17 Things All Pregnant Women Should Know About Prenatal Depression

First of all, you're not alone.

You've probably been told a million times that pregnancy is supposed to be this happy, glow-y time of your life — which can make you feel pretty crappy if that's not your experience.

The thing is, if you're not having a picture-perfect pregnancy, you're not unusual — and you're definitely not alone. You just need to take extra care of yourself.

To help you understand everything you should know about dealing with depression while pregnant, BuzzFeed Health talked to women's health and reproductive psychiatrist Dr. Sonya Rasminsky; clinical psychologist Shoshana Bennett, Ph.D., co-author of Beyond the Blues: Understanding and Treating Prenatal and Postpartum Depression & Anxiety; and maternal fetal medicine specialist Dr. Wendy White. Here's what they want you to keep in mind.

1. First things first: Prenatal depression is a real illness that many women deal with.

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It's not just pregnancy discomfort or blues. Prenatal — or antenatal — depression is an acute depression that occurs any time during a pregnancy and is a clinical problem worthy of treatment, according to Bennett. It affects about 15% of pregnant women.

"This is not a weakness, a personality flaw, or anything you've done wrong during your pregnancy," says Bennett. "It's a very real illness that hits indiscriminately."

2. You might confuse some of the symptoms with just being pregnant, but there are things to look out for.

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Fatigue and changes in your appetite and sleep schedule are to be expected with pregnancy, but they're also symptoms of depression — which can be confusing, especially in the first trimester when you might be feeling super ill on top of it.

"What you want to look out for is when you're not able to take any joy or any pleasure in anything," says Rasminsky. "If you're not happy to be pregnant, feel disconnected from your fetus, or find yourself wishing that you were no longer pregnant, these are all signs of a prenatal depression."

It's also worth noting that it is extremely common for anxiety to co-exist with prenatal depression, says Bennett, so if your racing thoughts and worries are keeping you up at night, don't brush them off as normal pre-motherhood jitters.

3. Don't be afraid to bring it up to your doctor, because prenatal depression is 100% treatable.

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Most doctors will be screening you for it anyway, but if they're not asking the right questions, speak up. "Don't wait until you feel like you can't go to work or function properly to start treatment," says Rasminsky. "Whatever course of treatment you and your doctor decide on can make a big difference early on."

4. And if possible, seeing a specialist like a reproductive psychiatrist can be super helpful.

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Experts are increasingly informed and trained to deal with perinatal depressions (prenatal and postpartum), but there are still gaps in knowledge that could make an outside consultation with an expert like a reproductive psychiatrist worth it.

"There's a lot of misinformation out there about perinatal depressions, both in the general public and among physicians and psychiatrists," says Rasminsky. For example, they might have outdated concerns about antidepressants (we'll get to that later) and bar you from getting the right treatment for you.

She suggests using Postpartum Support International to find an expert near you.

5. Nobody is immune, but there are some factors that might make you more likely to develop it.

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According to Bennett, prenatal depression can happen to anyone. However, you may also be at a higher risk if: you have a previous history of depression, anxiety, or other mood disorders; you have past or current thyroid problems like hypothyroidism; you have a lack of financial or social support; you're carrying multiples; or you experience negative mood changes with PMS or birth control (since these can be a predictor of how your body responds to hormonal changes).

Again, Bennett warns not to freak out if you have some of the risk factors: "Do these things mean you'll definitely suffer? No. But does it mean you should keep an eye on it? Absolutely."

6. Untreated depression has been associated with complications during pregnancy and birth.

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Some risks that have been associated with (but not caused by) depression during pregnancy include low birth weight and preterm labor, as well as pregnancy complications like gestational diabetes and high blood pressure, according to Rasminsky.

"There's also the fact that if you're depressed, you won't be able to take care of yourself the way you and your baby need," says Rasminsky. "You're not going to seek prenatal care the same way. You're not going to eat well. You're going to miss appointments. You might be more likely to drink or smoke."

7. Treating your depression during pregnancy can also lower your risk of developing postpartum depression.

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According to Bennett, women who are depressed in their second trimester have a threefold risk of having postpartum depression, and being depressed at the end of your pregnancy increases the risk sixfold.

"Treating depression during pregnancy really seems to mitigate the risk of postpartum depression," says Rasminsky. "People who come in with prenatal depression and get treated are generally not the people who develop postpartum depression."

8. Your doctor will take many things into consideration when deciding the most appropriate course of treatment.

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There are some factors that might help predict whether or not medication or therapy are right for you. Your doctor will look into your personal and family history, previous experience and success with medication or therapy, how your support system is at home, and what kind of stressors you deal with in your life.

They'll also take into account your personal values, desires, and beliefs. "Some women are just really nervous about taking medication and don't want to do it," says Rasminsky. "They'll take that into consideration too."

9. And a good doctor will never pressure you into one kind of treatment — they're only there to help you make the best decision for you.

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"Seeing a reproductive psychiatrist doesn't mean someone is going to tell you what to do," says Rasminsky. "It's about having someone there to help you weigh the risks and benefits, because that decision can be very overwhelming."

10. Doctors agree that research points towards antidepressants being generally safe to use, but experts can't guarantee there aren't some risks.

You've probably heard about studies connecting antidepressant use with birth anomalies such as congenital heart defects, persistent pulmonary hypertension, and autism — but it's hard to pin these definitively to antidepressants, because researchers can't control for other factors that could be to blame, according to White. "For example, it's possible antidepressant exposure is linked to congenital heart defects, but that could also be caused by poor nutrition, which is associated with depression," says White. "Untangling all of these factors and separating the risks of having depression while pregnant and taking antidepressants while pregnant is really, really hard."

Overwhelmingly, all of our experts agreed that the risk-benefit decision comes out in favor of taking antidepressants if you need them, especially for moderate-to-severe depression. "While there might be some risks, we do know more concretely that untreated depression is probably riskier than any exposure to the drug," says White.

11. So when deciding if antidepressants are right for you, it's important to put the current research into perspective.

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"One thing we know for sure is that these medications aren't teratogens — meaning they're not things we know cause specific harm," says Rasminky. "While things have popped up here and there with regards to their association with birth defects, there has been no clear pattern in many, many studies."

That includes studies relating to autism risk. “There’s a big question right now of whether antidepressants raise the risk of autism and the current understanding is that likely the answer is no,” says Raminsky. “But it remains controversial because there are a couple of studies that show a potential association. But association is not the same as causation — autism is multifactorial. We don’t know why it happens, but there are many risk factors and if antidepressants are one, they’re only a small one.”

That said, one side effect that doctors do warn patients about is the possibility of postnatal adaptation syndrome, which is essentially withdrawal that might make your baby more fussy, jittery, or irritable. It usually goes away within a few days and is more something to be aware of than worried about, says Rasminsky, as there are no long-term consequences.

12. Therapy has also proven to be an equally effective method of treatment for some.

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Medication isn't the only option. "Therapy can be extremely useful and can be enough to carry a woman through a pregnancy," says Bennett. "It's all about what's going to work right for you."

This could also include working with your doctor to design a regimen involving light therapy and supplements.

13. Outside of professional treatment, there are also things you can do to improve your symptoms day-to-day, like sleep and exercise.

Obviously, this is easier said than done when you're pregnant and depressed, but both experts agreed that these things can make a tremendous difference. Do what you can to get uninterrupted sleep and whatever exercise you feel equipped to do, whether that's only a walk to the end of the block or a prenatal yoga class.

"These aren't cures by any means, but they are extremely useful to relieve the symptoms of depression and make life a little easier," says Bennett.

14. Eat on a clock because you can’t trust your body to tell you when to eat when you’re depressed and anxious.

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Bennett suggests eating six meals throughout the day, each with a good source of protein and a complex carbohydrate, which essentially help produce serotonin that will help with depressive symptoms. "Set your clock to chime six times throughout the day," says Bennett. "Every time it chimes, even if you don't feel hungry, you put something in your body."

15. Set up a support system and actually talk about what you're going through.

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There's no denying that stigma still surrounds mental illnesses, but it's important to remember that dealing with depression is nothing to be ashamed of — and nothing to hide. Share what you're going through with your loved ones so you have more support when you need help.

Who can make you food when you can't get out of bed? Who can pick up the house when you're having a bad day? Who can you unload to about what you're going through? "Physical and emotional support are important," says Bennett, "so make sure you have both."

16. If you have a history of depression, it can help a ton to set up a mental health plan of action before you get pregnant.

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"It's really hard to pick up the phone and ask for help when you're in the throes of a depression, so if you're worried that this is something you might deal with, talk about your concerns with your doctor and have a strategy in place," says Rasminsky. "If you do that, it's easier to call and say, 'You know that thing we talked about that might happen? I think it might be happening. Can I come in for an appointment?'"

Same goes for if you've dealt with perinatal depressions before. "You might be at higher risk, but it doesn't necessarily mean it'll happen again," says Bennett. "You can put a very strong wellness strategy in place and have a completely different experience during your next pregnancy."

17. At the end of the day, remember that you deserve to get help, and that there are treatments available to you.

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"We feel the need to justify getting help for the health of the baby, but it's also important that you're going to be walking around dealing with this for nine months," says Rasminsky. "That's a long time to be depressed. That takes its toll. Why should you suffer for such a prolonged period of time? That, to me, is the most powerful argument to get the help you need."