An Introduction To Cognitive
Cognitive-Behaviour Therapy is a combination of 2 effective types of therapy: behaviour therapy and cognitive therapy.
Behaviour therapy focuses on getting you active in your life again. The aim is to decrease behaviours that make the symptoms worse and increase behaviours that reduce the symptoms .
Cognitive therapy helps to a) identify patterns of thinking or self-talk which are upsetting or lead to negative behaviours and b) learn ways to challenge these thoughts when they arise and replace them with more accurate and fair thoughts.
The real strength of CBT is that it focuses on building skills to help people to take an active role in reducing their depression symptoms. This can help to prevent future episodes of depression. Learning and using CBT effectively requires some time, effort and motivation. In order to get benefits from this powerful treatment, people need to practise their new skills regularly. This can be challenging when severe depression is making a woman feel exhausted. Professional guidance from a mental health professional with specialized CBT training and sometimes medication can be useful to decrease the symptoms enough to allow the woman with depression to work on learning and practising her new cognitive behavioural skills.
The key components of CBT include:
- Educating and empowering oneself
- Healthy thinking
- Planning to maintain ones progress and prevent relapse.
How Can I Get Help
If you feel anxious or depressed, talk to a doctor, counselor, or therapist, and get help right away. The sooner treatment starts, the sooner you’ll feel better.
Also talk to a doctor about your overall health and any mental health issues you’ve had in the past. It’s best for your doctor to know your full medical history, in case anything comes up during or after your pregnancy.
It Felt Like A Light Turned Off In My Brain
Its unlikely that a woman who has experienced depression during her pregnancy will magically feel different once her baby is born. In fact, the feelings can continue to compound. When her son was born, Saremi says it quickly became clear to her that she was in an unsustainable situation when it came to her mental health.
Almost immediately after his birth while I was still in the delivery room it felt like all the lights turned off in my brain. I felt like I was fully enveloped in a dark cloud and I could see outside it, but nothing I saw made sense. I didnt feel connected to myself, much less my baby.
Saremi had to cancel newborn pictures because she says she couldnt stop crying, and when she got home, she was overwhelmed by scary, intrusive thoughts.
Afraid to be alone with her son or leave the house with him by herself, Saremi confesses she felt hopeless and despondent. According to Farkas, these feelings are common among women with perinatal depression and its important to normalize them by encouraging women to seek help. Many of them feel guilty for not feeling 100 percent happy during this time, Farkas says.
Many struggle with the tremendous change having a baby means and the responsibility of what it means to care for another human being who is fully dependent on them, she adds.
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Can Depression During Pregnancy Harm The Baby
Depression during pregnancy has both direct and indirect effects on the baby. A depressed mother will not take care of herself.
In severe conditions of antepartum depression, she may have suicidal thoughts and self-harm acts.
In these conditions, the baby will be adversely affected. Especially at later stages pregnancy when the baby is formed and can respond to stimuli, these dangers increase.
Babies of mothers having depression during pregnancy have problems concentrating. These children are less active and are irritable. They may keep crying or be silent. Such children may also have difficulty while learning and have behavioral problems.
Mothers who are depressed have more chance of undergoing a C-section surgery.
What Do You Need To Know About St Johns Wort To Treat Depression
St. John’s wort is an herb that some people use to treat depression. We dont know for sure how well it works in pregnant women or if it can cause problems during pregnancy. Herbal products arent regulated by the Food and Drug Administration , so there isnt much information about how safe it is for pregnant women or rules about how much you can take.
If youre thinking about taking St. Johns wort or any other herbal product during pregnancy, talk to your provider first. Theres very little information on how herbal products may affect your pregnancy.
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Natural Ways Of Dealing With Depression While Pregnant
Researches show that mothers who discontinued antidepressants during pregnancy have a relapse. This was worse than the cases where the woman continued her prescription even during pregnancy.
Depression and stress are potent silent killers. Moreover, nobody knows it that you are suffering from it!
Frequently Asked Questions Expand All
- What is depression?
Depression is a common illness that can be mild or very serious. It is more than feeling sad or upset for a short time or feeling grief after a loss. Depression changes your thoughts, feelings, behavior, and physical health. It affects how you function in your daily life. It also can affect how you relate to your family, friends, and coworkers. Depression can occur at different times of life or in different situations.
- How common is depression during pregnancy?
Depression is common during pregnancy, affecting about 1 in 10 pregnant women. Some women have depression and anxiety for the first time in their lives during pregnancy or after delivery.
- What are the signs of depression during pregnancy?
The signs of depression can seem like the normal ups and downs of pregnancy. A blue mood now and then is normal. But its important to know the signs of depression. Talk with your obstetriciangynecologist if you have any of these signs for at least 2 weeks:
Depressed mood most of the day, nearly every day
Loss of interest in work or other activities
Feeling guilty, hopeless, or worthless
Sleeping more than normal or having trouble sleeping
Loss of appetite, losing weight, or eating much more than normal and gaining weight
Feeling very tired or without energy
Having trouble paying attention, concentrating, or making decisions
Being restless or slowed down in a way that others notice
Thinking about death or suicide
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Can You Prevent Pregnancy Depression
The U.S. Preventive Services Task Force recommends that moms-to-be seek out therapy or counseling to address pregnancy depression preemptively if they have one or more of the following risk factors:
- Youre currently experiencing signs or symptoms of depression.
- You have a history of depression or other mental health conditions.
- Youre partnerless or are a teenager.
- Youre dealing with major stressors like low income or unemployment.
- Youre a victim of domestic abuse.
That said, pregnancy depression can affect any woman not just those deemed high-risk. Your provider may opt to screen you for depression during your pregnancy. The American College of Obstetricians and Gynecologists recommends screening women at least once for depression and anxiety either shortly before or after birth, so some providers might not screen during pregnancy.
That means that you should still let your provider know if you start to notice signs of possible depression whether they ask about your mood or not.
From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You’re Expecting. What to Expect follows strict reporting guidelines and uses only credible sources, such as peer-reviewed studies, academic research institutions and highly respected health organizations. Learn how we keep our content accurate and up-to-date by reading our medical review and editorial policy.
What Causes Depression During Pregnancy
Depression during pregnancyâalso known as antepartum depressionâis a mood disorder like any other form of depression. The American Congress of Obstetricians and Gynecologists estimates that as many as 23 percent of womenexperience symptoms of depression during their pregnancies.
During pregnancy, you become more sensitive to emotions, both your own and those of the people around you. This is a brain change thatâs part of the way that your body prepares you for pregnancy and is meant to help you respond to your babyâs needs. However, these hormonal changes can also affect the chemistry of your brain and potentially result in depression.
The medical community still isnât totally sure what causes depression, but certain factors can increase your risk of experiencing depression during your pregnancy, including:
- You have had depression in the past.
- Your family has a history of depression or other mental health conditions.
- You have suffered from abuse or are currently living in an abusive environment.
- Your pregnancy was not planned or is not wanted.
- Other stressful events are currently taking place in your life right now.
- You have diabetes .
- You are experiencing complications with your pregnancy or have experienced complications with past pregnancies.
- You smoke, drink alcohol, or use harmful drugs.
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How Is Depression Treated During Pregnancy
Its best if a team of providers treats your depression during pregnancy. These providers can work together to make sure you and your baby get the best care. Your providers may be:
- Your prenatal care provider. This is the provider who gives you medical care during pregnancy.
- Your primary care provider. This is your main health care provider who gives you general medical care.
- A mental health provider. This may be a psychiatrist, psychologist, social worker, counselor or a therapist.
- Your babys health care provider
Depression can be treated in several ways. You and your providers may decide to use a combination of treatments instead of just one. Treatment can include:
- Counseling, like CBT and IPT
- Support groups. These are groups of people who meet together or go online to share their feelings and experiences about certain topics. Ask your provider or counselor to help you find a support group.
- Medicine. Depression often is treated with medicines called antidepressants. You need a prescription from your provider for these medicines. You may be on one medicine or a combination of medicines. Dont start or stop taking any medicine for PPD without your providers OK.
- Electroconvulsive therapy . In this treatment, electric current is passed through the brain. This treatment is considered safe to use during pregnancy. Providers may recommend ECT to treat severe depression.
What Are Some Of The Signs Of Depression During Pregnancy
During pregnancy, your body goes through many changes. You may experience a lot of different emotions throughout pregnancy sometimes carrying you up the emotional roller coaster, and sometimes down. Its okay to feel all of these different emotions. However, if you find youre having any of the following symptoms during your pregnancy, it could be depression and you should reach out to your healthcare provider right away. Signs of depression during pregnancy can include:
- Having recurrent thoughts of death or suicide.
- Having a depressed mood for most of the day, nearly early day, for the last two weeks.
- Feeling guilty, hopeless or worthless.
- Having difficulty thinking, concentrating or making decisions.
- Losing interest or pleasure in most activities during the day, nearly every day, for the last two weeks.
If you have any of the above symptoms your provider may ask you the following questions:
- Over the past two weeks, have you felt down, depressed or hopeless?
- Over the past two weeks, have you felt little interest or pleasure in doing things?
If you answer yes to either of these questions, your healthcare provider will ask you more questions during a more in-depth depression screening test.
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Whats The Difference Between Baby Blues And Postpartum Depression
The baby blues is a mild form of postpartum depression that many new moms experience. It usually starts 1 to 3 days after the birth and can last for 10 days to a few weeks. With baby blues, many women have mood swingshappy one minute and crying the next. They may feel anxious, confused, or have trouble eating or sleeping. Up to 80% of new moms have the baby blues. Its common, and it will go away on its own.
About 13% of new mothers experience postpartum depression, which is more serious and lasts longer. You are at a greater risk if you have a family history of depression or have had depression before.
Some of the symptoms include:
- feeling like you cant care for your baby,
- extreme anxiety or panic attacks,
- trouble making decisions,
- hopelessness, and
- feeling out of control.
No one knows exactly what causes postpartum depression. If you think you have the symptoms, its important to get help right away. Postpartum depression needs to be treated. Talk to your doctor or call your local public health office.
What Leads To Mood Swings During Pregnancy
Even though various factors contribute to mood swings, the biggest culprit is a rapid increase in pregnancy hormones. During the first 12 weeks, any pregnant woman’s body ramps up the production of estrogen and progesterone, which, in turn, triggers moodiness and physical side effects like nausea and fatigue.
The thing is, there is a strong biological connection between pregnancy hormones and mood. On the one hand, progesterone is produced in early pregnancy to prevent premature contractions of the uterus. Accordingly, it can contribute to the development of fatigue, sluggishness, and even sadness. Estrogen, on the other hand, allows the uterus and placenta to transfer nutrients to the baby. This hormone is active in the brain area that regulates mood, which explains why it is associated with anxiety, irritability, and depression.
So if you wonder how early mood swings can start in pregnancy, it typically happens in the first trimester, starting as soon as week 4. Also, mood swings considerably affect the woman’s well-being toward the end of the third trimester.
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Should I Take An Antidepressant
Whether to take an antidepressant is a complex and often tough decision. The evidence on the safety of these medications in pregnancy does show some risk of potential birth defects, and also withdrawal symptoms in baby after birth. You have to weight the potential benefit to you and the baby against medical risks of taking antidepressants in pregnancy. I address this thoroughly in Depression in Pregnancy: Should You Take Medications?.
For mild to moderate depression, natural approaches can be tried first, and are often all that is needed, but women should also consider being under the care of a midwife or obstetrician and a mental health provider simultaneously.
Women with moderate to severe depression, in addition to trying these 10 tips, should be under the care of a physician who specializes in prenatal depression. Medications are an option that should be considered in severe cases, or in moderate-severe cases where your health is at risk because you aren’t able to take care of yourself but in moderate-severe cases one can often try natural treatment for a few weeks first .
The new medicine for women as I call my whole women approach to Functional Medicine, includes the best combination of available strategies for individual women, used with wisdom and common sense.
What Are The Symptoms Of Antenatal Depression
“Pregnancy is meant to be such a happy time but because we dont talk about mental health in pregnancy women dont know that it can be a very different story.”
Typical signs of depression include if you:
- feel generally down most of the time
- cant be bothered with things
- cant concentrate or make decisions
- dont enjoy life
- feel irritable and dont want to be with other people
- feel restless and agitated
- feel guilty
- think about harming yourself or suicide.
You may not have all these symptoms and they may come on gradually or you may suddenly start to feel very low.
If you feel like you want to harm yourself or feel like you want to die, its important to tell someone. This could be a family member, friend, your GP or midwife. Help is available now if you need it. You can call the Samaritans on 116 123.
“I wasnt sleeping well and Id wake up with that horrible feeling of doom starting every day. Id cry at the drop of a hat about things that wouldnt normally make me cry.”
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Can Depression During Pregnancy Be Prevented
The U.S. Preventive Services Task Force says that certain kinds of counseling can prevent perinatal depression for women at increased risk of depression. Counseling is when you talk about your feelings and concerns with a counselor or therapist. This person helps you understand your feelings, solve problems and cope with things in your everyday life.
The Task Force recommends counseling for women who have one or more of these risk factors:
- Current signs and symptoms of depression
- A history of depression or other mental health condition
- Being pregnant as a teenager or being a single mom
- Having stressful life circumstances, like low income
- Being a victim of IPV
The Task Force recommends two kinds of counseling to prevent depression for women at increased risk: