by Dr. Alice Domar
I’ve been a licensed psychologist specializing in reproductive medicine for 29 years and see pregnant women almost on a daily basis. And yet I am still often stumped when one of my expectant patients lists her symptoms and asks me if she is experiencing a normal pregnancy or not.
That’s because if you were to look at one of the most common depression screening tools, the Beck Depression Inventory, the symptoms look very similar to pregnancy:
- Changes in appetite? Check.
- Changes in libido? Check.
- Changes in sleep? Check.
- Changes in energy level? Check.
- Crying more often? Check.
So how do you know whether you are simply experiencing the normal symptoms of pregnancy or experiencing symptoms of depression? Here’s what I tell my patients:
1. Think about your own mental health history.
Women with a history of depression are more likely to get depressed during and after pregnancy.
2. How long have your symptoms lasted?
Symptoms that last more than two weeks may point toward depression.
3. Try to separate your physical from your psychological symptoms.
Many of the physical symptoms of pregnancy are also typical of depression, but some of the symptoms of depression may be more specific. Do you not get as much enjoyment out of things? Do you not look forward to things as you used to? If yes, that may point to depression.
4. Tap into your gut feeling.
What does your intuition say? In my opinion, women know themselves better than anyone else. If you believe you are simply feeling yucky because of your pregnancy symptoms, I would trust your instinct.
5. Consider your history of medication.
If you have a history of depression and were on medication, going off the medication because of the pregnancy may well make you more vulnerable to relapse. So your symptoms may point more to depression.
If you are unsure, the absolute best course of action is to talk to your obstetrician, nurse practitioner, or family care doctor. They have a ton of experience helping pregnant women sort through their feelings and can help you figure out what is going on.
If you together decide that in fact you are experiencing symptoms of depression, that does not mean you necessarily have to go on medication. Medication is one of many options; other options include counseling, especially cognitive-behavioral therapy, exercise, nutritional adjustments, getting more support in your life, and even partner massage.