People are paying much more attention to postpartum mental health than in years past. In addition to providing more education and screening, people are actively trying to decrease the stigma around postpartum mental health—celebrities and non-celebrities alike are coming forward with stories, organizations are taking stances and policymakers are paying more attention to mental health. We have so much more work to do, but we are moving in the right direction.
I am worried, though, that we are still not paying enough attention to the people who are suffering from depression during their pregnancies. Antenatal or prenatal depression is incredibly common: One study found that global rates of antenatal depression could range from 15 to 65%.
But we don't talk about it. We don't assess for it routinely at every prenatal visit. We don't invite people to tell us about their sadness when they are pregnant.
And if this is you, if you are pregnant and depressed (or anxious or anything else), I really want you to know that it's okay—because I worry that you don't think it's okay.
You see friends and family members suffer miscarriages and go through infertility. You watch commercials that portray pregnancy, motherhood and parenthood as the greatest possible gifts a human could ask for. You should be happy right now—but you're not. And I worry that, through no fault of your own, you have absorbed the message that being depressed during pregnancy somehow makes you ungrateful.
Please hear me: This could not be further from the truth.
Just like with postpartum depression—and every other type of mental health concern that exists—prenatal depression is not your fault. There are a host of factors beyond your control at play here. In addition to physical changes in your brain and body, research has found that psychosocial stressors contribute to prenatal depression in a significant way. This includes financial stress, single parenthood and lack of social support—things that are often out of your control.
Depression is an illness, just like asthma or migraines. My very strong suspicion is that you'd much prefer not to have depression right now. This wasn't a choice you made, it just happened. It is not fair and it is not your fault.
The other huge pieces of this are the societal factors at play that are making you feel so guilty. The commercials, the comments from friends—all that pressure making you believe that you should be delighted right now. That's not fair either. Because, even in the absence of mental illness, pregnancy can be really hard. I have made pregnancy my entire professional existence and there were many days when I did not find it to be the magical journey I signed up for.
So first, please be gentle with yourself. You are not ungrateful and or unworthy or anything else that social media has made you feel. You are a human going through an incredibly vulnerable human experience. Exhale, release the tension you've been carrying in your shoulders for just a moment and be kind to yourself.
Next, consider help. Just like with postpartum depression, prenatal depression is treatable. There are many therapists who specialize in helping people go through exactly what you are going through right now. You can ask your provider or a friend for a recommendation, or visit a website like Psychology Today. And if you are having thoughts about harming yourself or someone else you can call 911 or go to an emergency room.
Prenatal depression does not define you—but it certainly is taking its toll on you right now. It's not your fault, and you are not alone. I promise.