Perinatal Depression Can Recur—But Screening and Treatment Can Help
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Loading... - Ava Campbell
- 13 Apr 2022
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Britney Spears, 40, announced that she's expecting her third child in an Instagram post Monday.
The singer wrote in the caption that, during pregnancy, she previously suffered from perinatal depression: "[I]t's hard because when I was pregnant I had perinatal depression…I have to say it was absolutely horrible…women didn't talk about it back then…some people considered it dangerous if a woman complained like that with a baby inside her."
She went on to say that perinatal depression is talked about more now than it was during her previous pregnancies (2005 and 2006), writing: "Now women talk about it everyday…thank Jesus we don't have to keep that pain a reserved proper secret."
The post raised questions about what perinatal depression is–and whether previously suffering from it once makes you high-risk during a subsequent pregnancy. Below, what to know about the condition, including symptoms and treatment options.
Perinatal Depression, Explained
Perinatal depression is a mood disorder that occurs during the perinatal period, which includes pregnancy and up to a year after giving birth, according to the National Institute of Mental Health (NIMH).
"Anything before, during, and after pregnancy is part of the perinatal period. Even when you're trying to conceive," Tamar Gur, MD, PhD, a women's health expert and reproductive psychiatrist at the Ohio State University Wexner Medical Center, told Health. (Postpartum depression falls under the umbrella of the term "perinatal depression," Dr. Gur explained.)
Perinatal depression impacts up to 20% of pregnant people in the U.S. during pregnancy, the postpartum period, or both, according to a review published in the Cleveland Clinic Journal of Medicine (CCJM) in 2020. The condition can affect children as well as mothers: Untreated perinatal depression has been linked to imparired cognitive, social, and emotional development in the baby, as well as low birth weight, according to the CCJM review.
Past Perinatal Depression Increases Future Risk
Experts say that a previous perinatal depression diagnosis does increase your chances of suffering from it during a subsequent pregnancy. "A previous history of anxiety, depression, or perinatal depression increases the risk," Dr. Gur said. "It doesn't mean you're doomed to have perinatal depression, but there is an increased risk."
Researchers don't yet know why this is the case, Catherine Birndorf, MD, founder of The Motherhood Center in New York City, told Health. However, a woman's stress level and hormones might be contributing factors, she explained.
Research backs up the claim that if you've suffered from postpartum depression, specifically, your chances of doing so again after a subsequent pregnancy are higher. A 2017 study published in PLoS Medicine found that patients are at a higher risk of recurring postpartum depression after an initial diagnosis. Specifically, among 450,000 first-time mothers in Denmark, those who experienced postpartum depression were 27 to 46 times more likely to experience it again after subsequent births.
Perinatal Depression Signs and Symptoms
In order for a woman's condition to be classified as perinatal depression, it must last longer than 14 days and "impair a woman's quality of life," according to the CCJM review.
Some pregnant people experience only a few symptoms of perinatal depression, while others experience several, according to the NIMH. The institute lists the following as some of the more common symptoms of perinatal depression:
- Feeling sad, anxious, or "empty"
- Irritability
- Feelings of guilt, worthlessness, hopelessness, or helplessness
- Loss of interest or pleasure in activities
- Fatigue or decrease in energy
- Restlessness or difficulty sitting still
- Difficulty concentrating, making decisions, or remembering
- Difficulty sleeping (even when the baby is sleeping)
- Waking up early in the morning or oversleeping
- Abnormal appetite, weight changes, or both
- Headaches, cramps, aches, pains, or digestive problems that do not have a clear physical cause or do not ease with treatment
- Trouble bonding or forming an emotional attachment with the new baby
- Persistent doubts about the ability to care for the new baby
- Thoughts about death, suicide, or harming oneself or the baby
If you develop these symptoms during the perinatal period, you should talk to your health care provider, Gloria A. Bachmann, MD, associate dean of women's health at Rutgers Robert Wood Johnson Medical School, told Health.
"Every unusual symptom that a woman has during pregnancy, she should reach to a health care provider or family member for support," Dr. Bachmann said. "No woman should suffer in silence."
Dr. Birndorf echoed this advice: "If you notice you're not yourself, you're very distressed, or you're impaired functionally, you need to speak up."
A good first step would be calling your ob-gyn or primary care physician, Dr. Gur said. Another option would be to ask your health insurance provider for a referral to an expert, she added.
You should seek help urgently if certain symptoms of perinatal depression arise, Janelle Bolden, MD, chief of maternal fetal medicine at Northwestern Medicine, told Health. "You should seek help immediately—call 911, go to an ER, or call the National Suicide Prevention Hotline—with thoughts about hurting yourself or your baby, death, or suicide."
Perinatal depression is common and providers should warn pregnant people about the symptoms to watch for, Dr. Bachmann said: "Perinatal mood disorders are not a rare occurrence. Women should be told from the get-go that if you experience this, you should get help immediately. We have to normalize it and say this is part of the pregnancy experience."
The Importance of Screening for Perinatal Depression
Several health organizations–including the U.S. Preventive Services Task Force, American College of Obstetricians and Gynecologists, American Psychiatric Association, and the American Academy of Pediatrics–recommend that all pregnant people in the perinatal period be screened for perinatal depression. Read More...
