Tuesday, September 15, 2009

Prenatal Blues, Depression and Relationships

There seems to be more information available on postpartum depression (after pregnancy) than prenatal blues or depression (during pregnancy). In July 2008, I noticed unusual mood swings during my second pregnancy. The first trimester is often tiring due to the body adjusting to the baby, sleepiness, nausea, sickness, moodiness etc. I had also just completed fulltime grad school and was mentally exhausted. I got concerned because it was hard to tell the difference between academic burnout, pregnancy/prenatal blues and depression. I was also scared it might lead to postpartum depression after birth.

My symptoms of prenatal blues

I knew something was wrong with my mood swings but didn't want to talk about it. I felt run down, physically tired, nauseated, moody, sleepy in the afternoons and sleepless at night, grouchy, felt thrown off balance after grad school etc. I also felt bad I was not excited though we had planned the pregnancy and I craved a second baby. We had just put our then 2 year old son in preschool for two days a week and though feeling the blues, I still enjoyed playing with him and chatting with hubby. 

In searching for answers, I found an article in Today's Parent on prenatal blues in pregnancy. It said " But for a variety of reasons — including symptoms people confuse with other common pregnancy complaints or don’t associate with depression, a lack of education on the subject, and the stigma of mental health issues — prenatal mood disorders often go undiagnosed. Women themselves may not know something is wrong until either the fog lifts or the depression deepens and relationships buckle under the strain." 

According to the Baby Center's medical advisory board: You might be at risk for prenatal depression (stronger version of prenatal blues) if you have experienced the following: "Personal or family history of depression, Relationship difficulties, Fertility treatments, Previous pregnancy loss, Problems with your pregnancy, Stressful life events, Past history of abuse, Other risk factors. (young, single, or have an unplanned pregnancy)."


They also list the following symptoms of prenatal depression:

• A sense that nothing feels enjoyable or fun anymore
• Feeling blue, sad, or "empty" for most of the day, every day
• It's harder to concentrate
• Extreme irritability or agitation or excessive crying
• Trouble sleeping or sleeping all the time
• Extreme or never-ending fatigue
• A desire to eat all the time or not wanting to eat at all
• Inappropriate guilt or feelings of worthlessness or hopelessness

If you've experienced three or more of the following symptoms for more than two weeks, talk to your healthcare provider about whether you should see a therapist:

How did this affect the relationship with my husband?

I had a subtle attitude that let my hubby know I didn't want to talk about it. He also didn't know what to say to alleviate the moodiness because I was so touchy about the subject. I however, did not lose functionality - I still played with our preschooler and enjoyed hanging out with my hubby and close friends.

Here's what my husband did to help:
  • He took up alot more of the housework
  • He helped me avoid extra outside responsibilities - I could use him as an excuse to cancel unnecessary engagements or delegate to others.
  • He made sure I planned lunch dates with close girlfriends for some therapeutic girl talk.
  • He made dinner some nights so I would not have to smell the food - nausea, mood swings and exhaustion don't mix well :)
  • He avoided pressuring me to talk about it until I was ready to explain what I was feeling. However, I didn't just clam up - I tried to keep him updated on some of what I was thinking or feeling.
  • He pushed me to take outdoor walks near the park and a close beach to refresh my mind.
  • He played with our older son or took him to the park so I could have rest periods.
Reaching out for help

My mood lifted during the second trimester - I regained some energy and wasn't feeling as emotionally run down. This is what confirmed my self-diagnosis of prenatal blues. My mistake however was that I did not tell my Obgyn about it. I had just switched and was still feeling her out - didn't want them to send alarm bells all over my medical records.

I considered seeing a counselor but didn't get around to booking the appointment - a mistake that prolonged my anxiety over the moods. I did however talk to girl friends. If you are experiencing prenatal blues or prenatal depression, please talk to your doctor. Treatment according to the experts includes counseling/psychotherapy and/or sometimes antidepressants.

Ways to prevent prenatal/pregnancy depression - according to Baby Center:

I am a huge fan of babycenter and have subscribed to their online newsletters since the birth of my first son in 2005. Here's the list:
  • Take it easy - There's stuff to be done but taking care of you and the baby is more important
  • Bond with your partner - Your loved one cares about you. If you are in a relationship with someone who might endanger your life, please reach out to a trusted friend or call the national domestic violence hotline 1-800-799-SAFE for help.
  • Talk it out - with partner, friends & family
  • Manage your stress - Easier said than done :) Give yourself breaks, exercise even if its taking walks around the block & park, eat well - if you can keep it down :)
  • Join an online pregnant mom's group is my personal advice.
Preventing prenatal blues or depression from turning to post partum depression

This was my greatest fear because I got baby blues the first night I brought my older son home back in 2005. I couldn't stop crying because I thought the house was not clean enough, I was in pain from an episiotomy, couldn't cook and my hormones were raging. I called my angel friend Ruth and couldn't talk through the tears - so my panicked hubby talked to her and she showed up at 10.30pm! She brought dinner and stayed and talked with me until 1am - what a friend! She left her hubby and son home to be there for us. I learned my lesson about arranging for outside support when family lives far away or in another continent in our case.

Here's what I learned and did to avoid post baby depression:
  • Arrange for support before you go to the hospital - someone to help clean the house, dishes, laundry if possible. That way you'll avoid the super mom syndrome that hits right after birth!
  • Have another female available to talk to - priceless! our female friends who are mothers will gently remind us to take it easy, we have 18 years to try get it right :)
  • Allow your spouse or partner to help you - stop micromanaging what they do. They might not wipe the counter in the same direction as you do but it gets cleaned. Major in the majors and ignore the minors.
  • You are not superwoman or supermom - Its okay not to have the house spotlessly clean - the baby is not crawling yet:) Ask your spouse, friend or family to help, if not look for volunteer doulas who help new mothers.
  • Arrange for help with older siblings - To avoid feeling overwhelmed and super guilty!
  • Call that number the pediatrician gave you - if it will ease your mind, call the number or the nurses hotline and ask questions about your newborn baby. You are not the first mom to do that.
  • Take time out for yourself - have your spouse, friend or relative watch the baby while you take a long luxurious shower, watch a show you like without interruption, talk on the phone with friends or family, read a magazine, take a short walk if you can etc.
  • Join a local moms support group - its not a sign of weakness, you will get the most incredible ideas! My favorite group is MOPs International I once ran and belonged to one. There are other moms groups - checkout http://www.charmpost.com/ or South Florida Parenting if you live here in South Florida.  
 If you are currently pregnant - I hope this article helps you navigate this wonderful, exhausting, happy, moody, maddening, craving,  feeling fat (I did), glowing beautiful time in your life. Please share the tips with your hubby or partner, family, friend so they can support you.


  1. Nice blog with interesting information!! Keep up the good work Julia

    Irene and Jimmy (http://www.ireneandjimmy.com)

  2. Postpartum Depression (PPD) is the most common forms of depression that needs to be treated promptly for the well-being of both mother and baby. If not treated on time, it can have dire effects on child's development. SSRIs function as mood enhancers by raising the brain’s usage of the neurotransmitter serotonin. But SSRI treatment is not recommended for those having seizure disorders or a past of mania inclusive of bipolar disorder.


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