Antenatal depression

Antenatal depression (also known as perinatal depression) has the same symptoms as postnatal depression. Both forms of depression:

• involve serious negative emotional changes that last longer than two weeks
• stop you from doing what you need or want to do day-to-day
• are treated in the same way.

The only difference between them is when they start. Antenatal depression develops during pregnancy, and postnatal depression can happen any time in the year after your baby’s born. PlunketLine can help if you need to talk. Call us day or night on 0800 933 922.

Symptoms vary, and they might include:

• losing your joy, or feeling an absence of pleasure
• feeling sad, hopeless, worthless, and/or useless
• having little or no energy
• having abrupt mood swings
• losing interest in things that normally bring you joy
• feeling persistent worry, often about your unborn baby’s health or wellbeing
• feeling you just can’t cope with anything
• feeling nervous, on edge, or panicky
• panic attacks (a racing heart, palpitations, shortness of breath, shaking or feeling physically ‘detached’ from your surroundings)
• crying a lot
• not sleeping well, or sleeping too much
• having a poor or excessive appetite
• not caring about how you - or things around you - look
• being easily annoyed or angry with the people around you, like your partner, other children or your whānau
• withdrawing from friends or family
• finding it hard to focus, like your brain is foggy
• engaging in more risky behaviour
• thinking negative thoughts or having thoughts of harming yourself.

If you or your whānau notice any of these feelings, especially if they last for more than a few days, talk to your doctor, midwife, Plunket nurse, or Well Child provider as soon as possible. 

As with other types of depression, there’s no simple reason why some people are affected by antenatal depression and some aren’t.

It seems to be more common if:

• you’ve suffered from anxiety or depression in the past
• you have a family history of anxiety or depression
• you have a history of reproductive loss (miscarriage, infertility, IVF, termination, stillbirth), or death of a baby
• this was an unwanted/unplanned pregnancy
• you’ve experienced trauma before
• you’re normally sleep-deprived
• you have pre-existing physical issues
• you have a stressful relationship, or there’s violence in your relationship
• you had limited support from your parents when you were a child
• you’re under financial stress
• you’ve recently been through something stressful.

If symptoms last for more than two weeks, it’s time to seek support.

Depression is a treatable illness – being anxious or depressed doesn’t mean you’ve failed as a parent-to-be, or as a person.

If you’re worried:

• talk to your partner, someone in your whānau, or a trusted friend
• talk to your doctor or midwife. Your doctor will be able to talk to you about treatment options, which may include taking medicine. They should also know what support is available in your area.

If you’ve had depression or another mental illness before, you might like to think about the help or practical support that has worked for you in the past and put a plan in place for after your baby is born. You could ask other people to be ready to help you, or let people know what to look for when you start to feel low so that you can get help early.

It’s also good for your partner and other support people to know what to do if they’re worried about you, and to get advice on the best way to support you.

It’s really important for both you and your baby you get the help you need to be happy and healthy. If you don’t get help the first time you ask, ask again, or find someone else who will listen.

• Talk to other people – you may be surprised by who has experienced the same feelings as you.
• Ask for help. This is a sign of strength, you don’t have to go through this alone.

You can find out more about depression and get support from:

• PADA – Perinatal Anxiety and Depression Aotearoa 
• PlunketLine 0800-933-922
• Need to talk? (1737 free call or text)
• the Depression Helpline (0800-111-757)
• Lifeline (0800-543-354)
• the Samaritans (0800-726-666)
• Youthline (0800-376-633)
• the Mental Health Foundation of New Zealand.

Plunket also has a podcast on Parental Mental Health.

• Ask gently if they want to talk to you, or someone else, about it
• Reassure them they’re not alone. There are things that can be done to help
• Suggest that they speak to their GP, or another health professional they trust.

You may be able to access:

• depression support groups, face to face and online groups
• community mental health services
• counselling
• other appropriately trained professionals.

People generally want to help, and it’s good to let them – accept offers of support or help that you feel comfortable with.

It might help if you:

• have realistic expectations of yourself – try to take it one day at a time and accept that you’ll have good days and bad days
• have things to look forward to during the day and for the week - this could be as simple as a walk or lunch with a friend or a yummy treat in the shopping
• write down how you’re feeling. Read about antenatal depression to help you understand why you’re feeling the way you do. Keep a daily mood calendar to track your mood, and rate your anxiety level.
• look after your body by:
  • eating well – if you can’t stomach big meals, try eating small meals often. Make time to rest and relax.
  • working on your physical wellness. Deep belly breathing, planned time out, using a meditation or mindfulness app (like Headspace or Calm, for example) and going for a walk are great stress releases and can help make you feel better.