For many pregnant women and their partners, a discussion about emotional health quickly turns to postpartum depression. It’s the thing that every couple knows about…and every couple fears. Media coverage about new mothers hurting their children (or themselves) loom large in people’s minds, and serve to remind us that “we really need to do something about this.”

But a sole focus on postpartum depression at the exclusion of what happens in pregnancy makes it very confusing and difficult for pregnant women.

Depression and Anxiety More Common in Pregnancy

The rates of prenatal depression and anxiety are almost double those in the postpartum period. And 50% to 80% of women with postpartum depression first had anxiety or depression when they were pregnant. Yet, pregnant women who experience constant worry, frequent anger, lasting irritability, or deep sadness often don’t think that these emotional struggles are legitimate. They think it’s their hormones going crazy, or they’re having a bad day.

Why? Because there is so little information in pregnancy books or prenatal education classes about the fact that prenatal emotional health problems exist…and are experienced by many women. Also, we’re tuned in to think mostly about depression. We don’t think that anxiety or anger or irritability could be warning signs of something more.

Normal v. Not-Normal

One challenge that keeps many pregnant women and their partners from acting on their suspicions that something may not be quite right is the very real confusion around what is “normal” and “not normal” when it comes to emotional health in pregnancy. In our research, 53% of women report this uncertainty. Unlike postpartum depression, most books on pregnancy and prenatal classes don’t cover prenatal emotional health problems. When women do come across lists of “symptoms,” many don’t recognize themselves in that list. What they’re experiencing seems to be different, and it raises great uncertainty about whether they’re really struggling and need help, or they’re having a normal experience that will go away on its own.

In a Midwest US research study that interviewed women about their experience with emotional health challenges, one woman described this very thing:

We knew the … warning signs but like I said, I didn’t feel like I fit into this neat little box, I kind of had this anxiety piece that I wasn’t seeing in these symptoms so I think…I still don’t know where that fits.

This study concluded, “Though most parents came to an eventual conclusion about whether their symptoms were normal or not, uncertainty was commonly reported as part of this comparison process. For some, this uncertainty was about not knowing clear depression criteria; for others, the uncertainty was about experiencing symptoms such as anxiety that did not clearly fall within their prototype of … symptoms.”

We see this in our research, too.  Over 75% of pregnant women told us that they would not talk to their doctor about concerns about their emotional health if their partner, a friend, or a family member told them what they were experiencing was “normal.” This tells us that most women – three in every four– aren’t sure about whether what they are experiencing is real, “normal” or “bad enough.”

One woman in the Midwest study described it this way:

I remember asking [partner] and I talked to my mom about a bunch of things, what do you think, do you think that this is just winter blues or, and so we talked about it, but we didn’t think it was so bad right then that I needed to go to see a doctor. We thought it was kind of being a little down in the dumps.

This new mother was diagnosed eventually with depression.  But she wasn’t sure. Her partner thought she had the blues. Her mother thought she was down in the dumps.

Spread the Message

This is a story that we hear time and time again. Most of what we know about prenatal anxiety and depression has only surfaced in the last few years. It takes time for the message to spread, and for the public, media and healthcare professionals to get up-to-date on the fact that emotional health problems are common in pregnancy.

Spread the message. Many women will feel comforted to know that they are not alone. That one in four women suffer from anxiety, depression, high stress, frequent anger, and uncharacteristic irritability. Many partners will feel relieved to understand what is going on …. and how they can begin to help their pregnant partners. This is a message of hope.

Lana tells her story beautifully here. She does describe her own confusion about emotional struggles in pregnancy…but she ends with her message of hope.

I’d love to hear your comments and your experiences. Please feel free to share!

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Warmly,

Dawn