Do I have antenatal depression?

This is a post about anxiety and depression. It might be triggering for you if you’re currently struggling with your mental health. If you read this and it strikes a chord with you or you think you might need help – please see your midwife or GP or if you’re in New Zealand call Healthline on 0800 611 116. This is just my journey, every one has a different journey. It’s scary to post this publicly so please consider that before you comment.

I wanted to write this post because the post I wrote last month about my journey through antenatal depression (also known as prenatal depression) has seen my inbox fill up with emails from parents and the people who love them.

I’m grateful for every email and message and tweet and Facebook comment I get about my posts. I feel particularly honoured that parents want to share their experiences with me – especially on a topic as painful as this one.

Most of the emails I get ask two questions:

Do I have antenatal or prenatal depression?

and

Does my wife or friend have antenatal or prenatal depression?

To catch you up, if you didn’t read that first post, I believe I had mild antenatal depression with my first pregnancy, but I had severe, diagnosed, antenatal depression and anxiety with my second. It was devastating and debilitating, and to this day, even though I know it was an illness that I didn’t cause – a horrible bolt of lightening that I just had the no-good luck of walking under – I feel terrible guilt. And I work really hard to remind myself that this guilt isn’t helping anyone.

Antenatal depression is a thief. A thief of joy. While other mothers feel full of hope and wonder and anticipation when they’re pregnant – mothers with antenatal depression often feel a sense of dread, desperation and fear. There is little celebration in your body changing, the swell of pregnancy, every curve and stretch: It feels more like a wake.

I wanted to be pregnant more than anything in the world. Yet when I was pregnant I felt out of control, overwhelmed, unable to keep my hormones and emotions in check. After four years of trying to get pregnant with my first I wondered why I felt so dull around the edges. Why I wasn’t more euphoric like I imagined I’d be. My second pregnancy was far worse.

Pregnancy is physically tough. And we don’t talk about that enough. But the mental stuff? We don’t talk about that at all. And I think it’s fear – fear that by talking about it we will reveal that we are bad mothers from the outset, before we even get a chance to be mothers.

But that’s not true. And it’s not fair. Would you say that to someone you love if they became physically unwell during pregnancy? You wouldn’t. But the stigma in being mentally unwell is strong. When I first published that post on my antenatal depression I felt terrified. I was so anxious. What would my friends and family say to me? Would people attack me? Suggest my children should have been taken away? My fears were unfounded, and something else happened too…

I started getting emails and messages. Stories from women who had suffered in silence but also those who were suffering now. And needed help. I read emails from women and their partners talking about how they’re going to get help. And that made me realise it’s important to share (seconded by lessons from earlier this month).

So – I want to answer those questions. And talk about ways you can support pregnant mothers and see early warning signs that could be antenatal depression. I’m not a mental health expert – and I would love to run a campaign with a group with that expertise. But in the absence of that, I thought I’d just write about my experience. And this is JUST my experience – I’m not giving medical advice here. I’m just saying, if you read below and recognise yourself or a friend, reach out to them or a medical professional. Please, please reach out.

If you’ve been through it – please share (if it’s not too painful for you) in the comments so others can see what depression looked like for you. You could save a life.

This is what antenatal depression felt and looked like to me:

Anxiety – I felt really anxious through most of my pregnancy. Often we think of antenatal depression and postnatal depression as just about being ‘sad’ or having ‘the baby blues’. Anxiety is very rarely talked about. It’s a HUGE part of antenatal depression and can also sit on its own outside of depression. If you’re constantly worried and fearful and your mind is racing over possible things that could go wrong – it could be anxiety. It’s normal to worry about labour, or worry about sleep once baby is here, or whether you can breastfeed. It probably isn’t normal to worry about having a stillbirth most days, or worry that you’re going to die in labour a lot. Which leads me to:

Catastrophic thinking – If you’re lying in bed till 2am imagining your husband trying to cope with raising your child on his own because you’re convinced you’re going to die and your baby is going to die, that’s a bad sign. Catastrophic thinking is thinking the worst but it is that – magnified. When the baby didn’t kick, he was dead. When he kicked too much, I imagined he was choking, when I had a cramp, I was dying. Not being able to reign yourself in and say “I’m being silly, it’s probably fine” is a sign of catastrophic thinking which is a symptom of anxiety, depression, and other mental health conditions.

Anger – I felt very angry a lot of the time. I had an incredibly short temper with everyone around me. I felt positively hostile for a lot of my pregnancy. It’s understandable when you’re exhausted and having physical symptoms from pregnancy to get pissed off with people. But rage could be a sign that maybe things aren’t right.

Dulled senses – I often felt like I couldn’t feel anything when I was at my worst. I felt like I was in a fog. Like my life was in slow motion. I wasn’t excited about anything. Good news didn’t feel good. Bad news didn’t even feel bad. I just was. I was in a room but I wasn’t present. Numb. I couldn’t feel much of anything. And I didn’t feel particularly connected to the baby growing inside me. This was a sign for me that I was unwell.

Guilt – Feeling guilty all the time is a sign of depression. Being convinced you’re already a bad parent isn’t healthy.

Listen to the voice in your head and if she’s talking shit – stop her.

Do you ever say any of the following statements?

  • I’m never going to be a good mum
  • I’m already a bad mum
  • There’s something wrong with the baby
  • There’s something wrong with me
  • My partner is going to leave me
  • I’m going to ruin my family
  • My life is going to be destroyed by having a child
  • I’m terrified of labour
  • I’m terrified of being a mother

There are heaps of normal questions parents might have when their lives are about to change – but it’s the language and weight of those questions that you should keep an eye on. Being a bit scared of labour is normal. Feeling incapacitated because you’re so terrified of labour that you can’t even think about it without getting a racing heart or crying isn’t.

Thinking about what kind of parent you want to be is normal – and good (really good)! Knowing you’ll be a bad parent – not good. Because you don’t know. And it’s hard to recognise that. I had a child, and while I don’t think I’m the best parent out there, I do OK. My son (an only child then) was happy, healthy, loved (still is) – so I had no reason to totally believe with all of my heart that my family was better off without

Antenatal depression is common.

There’s nothing wrong with you if you have it.

Think about all of the hormonal changes you have during pregnancy – oestrogen and progesterone rise and rise and rise. Think about the deficiencies in minerals such as iron and zinc that you have – how your midwife is always telling you to take this supplement or that one.

Now think about all of the very real things you have to worry about when you’re pregnant – can you afford to raise a child? Do you have support? That’s just the practical stuff before you get into – what kind of parent will I be? When we are pregnant we think about the way we were raised and any baggage from that we might have – of course if you’ve been abused, you can be triggered just by thinking about childhood as a concept. Infertility can trigger depression. Your workplace might be shitty – you might not have job security.

When we are pregnant we have everyone giving their opinion on anything. You can’t smell a coffee without someone saying caffeine causes this or that. Did you look at sushi? DON’T YOU CARE ABOUT YOUR UNBORN CHILD? People want to touch you. They tell you horror stories about pregnancy, labour, parenting.

Add to this – the physical. I vomited every few hours. My depression was probably caused by (or at least severely exasperated by) lack of sleep. I vomited every two hours. There wasn’t much to enjoy to begin with!

Is it any wonder that this is a time when our mental health is at risk? Of course not. Be kind to yourself!

Antenatal depression affects one in eight women. You’re not alone.

It will feel like it. And it’s scary and horrible to ask for help. I really thought my kids would be taken from me when I asked for help. But I’m so glad I reached out.

If you’re reading this and you recognise these symptoms as your own – talk to your midwife or GP. If you recognise them in your partner – talk to them. Ask them about how they’re feeling. Suggest seeing your GP or Midwife together.

imageWhat’s the worst that can happen?

What’s the worst that can happen if you don’t get help?

I got help and I got better. Way better. Really quickly. I’m stronger now for having gone through this. And it wasn’t the terrifying ordeal I thought it would be. I wasn’t taken away by force. My children weren’t taken from me. I wasn’t sedated. I recognise my privilege in this – and that I live in a country with free health care and I think a good maternal mental health system (at least in Wellington – my experience was positive).

Treatment for me was simple and easy and didn’t take long. There are lots of ways you can immediately begin to treat antenatal depression – my only regret is I didn’t do it sooner. As soon as you start to notice any of the symptoms above, talk to your midwife. Nip it in the bud. If all of the symptoms strike a chord with you, it’s not too late to get help. Even if you’re in your last week of pregnancy.

Get help. You’re worth it. You matter.

***

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  1. It took me weeks to get the courage but I finally asked my mum to come over and I told her I thought I had antenatal depression. She told me there’s no such thing and I should just feel lucky I was pregnant as lots of people can’t be or they lose babies. I was devastated by what she said. That night I tried to kill myself. Thankfully I didn’t do it right and I survived and my baby survived. I began treatment while recovering in hospital. I am so glad my daughter and I made it and I wish I’d sought help sooner. Thank you for writing this.

    • I am so glad you made it. I am so glad you got help. I’m so sorry your mother didn’t help you. Your experience is a reminder about how dangerous those words are – and I’ve heard them so often, seen them in comments on articles. People need to understand what they’re doing when they say these things. Arohanui x

  2. My first pregnancy I wasn’t depressed, but I wasn’t comfortable with it. I was in pain most of the time and I was scared of what a baby might mean for me. I had been ill a lot of the preceding decade and I’d only just got a career going in a small way. And I have never been that pleased to exist and was afraid it was wrong to make someone else do so. I was irrationally afraid my partner would leave, too, when he found how hard babies were. This would have been very out of character for him, but the idea kept intruding.

    The birth was awful. The next six months were awful. My baby was wonderful. Once I got over the PND I started thinking about another baby, because my child started asking for a sibling as soon as she could talk.

    I became pregnant when my child was 4 and a half. Right away, I was terrified – of the birth and of the sleep deprivation, mostly. I just didn’t have the resources in me to handle the prospect of either.

    After a few weeks of terror, I drove to the doctor. I wasn’t in a good state, and I wasn’t sure I’d be able to get help, or even explain the problem. I tend to present as fine to doctors even when I’m not.

    There wasn’t much parking and I had some difficulty finding a park. By the time I’d found one on a quiet side street I was in floods of tears. I couldn’t see to park, so I double parked and sat there with my hazard lights on for a little. I didn’t know if I’d even get to my appointment, because I had no way of leaving the car.

    At this point, things got better. A woman passing by saw me and knocked on the window to see if I was OK. She saw that I wasn’t and got another passerby to park my car. She walked me to the doctor and handed me over to a nurse, who recognised me and stayed until I could breathe properly again and talk. The doctor saw me even though I was now very late, and he put me into the free maternal counselling system at once. The counsellor was very good at her job and gave me a heap of tools for dealing with things.

    • Thank you so much for sharing M, your story made me tear up. I’m so so glad you got help. I’m so sorry you went through what you did. Sharing will help others, thank you for opening up to us and telling your story. Arohanui X

      • It was amazing how once I actually tried to get help, the help came. Even though I hadn’t actually made it into my appointment.

  3. Oh god, by this brings back memories. First pregnancy I knew I was depressed but GP shrugged it off saying he had never seen antenatal depression before. When I arrived home with the baby, it was like somebody had raised the light levels. I could see bright colours again. Second pregnancy was worse with earlier onset of depression but I got through it. Third pregnancy was a disaster. I couldn’t be in the company of more than two other people or I cried. I was an acute insomniac and paralysed into inaction. If I could get to the end of the day with dinner cooking by the time my husband came home and the two little ones in the bath, that was a good day. I ended up heavily medicated but had to stop taking it three weeks before due date, on medical advice. I could not complete the pregnancy, was induced early and when that all went wrong, had an emergency cesarean. Our son was born heavily drugged and ended up in neo natal unit.

    My guilt at what the baby went through was huge, along with fear when he was slow and relatively unresponsive in the first few weeks. I remember the huge wave of relief when he smiled.

    It wasn’t until I read an article on antenatal depression that it made any sense – not unusual, it said, especially in older women carrying bigger babies and typically gets worse with subsequent pregnancies. Yup. All that even though all our babies were planned and wanted and I started in good health. With hindsight, I was lucky that the depression went as soon as the babies were born and I was articulate enough to tell people that I was depressed and not coping though few offered practical help. The experience opened my eyes to the reality of depression many others suffer – at least mine had an end point. How much worse must it be when there is not that natural endpoint of giving birth?

    It is great to see more awareness of ante natal depression and that there are better treatment options available.

    • Thank you for sharing Abbie. I totally understand what you mean about arriving home. It was like the second I had my baby I was fine (though this isn’t always the case – antenatal depression can be a precursor to full Postnatal depression). I’m so sorry you had such a difficult second pregnancy. Now I know if I ever do this again I’ll get help from day one – as it does seem to get worse for subsequent pregnancies.

      You are so right about the struggle people with chronic depression face. Thank you for making that point and thank you for sharing x

  4. This is such an important post. Thank you.

    I also had antenatal depression, and I don’t have a lot to add about my symptoms because my experience of it was very similar to that described above. I just wanted to add that, if you have AND you are at a higher risk of PND too. I know that this sounds so obvious but at the time I didn’t make the connection and just thought things would improve after the birth “when my hormones all sorted out” (ha!). I subsequently had PND too. I’m not trying to say this to scaremonger, as I know if you’re struggling in pregnancy then more anxiety is not what you need. I guess I am just trying to say, please be vigilant if you or someone you know suffered from AND, and don’t wait to get help. I know it’s tough to talk about, but you’re not alone.

  5. I was quite anxious when I was pregnant – but I’d literally been coming out of a SAD depressive episode (my first proper depression episode since I was a teenager) when we conceived. The baby was due in October (she’s one today!!) – I was concerned about a repeat. Also, my husband had been diagnosed with bipolar II disorder a year before that, and we’d had a hellish year as a couple (almost definitely contributing to winter making me want to kill myself, rather than just hibernate). He hadn’t had the mental energy to be the kind, caring man I loved, and a year of snarling and put-downs (because why say ‘I really don’t want to talk about this, please can we change the subject?’ when you could say something deliberately cruel to shut up somebody who loves you instead?) meant I started 2014 thinking it was the year I was going to file for divorce. And then I was pregnant. And he said congratulations when I told him, and didn’t seem displeased – but also told me he wasn’t interested in babies, and didn’t want to be at the birth. He came with me to most of my scans, looked after me in practical ways, and was actually a fantastic support during labour but things really weren’t right still, and I really didn’t know if I’d be doing it on my own or not. In a lot of ways, actually, I got a double whammy a year ago: a wonderful daughter, and the man I married back. He is a brilliant, loving father – our little girl adores him and it’s mutual, and he’ll actually be looking after her in the day when I’m back at work (at present he’s typically out of the house over 90 hours a week, either working or commuting, so it will be great for them to be able to spend more time together, and for the most part I kinda have been doing things on my own since he bought a business in March).

    My GP arranged for some counselling sessions for me, which really did help. I wanted couples counselling – I do periodically still think it wouldn’t be the worst idea – but he kept on arguing he thought it would be easier to go to sessions after she was born, which made no sense to me, but you can’t really do couples counselling on your own…

    Pregnancy can be a very anxious time – you want to feel secure within your relationship with the father, whilst knowing that most of the literature says nothing puts a strain on them quite like having a small, sleep destroying, time-monopolising darling in your lives. You don’t know how you’ll cope, how they’ll cope, etc. Even if people think that their concerns are genuinely things it makes sense to be anxious about, rather than anxiety, it doesn’t mean that counselling can’t help, or that getting help isn’t a good idea. Because mental health issues are so common alongside pregnancy and early days, there is help and support readily available. Nobody’s going to judge you for taking it up. And not working yourself up into a tizzy of knots is better for everyone!

  6. Thank you, thank you, thank you! My first pregnancy was rough – lots of complications including HG for the entire 9 months, (wrongly) diagnosed macrosomia, PGP and the list goes on. I never once felt happy or confident or any of this “mother earth” “pregnant goddess” portrayed in society. I never connected with the baby, hated every single minute of being pregnant, which in turn made me think I was a bad mother, and was incredibly anxious about the future. I never “glowed”, I never spoke of the future, I was a mess. Every time I tried to speak out about it people would tell me ‘shhh, the baby can feel that anger’ and I turned in on myself. My midwife poo pooed it whenever I brought it up and I put it down to the complications. It is only through the strength of my husband that I made it through that pregnancy – there were very, very dark days. When baby was born it was like a veil had been lifted and I could not believe the very same people that had told me I was fine when I was pregnant all of a sudden were telling me I was glowing and looked amazing.

    Five months after my daughter was born I (HUGE SURPRISE) got pregnant again. All the same complications compounded by the fact that it was an unexpected pregnancy and I got very depressed. Fortunately I had a new midwife who took my concerns very seriously and put in place fantastic strategies for me. While I was still anxious, I was able to see light and, while the second pregnancy was tougher physically, I was able to get into a much better space mentally which made it easier.

    Thank you so much for raising this. For everyone going through something similar, speak out. Keep speaking out until someone listens to you. Be the squeaky wheel. You deserve it. Your family deserves it. You are not alone.

  7. Thanks for posting about this Emily. I have never heard of ante-natal depression before but for sure I will keep an eye out for it in the pregnant women I know from now on.

  8. Thank you for this post & your article on antenatal depression! I’m so glad you’re talking about this as I’ve found hardly anything online about it and really wish it was more known. I have recently had my second baby and I’ve been going through this. I was officially diagnosed with severe antenatal depression & anxiety at 22 weeks pregnant but I had it very early on in the pregnancy. At about 12 weeks in, I had thoughts of not wanting the baby (was originally happy about it) but I felt I couldn’t tell anyone including my husband. I spent the next month or so very withdrawn & could barely function (let alone look after a toddler, study & work part time!). At 16 weeks I broke down to my midwife & she recognised the issue & said she would refer me to the maternal mental health unit. Unfortunately she didn’t do this for 6 weeks (!!) and my health deteriorated rapidly. While waiting for the referral, I managed to get myself to my GP for help as I was scared of harming myself & like many have said they felt their families would be better off without them. Once under the care of my local maternal mental health team I have improved hugely with medication & weekly counselling and thankfully have a great bond with my little boy (but I was very scared this would not be the case). However I still face a near daily battle with this awful disease.
    They have said my depressive episode is likely to have been caused by undiagnosed post traumatic stress disorder I got my from the birth of my first child (she had to be resuscitated due to cord prolapse). Apparently a prior traumatic birth is a common cause for antenatal depression.
    my symptoms included: not wanting to talk about the baby; strong feelings of not wanting it; harmful thoughts to myself & the baby; brain fog (felt like half my brain was missing!); extreme physical tiredness; crying a lot; thoughts of not being able to cope with a second child; wanting to run away.

    I feel huge guilt over all the awful thoughts but try to remind myself they show how sick I was as this was never anything I have felt before. The force of the mental & physical symptoms have shocked me & when I go “down” the consuming nature still blows me away. A lot of my anxiety lifted once my baby arrived as I made preventative decisions in regards to the birth/coping with the PTSD in mind – I had an elective c-section & didn’t breast feed. These amongst other strategies have helped manage the stress but the depression still exists. Thankfully I know I’m getting better though.

    Thanks again Emily, for speaking about this publicly as it so needs to get out there. For anyone who may/have this or knows someone who could have symptoms, as others have said – please speak out! It is not your fault, this is a disease! If it was a physical illness we would seek help without fear. It took me some time to realise what was going on with me but eventually with the right support I’m getting well again.
    Please don’t go through this alone.

  9. This is a great post – thank you so much for sharing. I imagine PRE natal depression is not too much talked about. I suffered with Post Natal depression after both of mine. and ended up in a Mental Hospital the 2nd time. Thanks for posting this. I am sure its helped people.

  10. I don”t know if I have antenatal depression, but I feel like I do…. I am 36 weeks in 2 days pregnant, about two week ago, I woke up having anxiety attack , my emotion went all numb, I was so scare because I lost my emotional toward my husband all of a sudden. This is my first baby btw , I was so excited about the baby first few month but I do have stress about if I can take care of the baby because I am still young and I don”t know I am ready….my husband is working part time , so when he work I am all alone, and I don”t really have friend to vent my feeling to , my family aways busy. This pregnancy is really stressful , I am always worried about the baby, counting kicks. My due date is almost near I feel like I can”t handle this anymore I am always depress when I wakeup , just want to sleep all day…. And I am so scare every day because my emotional is gone toward my love ones, we were so happy two weeks ago too… What to do….

    • Oh Sindy! That sounds so hard! Have you spoken to your midwife about how you’re feeling? Or your partner? I think it would be a really good idea to talk to someone. There are some fears that are normal but some of your other worries you might need some help to get through. And there’s no shame in it. In terms of friends – did you do an antenatal class? Could you speak to Plunket about taking part in a Plunket in Neighbourhood group? Assuming you’re in New Zealand? If you’re in Wellington – you could contact Mother’s Network. There are a lot of places you could go to to meet some mums. It’s really hard without mums to help you through. Are you on Twitter or Facebook? They can also be a good source of support. Arohanui, I hope things work out.

  11. Hope you don’t mind me asking but what did you do to get better? I’m 12weeks and had a terrible month. Been to see GP today and I’m back on anti-dependants.

    • I asked my GP for a referral to Maternal Mental Health. I told close friends and my partner about the referral, too. MMH provided therapy sessions for me, which I found surprisingly useful, given how unhelpful I’d found counselling at other times in my life. The sessions focused on working out what was causing me to feel overwhelmed and then taking concrete actions to make things easier. I’d been taking a lot of responsibility for things I couldn’t control, in my mind, and that was making me panic. I have considerably better boundaries now. Antidepressants can be amazingly useful, so I hope they help a lot, and I hope you are able to get any other support you need too.

  12. I don’t mind at all Rachel. I went to my midwife then GP and was then referred to Maternal Mental Health. They did an assessment and decided therapy would be the best thing for me. So we did intensive therapy to prepare for the arrival of the baby and address my fears and anxieties. Some people have anti depressants or anti anxiety medication instead of or including therapy, some have in patient care, the psychologist at MMH will look at what you need and work with you to treat the symptoms and cause X best of luck, it’s so hard.

  13. After reading this I knew antenatal depression is what I had. I wondered why everything looked gloomy, and i would have these moments where it would seem like the lights came on. short lived and back to downer face. it was awful.

  14. I asked for help from my midwife 2weeks ago. I burst into tears in her office.
    The anxiety I feel on a daily basis is crippling. I haven’t enjoyed this pregnancy and yet I’ve longed for this baby for 8 years. I worry about the impact my mental health is having on my wee boy. I’ve developed gestational diabetes and worry about him with every mouth full of food I take. I worry that I’ll feel nothing when he’s born and placed in my arms. Every joy I should be able to feel, I can’t. I have a history of depression, and 18yrs ago when my last child was born, I battled post natal depression.
    You just know. I knew I was slipping and didn’t want to land back in my black hole of darkness. It’s comforting for me to know that my midwife is aware. I’ve already had a call from a mental health facility and am being referred to maternal mental health. I’m 3 weeks away from being induced. I’m hanging in there. And there’s nothing to feel ashamed about. And there’s no shame in asking for help.

  15. Boy has this post struck a chord with me. I am 17 weeks pregnant with a much-longed-for second baby through IVF and not an hour goes by without me worrying and anxious about some detail or symptom that my mind has convinced me will take this baby from me. The lights feel like they are permanently out and even the amazing joy that my toddler gives me is becoming dulled by the constant worry hanging over me. I had anxiety in my first pregnancy, but not like this. I am going to talk to my doctor tomorrow about MMH. Thank you Emily. Hearing about the experiences of others has reminded me I”m not losing my mind. Well not totally anyway.