Depression In Pregnancy— keeping it away

When Janerose* discovered that she was pregnant, the first thought that occurred to her was suicide. The thought of a job-seeking boyfriend and strict church-going parents made the situation worse. Not only was she still relying on her parents to finance her higher education, but Eddy*, her boyfriend, had doubts about being the baby’s father.

When the situation is like this, many young girls find that they have limited options to the way out. Topping the list of their options is abortion and suicide. If they decide to take the pregnancy to full term, the emotional turmoil weighs heavily on them, and the result may not be healthy babies.

Dr, Maxwell Okonji, a consultant psychologist and psychiatrist says that if a woman harbours negative attitudes and thoughts towards a pregnancy from the beginning, there are bound to arise many mental health complications.

‘There is nothing as important as a pregnant woman getting all the emotional support she can get during pregnancy. It makes her appreciate the pregnancy and in turn care of it well.’

The Doctor talked to Pregnant’s Elizabeth Ombati on how you can use your mental muscle to handle any pregnancy misgivings.

Being positive

‘Once you discover that you are pregnant, you need to be optimistic,’ says Dr. Okonji. Positive handling of a pregnancy is one of the surest ways of carrying it to full term, minus health

He adds, ‘Stress and worry, which are bound to accompany the numerous emotional and physical changes that come along with pregnancy, can lead to depression.’  Depression, particularly during pregnancy, often drains your desire and energy, which can prevent you from seeking appropriate prenatal care. Depressed pregnant women are more likely to abuse alcohol or drugs during the term. When it is most severe, depression can lead to self-harm and even suicide.

Are you depressed?

The following are signs that you may be a victim of this dangerous condition:

o Persistent feelings of sadness, self pity and hopelessness during the pregnancy. The feelings could be accompanied by difficulty in sleeping or oversleeping, weight loss or change in appetite, irritability or mood swings; difficulty in concentrating, uncharacteristic or bizarre behavior, and thoughts of self-harm.
o You may notice that you have become unusually hostile and fighting with your spouse—often with no prompt. If you realize that it is going overboard, talk to your spouse so as to visit a counselor.
o Are you feeling as though you could do without the pregnancy at that time? Is it a reason that is constantly making you angry? If the answer is yes. you may be depressed.

What are the chances of one suffering from depression during pregnancy?

Having a mental condition before pregnancy makes depression more likely during pregnancy. Again, if during a previous pregnancy a woman showed signs of depression, chances are high that when she falls pregnant again, it will recur.

Is it safe to carry on the pregnancy?

In cases where depression is severe, termination of the pregnancy may be called for. This is purely on medical grounds. When the woman is so distressed and is hellbent on taking her own life, the pregnancy has to be terminated.

This usually happens during the first three months. Termination, is however as a last resort, after other modes of treatment have failed.

Do mood changes pose a threat?

In the first three months of pregnancy, it is not unusual for a pregnant woman to have to experience nausea and vomiting. These are normally very frustrating to the mother, particularly if it’s the first pregnancy.

During this time, it is normal to have mood changes like touchiness and irritability. Over-friendliness to certain people and nastiness to others is a normal occurrence. This happens to a varying extent and not to all women.

After the third month or so, those early signs of pregnancy and the mood changes disappear. The middle trimester, from four to six months, is a stable time for most women, with little or no problems during that time. The second and third trimester present more mood changes as the mother begins to feel the baby and in turn prepares to receive her.

Mood changes are quite normal and do not pose any threat to the pregnancy. However, in case you as a woman notice that the moods border on the extreme, then it is recommended that you talk to a counselor.

* Not their real names.

Treating Depression

Medication for depression—antidepressants—has many side effects on the forming baby particularly during the first three months and has to be monitored keenly. Careless intake of anti-depressants has been associated with malformations, risks of preterm labour or miscarriage. They should therefore be avoided in pregnancy. The medication can also find its way to the baby as it passes through the breast milk.

Psychotherapy is a recommended treatment for depression during pregnancy because it is safe and healthy for both mother and baby. It works to find out the root cause of the depression as it can help you deal with feelings of sadness, guilt, and worthlessness. It is unfortunate that because of these mood changes there may be distance and rift between a couple.

Getting emotional support for a pregnant woman is very important. As the partner, you should go out of your way to be as supportive as possible even if her demands may at times look unreasonable.

Are cravings tied to mental health issues?

It is documented that during pregnancy, women crave all kinds of things, the commonest in Kenya being soil or some form of rock. It is not clear why the craving is there but it is thought that it is something that comes as we evolve. This is the body’s way of trying to replenish elements which it may lack. It is not uncommon during pregnancy for the body to demand elements like iron and folic acid. The body may be sending signals that it needs these elements.

This is also seen in lower animals that act the same. It is possible that this craving that we see may be a part of the body trying in a primitive way to make sure that any deficiencies in the body are taken care of.

Hence, it is not necessarily related to any mental health concern.

END: PG 16/42-43