Motherload, where disagreeing parents from different sides of an issue sit down with a mediator and talk about how to support (and not judge) each other’s parenting perspectives. New episodes air Mondays on Facebook.