Why Moms are at High Risk for Depression by Hailey Shafir, LPCS, LCAS, CCS-I

Photo by Andrae Ricketts

Photo by Andrae Ricketts

Women are encouraged to talk about the many rewarding aspects of motherhood, but not the more challenging aspects, causing many moms to feel alone in these challenges. Contrary to what motherhood looks like on Instagram, being a mom is often difficult and stressful. The self-care sacrifices made by moms may be more than just yoga classes or pedicures, but also sacrifices like social interactions with other adults, sex with their partner, full nights of sleep, and sometimes even showers. Now, add up these sacrifices over the course of a month, a year, or five years. These cumulative effects may help to explain why women between the ages of 25-44 are at the highest risk for depression.  


Many women overlook the signs and symptoms of depression, mistaking these as a “normal” part of life. This is a problem because unidentified depression is more likely to go untreated. Out of the 12 million women in the U.S.who will experience depression each year, less than half will seek treatment. Untreated depression is known to put people at higher risk for other health and mental health problems, and new research also suggests it causes structural changes to the brainwhich can lead to degenerative diseases like Alzheimer’s or Parkinson’s disease. People with untreated depression are also more likely to turn to drugs and alcohol to cope, leading to higher rates of addiction. Untreated maternal depression can also seep into parenting, and has been proven to have negative impacts on children, making them more likely to experience developmental, attachment, and behavior problems.


Signs and Symptoms of Depression


Symptoms of depression include feelings of sadness and emptiness, trouble focusing, or a loss of energy, interest, or motivation in things a person used to do. Some people may also experience anxietyor irritability during a depressive episode. Some also notice changes in their appetite, eating or sleeping patterns. There are different types of depression; and many of these subtypes are unique to women, particularly women who are moms. Depressive symptoms that occur during or directly after pregnancy or symptoms that follow a woman’s menstrual cycle are examples of these subtypes. In addition to hormonal changes, stress, fatigue, isolation, and a lack of self-care are all known risk factors for depression, and also a part of daily life for many women, especially moms.


Peripartum Depression During Pregnancy


Peripartum Depression describes depressive symptoms which start during pregnancy or within the first month after giving birth, affecting 25% of perinatal women. The stress of pregnancy can include anxiety about finances, lifestyle changes, a relationship, or any of the other parts of life which will change dramatically once a baby is born. Morning sickness, complications or having a high-risk pregnancy may create additional stress during pregnancy. In addition, the fatigue, body and hormonal changes and new physical limitations can make pregnant women more vulnerable to depression. Research shows that when left untreated, depression during pregnancy increases risk for substance use, smoking, and other choices which negatively impact prenatal health. Untreated depression during pregnancy also increases the risk for serious complicationsincluding poor fetal development, eclampsia, pre-term delivery, and even spontaneous abortion. Women who notice depressive symptoms during pregnancy can be proactive by talking with their doctors about their symptoms and treatment options.


Peripartum Depression After Birth


Directly after giving birth, a woman’s hormone levels drop drastically, which can cause emotional imbalances. Many new moms will experience mixed emotions after the birth of their child- incredible joy and love paired with indescribable emptiness and sadness. When these “baby blues” last longer than a week or two, become more severe, or begin to get in the way of daily life, it is important to seek help. When untreated, postpartum depression can last months or even years, and often worsens. Also, research shows that moms who experience depression in the postpartum period are less responsive to their babies, less bonded, and their babies are less likely to hit developmental markers on time. Treatment for Peripartum Depression can be very effective, and may include a combination of therapy and medication.


Premenstrual Dysphoric Disorder


While many women describe feeling more emotional or irritable right before or during their period, some women experience a much more intense version of what is often described as “PMS”.  Premenstrual Dysphoric Disorder, or PMDD, describes depressive symptoms which consistently follow a woman’s menstrual cycle. Often, women with this disorder describe that in the days leading up to their period, they notice sudden and drastic changes in their mood, energy levels, and their ability to function. While some of the symptoms of PMDD overlap with the symptoms of depression, the most common complaint from women with this disorder is mood changes which can include sadness, irritability, or anxiety. PMDD, is suspected when women describe a consistent pattern of these mood changes showing up during their cycle or the 3 days before or after and subsiding just as quickly. This disorder can be treated with therapy or medication, which might include antidepressants or hormonal birth control.


Perimenopausal Depression


Perimenopausal Depression is depression that begins in the phase leading up to menopause. The hormonal changes involved in menopause are thought to often be a main culprit of this disorder, and women are twice as likely to becoming depressed during this time. This risk is further increased during this time for women who are experiencing high levels of stress. While woman’s body undergoes many uncomfortable changes during this time, intense and lasting sadness, anxiety, or irritability are nota normal part of this process, and often indicate depression. Women who are entering into this phase of life should be more vigilant for symptoms of depression and should act early if depression is suspected. In some cases, hormonal treatment may be recommended and in other cases, more traditional depression treatments like medication and/or therapy are indicated.


Getting Help for Depression


When untreated, depression usually does not get better on its own, and may even get worse. People who develop moderate to severe depression may experience feelings of hopelessness, worthlessness, or even have thoughts about death or suicide. They may have trouble getting through their daily routines, having to force themselves to do small tasks like getting out of bed or into the shower. Some women may turn to unhealthy escapes like alcohol or other substances, sometimes requiring more intensive treatment for addiction and depression. By knowing the symptoms and getting help early, women can decrease their risk for developing severe depression, helping them to be happier and healthier. Self-care is another important part of preventing depression, and includes making time for friends and family, enjoyable activities, and meeting basic needs for sleep, nutrition, and exercise. Moms who are proactive about self-care will be better able to enjoy parenting, without letting the stressful aspects overshadow these important years.