Expert: Ashwini Nadkarni, MD, Psychiatrist at Brigham and Women’s Hospital

What is depression?

Depression is a medical illness consisting of problems with mood that affect day-to-day functioning. People with depression often experience a general feeling of sadness or an inability to enjoy their usual activities for at least two weeks. Other symptoms include:

• Sleep issues such as difficulty sleeping, sleeping too much or during the day, and feeling tired all the time
• Low energy even with appropriate rest, exercise, and nutrition
• Decreased appetite or disinterest in eating
• Inability to maintain personal hygiene
• Difficulty concentrating on everyday tasks and responsibilities
• Suicidal thoughts or specific plans for suicide
• Preoccupation with death
• Feelings of irritability or guilt

Anxiety—constant worrying—often appears alongside depression. These conditions can be treated in a variety of ways. Therapy, medication and lifestyle changes are all common treatments for anxiety and depression

Why do some people have depression while others don’t? Researchers aren’t exactly sure, although brain chemistry, life events, and family history all play a part. Depression can emerge due to a variety of factors. Depression certainly has a hereditary component. Researchers are still trying to understand the precise interaction between genes and the environment and how they relate to depression.

Depression during pregnancy

As many as 20 percent of women experience depression during pregnancy. A history of depression prior to conceiving and discontinuing psychiatric medications increases the likelihood of developing depression in pregnancy. In some cases, pregnancy is the first time some patients experience depression. But pregnancy can make depressive symptoms more severe, and it also increases your chances of having postpartum depression.

For these reasons, it’s very important to seek medical advice if you are depressed during pregnancy. While social stigma surrounding mental illness can make it difficult to speak up, no one should feel ashamed about their depression or anxiety. There are a variety of treatment options available and it’s best for you and your baby if you are upfront with your doctor about mood changes or other symptoms.

Talk to your doctor if you already take anti-depressants.

If you find out you’re pregnant and are on anti-anxiety or anti-depression medication, call your doctor before stopping your treatment. Depression in pregnancy can have important consequences for both the mother and the baby. Therefore, decision-making around starting or stopping psychiatric medications during pregnancy must weigh both the risks to the fetus associated with exposure to the specific medication as well as the risks to the fetus of untreated psychiatric disease in the mother.

How does pregnancy affect moms who have already suffered from depression or anxiety?

Women who experienced depression before conceiving are likely to continue having symptoms during their pregnancy. If you’ve suffered from depression or anxiety in the past and are considering having a baby, talk to your doctor before getting pregnant. Your physician can help you figure out a plan to treat your depression without harming your baby. Quitting anti-depressants without arranging for alternate treatment such as counseling does more harm than good. Of course, changes in mood during pregnancy can sometimes be attributed to normal hormonal shifts, but don’t write off your emotions or let others do so.

If you’re feeling consistently sad, hopeless or moody—or if you experience suicidal thoughts—speak to your healthcare provider immediately.