What Causes Perinatal Depression

As an expectant or new mother, you may experience a range of emotions. However, persistent feelings of sadness, anxiety, or hopelessness could indicate something more serious. Perinatal depression is a complex condition affecting pregnant women and new mothers. Unlike the brief “baby blues,” it lasts over 14 days and significantly impacts quality of life. This disorder stems from an intricate interplay of genetic, epigenetic, neuroendocrine, and environmental factors. Strikingly, it’s quite common, affecting 1 in 7-10 pregnant women and 1 in 5-8 postpartum women annually.

Causes of Perinatal Depression

As we talk about “causes” and risk factors for perinatal depression, it’s important to know that this is not your fault. As Postpartum Support International says: “You are not alone. You are not to blame. With help, you will be well.” One of the reasons to talk about risk factors and causes is actually to help normalize that perinatal depression is not something you've done wrong, but actually might stem from a lot of things that are out of your control. And most importantly, it's treatable.

Perinatal depression can stem from various factors, including hormonal changes, genetic predisposition, and environmental stressors. Understanding these potential causes is crucial for early intervention and treatment.

Hormonal Changes

During pregnancy and after childbirth, your body experiences significant hormonal fluctuations. Estrogen and progesterone levels, in particular, can dramatically impact your mood. These hormonal shifts may contribute to the development of perinatal depression, affecting your emotional well-being and mental health during this crucial period.

Life Stressors

Pregnancy and childbirth are transformative life events that often bring significant stress. You may face financial pressures, relationship changes, or career adjustments. Even if your life is relatively consistent, just having a baby is a huge change. Coupled with societal expectations, the physical and emotional demands of carrying a child can be overwhelming. These stressors may contribute to the development of perinatal depression in some individuals.

Lack of Support and Unplanned Pregnancies

You may face an increased risk of perinatal depression if you lack a strong support system. Without family and friends to lean on, the challenges of pregnancy and new parenthood can feel overwhelming. Additionally, an unwanted or unplanned pregnancy can contribute to feelings of stress and anxiety, potentially triggering depressive symptoms.

Medical Conditions

Certain medical conditions can increase your risk of developing perinatal depression. These may include thyroid disorders, diabetes, or autoimmune diseases. Hormonal imbalances can also contribute, particularly fluctuations in estrogen and progesterone levels. Additionally, a history of mood disorders or other mental health issues may predispose you to perinatal depression.

Other Perinatal Mental Health Conditions

While perinatal depression is common, it’s crucial to recognize that other mental health issues can arise during this period. Anxiety disorders frequently coexist with depression, and some women experience bipolar disorder or postpartum OCD. In rare cases, postpartum psychosis can occur, presenting as a medical emergency with disorganized behavior and psychotic symptoms.

Treatment Options for Perinatal Depression

Effective treatment for perinatal depression usually often involves a combination of psychotherapy, increased peer support (from family and friends or support groups) and sometimes medication. Individual counseling, couples counseling, and group therapy can be beneficial without medication. However, medication may be necessary and helpful, and research shows that many pose low risks during pregnancy and breastfeeding. If you were on a psychiatric medication that helped you feel better before you got pregnant, it's a good idea to mention this to your doctor or psychiatrist to see if it might make sense to begin taking it again.

Talking to a doctor or psychiatrist who is specifically trained in perinatal mental health can result in a better experience, as some providers might needlessly shy away from prescribing psychiatric meds if they are not trained in the impacts for peripartum folks. You can access a list of doctors and mental health professionals who have advanced training in perinatal mental health at Postpartum Support International. An integrated care model involving collaboration between mental health and primary care providers is usually the best plan when managing perinatal depression.

Perinatal depression is a complex condition with multiple potential causes. While hormonal changes play a significant role, factors like stress, lack of support, and prior mental health issues also contribute. Understanding these risk factors can help you identify if you may be vulnerable. Remember, experiencing perinatal depression does not reflect on your abilities as a parent. If you’re struggling, don’t hesitate to contact your healthcare provider. You don’t have to do this alone - you can manage symptoms and bond with your baby with proper support and treatment. If you’d like to try therapy to help you navigate this period, book a consultation to learn more about counseling for perinatal depression.