Prenatal Depression

I write a lot about postpartum depression and my ongoing recovery process. But I’ve alluded to my struggles with prenatal depression. So today, we’re going to talk about that. I have a lot of pregnant friends and talk to a lot of women who ask: how do you know if you have prenatal depression?

The answer isn’t an easy one. Just like postpartum depression, a lot of symptoms get conflated with the physiological and lifestyle changes that are occurring during these times. It’s hard to decipher between “that’s just being pregnant” and during the postpartum period “that’s just being a parent of a newborn”.

To be fair, I didn’t realize how significant my prenatal depression was until I recovered from the postpartum depression. Of course, I also didn’t realize how significant the postpartum depression was until I recovered. Depression is weird like that.

But looking back, there were some signs.

In the first trimester, I was lethargic. Sick in the afternoon and evenings, but incredibly lethargic. I didn’t want to do anything. I didn’t want to take the trash out, cook, straighten up the house, anything. Work was the only thing I could manage.

I remember one Saturday, a couple of hours before friends were going to come over, saying to my husband, “OK, we need to clean the bathroom, declutter the living room, go to the grocery store and pick up X, Y and Z, vacuum the first floor and the stairs and dust the living room. You go do all that. I’m going to lay on the couch and watch TV.”

I don’t know if this was prenatal depression. Weariness is a common symptom of the first trimester of pregnancy. But tiredness is different from just not wanting to do anything. So that’s something to watch for in the first trimester.

In the second trimester, everyone talked about how they had tons of energy, they felt good, they had that ‘pregnancy glow’.

Probably what was more telling was that in my second trimester, the lethargy continued. I do believe that prenatal depression was the culprit. This is where my pregnancy experience starts to diverge from most other women’s experiences.

I just had no energy. At all. Ever.

My office mates were more excited about weekly ‘bump’ pictures than I was.

Adding to my second trimester struggles, I was overly stressed and agitated. Now, I was working on the hardest semesters that I had in my Masters program, so it’s very possible that it could just have been the school stress, but I felt acutely like I couldn’t cope nearly as well as I usually can during high-stress times.

At first I thought the inability to cope was due to the pregnancy…but now I’m not sure. The anxiety I felt during my postpartum depression felt more like a coping problem…which resembled the feelings that I had during my second trimester. Moreover, when I finished that semester, the inability-to-cope feelings intensified, even during semester break.

Of course, I’ve written that another symptom is weight gain. I wasn’t just not exercising. I was eating. All the carbs…all the time. I was eating when I wasn’t hungry. I was eating for comfort.

Another possible symptom is a lack of bonding to my unborn child.

I tend to compartmentalize in general, so I was telling myself that I would “get excited about my baby” once I was done with school. But I don’t remember feeling any type of bond or love for my unborn child. It felt alien having something inside me, not moving and breathtaking. Admittedly, I’m not the type of person to gush about things like that, but I think I was even more detached than normal.

Sparks of excitement occurred when we went on a tour of the hospital or when I had my baby shower. But those were rare and infrequent. Plus, I now realize that my ability to look forward to things had definitely slowed and was bordering on nonexistent.

I finally broke down weeping in my OBGYN’s office at around 36 weeks when I simply felt like I could not deal with life anymore. My suicidal ideation had started and I was obsessed with fantasizing ways that I could have an “accident” that wouldn’t harm our child.

While I didn’t share the suicide ideation with the OBGYN, she and I concluded that my situation was heavily circumstantial since I was in a tough Masters program and overextended.

I think the key here is not to brush off depression because of environmental or circumstantial triggers. While an event (or events) may have triggered the depressive episode that doesn’t mean that depression can necessarily be resolved by offloading the trigger.

In my case, the trigger had kicked off a major depressive episode which got so severe that it ultimately had to be treated.

So to recap, possible symptoms of prenatal depression:

  • Lethargy throughout the entire pregnancy
  • Heightened anxiety about things you can’t control
  • Emotional eating (or unable to eat)
  • Lack of bonding or lack of excitement about your forthcoming child
  • Feeling an inability to cope with life’s obstacles
  • Feeling off, or not feeling like yourself
  • Feeling like time is crawling
  • Feeling like you can’t look forward to things or enjoy things
  • Suicidal ideation

I would caveat though that it was very difficult to see these symptoms while experiencing the prenatal depression. I did not realize the depth of how I was NOT MYSELF during the pregnancy until I was in recovery, almost a year later. These symptoms do not necessarily mean that you have prenatal depression or anxiety. Further, as I read through nearly all of these symptoms (suicide ideation excepted of course), a lot of them could just be pregnancy related.

So that’s why it’s important to be proactive, engage in self-care and be in-tune with yourself as best as you can.

I realize this isn’t as definitive as it should be, but hopefully my illustration of my experience will help other future moms be more well equipped to recognize and deal with prenatal depression.

Postpartum World_ICON_4C_Green Rattle

3 thoughts on “Prenatal Depression

  1. Thank you for this! I didn’t realize that I had prenatal depression or anxiety until I had begun to heal from the postpartum depression and anxiety as well. My OB never screened me, or talked about the risk factors that I had – even though most of them were in my chart.

    Like you, I was going through a major life change – I had quit my job to start my own business – and we put a lot of my troubles down to that. Going through a second pregnancy also showed me just how sick I was during my first one.

    I really wish I’d seen a checklist of symptoms somewhere – like the one that Postpartum Progress has, or that I’d found a blog post like yours.


  2. I totally agree. I had read one NY Times article about it. But I had no idea how bad mine was until I got better.

    I don’t understand why they don’t talk about it more at the OBGYN’s office.

    I’m sorry you went through it too. It’s so hard.


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