PREpartum Depression

Thanks to people like Brooke Shields, the world is coming to a wider and more helpful acknowledgment of postpartum depression. This was needed in a culture where women feel so pressured to be perfect so quickly, as soon as they deliver a baby. But is there such thing as PRE-partum depression? A close friend of mine, who was about eight weeks away from delivery, seemed to be struggling with it and my husband (who is close friends with her husband) asked me why.

(Now, just to be safe, if your depression is severe, you need to seek professional help immediately.  Severe symptoms include: inability to eat, insomnia, inability to get out of bed, suicidal thoughts, self-destructive behaviors, desires to run away, or desires to harm the baby. If you have any of these, you need to tell someone and get immediate attention.)

But for those pregnant women like my friend who are not quite so close to the line, you may be wondering why this amazing time could have such a gray cloud over it.  Why?  Well, why not? There are lots of reasons for the blues.

First of all, as any pain-management professional will tell you, if you have a source of constant pain, this can bring on depression.  My friend had pregnancy-induced sciatica. She was already thin and slight to begin with, which was putting extra strain on her back. But then to make it worse, her baby seemed to be lodged SIDEWAYS. It was enormously uncomfortable and every time the baby kicked, it was painful. She couldn’t lay down very well because of shooting pain down her leg, which, on top of customary No Sleeping Disease in the last months of pregnancy, made it pretty much impossible to stay asleep.  Many moms acquire some sort of constant ailment late in pregnancy just like her, such as chronic heartburn or nausea, which is not only a joy-stopper but a roadblock to the comfort and rest we all need daily.

No Sleeping Disease itself also cannot be overlooked.  For all the husbands out there who might be wondering what this has to do with depression, I’ll just suggest an experiment: Every night for about two or three weeks, have your wife wake you up every couple hours. Have her use a variety of techniques—it doesn’t really matter: twisting your leg, pushing or gently moving your belly, crunching your foot until it goes asleep, etc. And eat a lot of peppery-onion dinners just before bed so you can wake yourself up about every hour or two with heartburn. Also tie yourself down to the bed so you can’t shift during the night. You will soon discover that while you can go a couple days without sleep and still be happy in life, after about a week it will start to affect your mood. You’ll get upset, annoyed, a little angry, and then eventually depressed. Once your wife stops the experiment and you get a couple straight nights of good sleep, you’ll feel fine again!

This is part of the reason why I assured my friend that even though the baby will introduce new waking problems, nothing is quite like the sleeping challenges of the end of a pregnancy. The specific troubles will go away immediately after the baby comes. You’ll be waking up all the time, but at least you will be FALLING ASLEEP and able to MOVE. I actually felt that the eighth to fourth weeks before delivery were harder than the last four weeks. I am not sure why, but my own patience and peace about Boat Woman Stage surprisingly kicked in around the last weeks… because of nesting hormones? Pre-birth serenity? Not sure =) If you can grab naps in this last stage, do it, any time you can.

Other physical pressures can leak over into emotional blues because they simply won’t go away.  Lots of moms feel down around the eighth month, when your skin starts to stretch and burn, your belly starts anchoring you to one position all night, your stomach/bladder are getting super-scrunched, and the baby is starting to get lodged usually under your ribs. You start to feel like this will NEVER END! You know that it will, but you feel like it won’t. And even if it does, it is still two months away! It seems like an eternity. You love this little life you are making, and are probably dreaming about what s/he looks like, what it will be like, but you are so bogged down with the physical strain of each day (or even hour, while you’re trying to sleep) that it is difficult to dwell on what real life could be like on the other side of pregnancy. It causes a tension in your thinking… would you rather be pregnant and deal with the pains, or have the baby and be up all night with it? Neither seems a good option and you start realizing, sadly, that it will be a long time before things go back to normal… maybe it never will!

This type of thinking, mixed emotions, etc., puts you more at risk. Then add into the fact that your husband is probably not understanding the super strain of these last weeks. He might even seem to be “forgetting” that you are pregnant. While you are never ceasing to think about it, he is probably forgetting you can’t get up to answer the phone, forgetting you can’t bend over to fill the dishwasher, forgetting that you are still super sensitive to the disgusting smell in the trash, forgetting that you aren’t sleeping at night, and on top of that, he is still asking for sex! It can drive a heavy mom-to-be mad!

As I told my friend, you have to gently remind your husband that you can’t do these things… (not the sex part, find a solution to that ) You aren’t the spry little person you were before and you need extra special care now that you are huge. Whereas most people tend to treat the newly pregnant mom very delicately, which is sweet, the reality is that the bigger pregnant mom needs as much or more care… her balance is off, her muscles are more likely to be strained, her joints are softer, her senses still delicate, her mind less awake, and her movements less agile/quick. All the things that were easy when you could still see your toes, are no longer! But your husband, God bless him, doesn’t know this. He knows rationally because he can see you, but not intuitively because he can’t really imagine what it’s like. So don’t get mad at him right away when he forgets or insensitively asks for something you can’t do… just speak up.

Other things can encourage prepartum depression.  Fears, anxieties, stress, and loneliness can also make an already emotional season worse. Big life incidents such as moving, problems with a family member, or losing one, job problems, career changes, spiritual issues, trouble with existing children, help not being available, loss of a friendship, marital difficulty, even sexual difficulty, cannot be underestimated. Neither can fears about being a mom, fear of losing the baby, fear of staying at home alone, fear of alienating your husband, fear of possible job loss, anxiety over finances, anxiety over health, image, or bodily changes, or other personal angst. This is just not the time to be facing big life issues, and yet who can put them on hold, just to have a baby? Pregnancy and family-building puts strain on most people in most contexts, but there are some that are harder than others.  And some moms-to-be receive things more penetratingly than others. We don’t all have the wherewithal for everything all the time. Especially if this is the first baby and you are launching out into The Great Unknown.

The best thing to do, as with postpartum depression, is to get help. Like I said initially, if the symptoms are unreasonable, then seek professional counseling.  Otherwise, connect with others. If you can’t connect to your husband (i.e. he’s part of the problem), then go out on a limb to try a close friend. Or your mom. Get someone to come over, gab with you on the phone, or whatever else you don’t want to do…EVERY DAY if possible. Try to take care of the most pressing thing (no pun intended) first… Get a body pillow if it’s your body. Get a pregnancy massage. Take multiple baths a day, or go to an indoor heated pool. Get heating pads, ice packs, belly belts, whatever. If it’s your emotions, get some books, some trash reading, some blogs, some places you can draw comfort. Get your friends and moms who are older to encourage you, reassure you, and give you all the silly tips you feel you need to know in order to make it. Use a journal, listen to music, go shopping (if you can walk). But don’t sit around and be sad by yourself. Don’t be scared to reach out. Don’t dismiss that you’re fine and everyone feels this way or you’ll just feel stupid if you start talking. That reluctance is the big green light that says, “Start talking!” Remember that this too shall pass, but it doesn’t have to be miserable until it does.

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