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Prenatal Depression

Pregnancy isn’t Magic: Prenatal Depression

By Amalah

Dear Amalah,

I’m 37 and a half weeks pregnant, and I’m not ok.

On my best days I can fake it, but on my worst days I feel like I want to disappear, that nothing is right, and that anything and everything is wrong. My fiancee says he feels like he’s losing me…that the person he used to know is fading away and being replaced with someone bitter and depressed and mean. My solution is to get up a few hours earlier so I can cry in private and get it out before he sees me.

This baby was a surprise (accident? mistake?). Two weeks after getting engaged in a wonderful, year-long romance I discovered I was pregnant. My fiancee and I had been planning to hold off on the whole having kids thing for a few years while we better established ourselves as a couple, and when we had jobs and he had crossed the threshold into his late 20s (we’re both grad students–he’s 26 and I’m 29) but despite the consistent use of an extremely reliable birth control method, the universe had other plans. His first reaction was to assume I would terminate the pregnancy and we would wait until we both felt ready. I made the Planned Parenthood appointment and was counting down the days until my D&C, because what I want more than anything is a family, and a functional family doesn’t exist when one party is only there out of obligation.

I think that is when I started to break. I spent my first few weeks of pregnancy grieving for this baby. I didn’t want my fiancee to touch me, hold me, or talk to me, and I spent my time not engaged in the essential activities of daily living curled up in bed.

Eventually we started to talk and I told him what I was feeling and together we decided yeah, the timing wasn’t perfect, but what is a perfect time to have a kid, anyway. Since that day, he has been behind me 100%. Though it’s tempered by a healthy dose of fear and uncertainty, he’s thrilled to be a dad, he reads the baby books, and can’t wait for our son to be born.

Except now I don’t know if I can do it. It all feels wrong. Everything is wrong. I’m so scared. First, about labor: my baby is in a bad position, and I’m terrified he won’t turn, and I’ll have to have the medicalized/interventionist birth that I’ve done everything in my power to avoid. And I know that if that happens, I will blame myself. And there is our relationship: I take all my fear and anxiety out on him, even though I don’t mean to. I am afraid that I am wrecking anything we ever had, and there won’t be a chance to repair it once a baby is in the mix.

The intimacy that we previously had is gone. Mostly because I have exactly two comfortable sleeping positions that both necessitate the use of body pillows, I don’t remember the last time we cuddled together or even just enjoyed each other’s company. I am shrill and demanding and mean to him, even though I honestly don’t mean to be.

I see a therapist, but it only seems to calm me down for about two hours every week. I just don’t know how I am going to get through this when I don’t have a vision of peace and calm and love waiting for me on the other side. What if it only gets harder? What if this is what drives us apart anymore, and I lose my partner because I’m too fucked up to be in this relationship?

I feel like the parts of me that aren’t sustaining a child are dying. I am afraid that I will never get the old me back, and that my relationship with myself, my partner, and my child will suffer irreparable damage. I live with these fears constantly, with almost no reprieve.

I don’t really even know what I’m asking for right now. Hope, I guess? Some redirection and reassurance?

Thanks,
L

Oh you poor, sweet, wonderful thing. I am so sorry you are not okay. I wish I could make it all okay.

Has your therapist, by any chance, mentioned the possibility of prenatal depression? Because that is a Thing and while I am not a doctor nor am I authorized to play one on the Internet, it sounds very much like a Thing you might have (and are clearly not being very effectively treated for by this therapist). Here’s an article about it, and here’s another one. Slate ran a three-part series on it.  The excellent Postpartum Progress blog has an entire category dedicated to it. Studies suggest prenatal depression is every bit as common as postpartum depression, and every bit as real and serious, and yet most of us are completely unaware that it can happen or of what warning signs to look out for. And I include myself in that “most” group, until my THIRD PREGNANCY, when my OB brought it up after I volunteered the information that my father was dying of cancer and wouldn’t most likely live to meet the baby. Thanks for the heads’ up all those other times, doc! Particularly since prenatal depression can happen without any external stress factors, but is more the result of misfiring, messed-up hormones. (Though since just about every pregnancy IS accompanied by external stress factors, it’s super easy to lay blame on things OTHER than the misfiring, messed-up hormones, and super hard to distinguish “normal” hormonal shifts from the not-normal ones.)

Let me warn you, however, before you click on those links: They might scare you. (Oh God, you already clicked on them, didn’t you? I’m sorry.) Prenatal depression is a serious, SERIOUS condition and can have adverse effects on both you and your baby — especially if you feel so depressed/sad/worthless that you stop taking care of yourself (eating right, taking vitamins, going to doctor visits, turning to alcohol, etc.). There appear to be a lot of links between untreated prenatal depression and other complications during labor and delivery, which again, I haaaaate being all scary but I’m going to need you super motivated to kick some mental health ass by the end of this column. (Then we’ll all hug, ‘kay?)

Of course, like all depression, everyone experiences it differently. For some people, it’s less “depression” and more “I am two breaths away from a panic attack at all times.” Some just have persistent, intrusive generalized anxiety. Some people cry all the time; some find themselves incapable of crying or feeling any emotions at all. Some people lose their appetite while others overeat.

Add to this overstuffed, mixed bag of symptoms the simple fact that “normal” pregnancy hormones can cause some of these things, and you’ve got a serious condition that is really, really easy to miss. Oh, I’m not eating much because of morning sickness. I’m eating too much because of cravings. I’m crying all the time because I’m just generally weepy. I’m not sleeping because I’m uncomfortable. I’m detaching from my partner because I feel fat and gross. I feel scared all the time because labor IS scary and my worries about money and timing and the effect this pregnancy is having on my relationship are ALL TOTALLY VALID THINGS TO WORRY ABOUT.

But. You are experiencing All Of These Things turned up to 11. Past 11. To an uncomfortable, painful, overwhelming level and you are describing great suffering here. And I can see you trying to contort your suffering into something that makes sense: unplanned pregnancy, last minute change of heart, shifts in your relationship, and above all blaming “yourself” for not embracing the joy! and excitement! and squee! that the world expects you — exalted glorious carrier of life — to feel. (Which: Eff you, world. Go get me a cheesesteak.)

This isn’t your fault. This isn’t you failing at pregnancy. There’s nothing different you could have done to prevent this from happening. And above all, this isn’t how it’s going to be forever.

Call your OB or midwife IMMEDIATELY. I freaking mean it. TELL THEM. Call your therapist. And if your therapist gives you a blank look at the words “prenatal depression,” find another one. (I might vote for that ANYWAY, because I’m not really feeling the love for a therapist who sees you weekly and yet still let you get to this point.) Get a referral for someone who specializes in pre/postnatal depression and call them. Print out those scary links and shove them in people’s faces — your partner, doctor, therapist — and say THIS. THIS IS ME. THIS IS NOT OKAY. HELP ME.

Prenatal depression is not like other pregnancy complications, like gestational diabetes or pre-eclampsia. It doesn’t always immediately and miraculously vanish after birth. Sometimes, yes! But sometimes, no. According to BabyCenter, about half of women who experience depression and anxiety during pregnancy go on to develop postpartum depression. (AckmorescarylinksI’msorry.) So please — please please please — don’t think that because you’re so close to the end of your pregnancy that it’s not “worth it” to raise the alarm and cause a fuss. Get a treatment plan and support network in place now. There are antidepressants you can take while breastfeeding, there are (better) therapists, there are holistic options, there is whatever you feel comfortable with. And get comfortable with the idea of leaning into your partner and letting him help without freaking out that you’re imposing on him or driving him away. Open up to family members like your mom or a sibling or someone you trust and let them know that you could really use their help and support in the months ahead — cleaning, delivering food, babysitting, whatever.

But above all, believe me: This isn’t how it’s going to be forever. There is light and hope and wonderful years of clear-headed motherhood ahead of you. Please just reach out for it, today, right now.

[Editor: in addition to Amalah’s links, here is the direct link to contact information for Postpartum Support International which also provides assistance for prenatal mood and anxiety.  Their depression helpline phone number is 1-800-944-4773. They offer free and anonymous info sessions.]

 

Amalah
About the Author

Amy Corbett Storch

Amalah

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Ama...

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Amalah. Also, it’s pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to [email protected].

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.

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Tricia
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Tricia

I don’t even know what to say except I feel so proud of you for reaching out for help! That was the hardest thing for me when I got pregnant. I thought I was a burden on people so I didn’t ask at first. Once I realized that there were people who wanted to help me it got so much easier to cope. And remember that no matter how your son gets here, he’s going to be here! And he won’t care how he was born, just that he can snuggle  on your chest and hold your hand and let… Read more »

Claire
Guest
Claire

Big hugs. I have no more useful advice than Amy has. I second everything she has said. Also, just a side note, if you don’t get that overwhelming rush of love straight away it’s ok too. I didn’t with my son, but it grew over time – he’s 20 months now and just awesome. My daughter is 7 weeks and again I’m working on it, on the bond and overwhelming rush of love. But I know it will come. It doesn’t make me a bad mum or person that it’s taken me a while. The other thing – seeing your… Read more »

Heather
Guest
Heather

I want to offer you my story. Your depression sounds very similar to mine.  I’ve had bouts with situational depression before, and NOTHING came close to the depression of my pregnancy. I gutted through.  I made decisions that took my son’s safety into consideration (absolutely) but were made based on what I thought I could actually do.  For me, that meant a scheduled-c which I have never regretted but that was what worked for me YMMV. I found out later that my husband and mom were making plans in case the depression got worse. Less than a day after he… Read more »

kathleenicanrah
Guest
kathleenicanrah

Oh lady, I feeeeeel you.
I’m 26 weeks and have been diagnosed with prenatal depression and it is THE PITS. and makes me feel so crazy and I can’t even stand being around myself/in my own head so I don’t know how my husband and friends and everyone else is dealing with me.
I wrote some about my experience here: http://blog.ohbabyfitness.com/2013/08/01/pregnancy-and-depression/

I hope you get help and feel much much better soon, and sending all good thoughts for a peaceful, calm, wonderful delivery. Things are going to get better.

Alison
Guest

A therapist trained in Bowen Family Systems Theory has helped me tremendously both emotionally and physically and could be a really great option for something like this. The Bowen perspective and tools have been very stabilizing for me while trying to conceive, pregnant, and postpartum. A link to info on Bowen theory: http://thebowencenter.org/theory/ Best wishes to you! I know myself how terrifying depression and anxiety can be.

Felicity Marie
Guest
Felicity Marie

Oh yes, I could easily have written this letter two years ago. Except I wasn’t brave enough to reach out to anyway, and stupidly suffered in silence, counting the days until I could get this “alien” out of my body. Surprise pregnancy? Only dated my boyfriend for 5 months at that point? Never planned to be pregnant in my life, ever? Yep, yep, and yep. My pregnancy sucked, and for a few weeks after I felt better. Then, PPD hit hard. Really hard. It took months for me to find someone to talk to about it.  But you know, then… Read more »

nb
Guest
nb

Oh, honey. *hugs* This shiz is hard, yo. It is hard no matter, what, and as Amy says: it’s turned up to 11 right now, which is even harder. I’m just here to say (from the perspective of lady who’s never even *been* pregnant, so you know: I support you, I love you even though we’re strangers, and you are tougher than me): It is perfectly ok to be Not Ok. You are creating a whole freakin’ person—that is some serious work, and some serious mind bendery to get your head around. Please please please grab your therapist, your fiance,… Read more »

Kat
Guest
Kat

Completely agree with all posters – but I love this: “It’s perfectly okay to be Not Okay”. I don’t have anything more helpful than anyone else, but you are already on your way to feeling better if you are willing to reach out to get a little bit of advice. I can say this: my pregnancy was pretty rough on my now husband. Once the baby arrived, we healed a lot of hurts. We were united in our efforts to take the best care of our son possible, and so many things that seemed horrible during pregnancy (my snappy temper… Read more »

Ally
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Ally

I wish I could meet you (in a non-creepy way I promise). I am also 37 weeks pregnant. This is my fourth, a baby who I wanted so badly and had to use fertility treatments to conceive. About three weeks ago I feel like everything changed. I cry all the time and I just don’t want to have another child. Part of it is that my oldest is really really struggling and I can barely give him the attention he needs now. I’ve been talking to my OB a lot and he has been really helpful and supportive. I hope… Read more »

Stefanie
Guest
Stefanie

L, I’m so so sorry that you’re feeling this way. My first pregnancy was also a surprise, and although my then-fiance and I were both on board right away, major family drama caused me to feel the way you’re feeling, right around the same time. I remember driving to work each day and spending 20 minutes sobbing in my car before I could summon the strength to go inside, and a constant feeling of being alone, being hopeless, and being certain that I would never be able to handle the baby since I couldn’t even cope with being pregnant. Definitely… Read more »

Rachel
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Rachel

Hugs…Amy’s advice is excellent, and I also want to add that you need to show your fiancé this column and the links too. He may be able to help you find help. I hope things get better.

Brigid Keely
Guest

I have a long history of depression and anxiety and when I mentioned this to my APN she asked if I wanted to preemptively go on an anti-depressant I’d used successfully before which was safe to use while pregnant. I think it really helped stave off very, very serious PPD while also alleviating existing depression and anxiety symptoms. Like you, I was eager for a “natural,” vaginal birth. I wound up requesting (and getting) an epidural, and ultimately having a C-Section. My baby was in the appropriate position, but I wasn’t dilating and he wasn’t descending. There’s a huge huge… Read more »

anon for this
Guest
anon for this

I was very struck by your description of your finance’s reaction to terminate the pregnancy and now the effort you are making to welcome for a child that you once grieved for. I’m pretty sure going through that with a pregnancy would break me too. I would encourage you to seek counseling that is specifically geared toward grief and post-abortion healing (even though you didn’t have one, you need someone with that expertise). Look up a local pregnancy help center, pro-life organization websites always have hotlines, and maybe Planned Parenthood does too if you are more comfortable there. Keep contacting… Read more »

Elizabeth
Guest
Elizabeth

I’m so sorry that you are going through this, but I’m so happy that you are able to take a step back and recognize that something is wrong. In my case, I was over the moon happy to get pregnant, had a supportive husband, and then little by little sank into this funk that lasted until my baby was born. This was my first pregnancy, andIt was so easy to blame it on morning sickness, hormones, or just being tired. By about 20 weeks, I was barely functioning on a daily level. God love my husband, he tried to be… Read more »

Autumn
Guest
Autumn

First, interwebs hugs! Second, congratulations on reaching out and more “hugs” My daughter was very planned but even so when that little stick had the 2 lines, my first thought was what the stupid thing did we do.  Talk to your doctor.  If he/she tries to brush things off, show them the links that others have provided and say you have a problem (now we are on a 12 step program. . . but not really that different).  Find a new therapist who specializes in women’s health/post partum.   Your condition is serious but treatable.  And you have made the… Read more »

Kim
Guest
Kim

The one thing I want to add to everyone else’s good advice is that it absolutely does not matter how your child is born, as long as you get a healthy baby.  We can work toward and hope for a natural birth with no interventions, but any way that baby gets out is ok.  If you need an epidural, or pitocin, or a C-section – ll of that pales next to a healthy child. 

I hate when women think they’ve somehow failed because they didn’t have a “natural” birth.  There is no failure in childbirth.  NONE.

Tara
Guest
Tara

Yes yes yes! My pregnancy was not a surprise at all – totally planned, totally wanted, but still, I haaaaaaaaaaaated being pregnant, was filled with doubt, totally lost my sense of self worth, had zero intimacy with my husband, all of it. I got so upset when people *pressed* me to be excited. I got even more upset when no one would allow me to vent/complain, like that made me the most evil sub-human in existence. I also very much wanted a natural birth, and ended up with a scheduled C section. And it was…totally fine! And as soon as… Read more »

MR
Guest
MR

((Hugs)) Everyone has had really good advice. I wanted to add a little piece about birth. OP, you said baby was in bad position, and that is making you dread the natural birth you wanted. I am so sorry! Hopefully baby will turn, and all will work out great. In case a cesarean ends up being necessary, please check out the natural cesarean (http://youtu.be/m5RIcaK98Yg). It has a lot of lovely ideas on how to make a cesarean more family friendly so you don’t miss out on some of the things you probably were looking forward to with a natural birth.… Read more »

shelly
Guest
shelly

First and most importantly, the main objective of pregnancy is a live baby. Not a “birth experience”. At the end of the day no one gives a rats behind about whether or not you had natural, c section etc. The first primary and only goal is whoh. Live baby. Stop thinking about the “birth experience”. Then take a deep breath and go “wow my entire life is about to change and yes it is OK to freak the fuck out.” We do not all have a magical fairy dust unicorn filled pregnancy. It is OK to hate, loatl abhore and… Read more »

Amy
Guest
Amy

Hey now. Maybe *you* didn’t give a “rat’s behind” about how you got your babies out, but giving birth is a) a MAJOR thing happening to your body and b) a MAJOR change happening in your life. I think it’s perfectly natural to want those things to happen in a way that you find safe, comfortable, and in accordance with the way you try to live your life, and to try to make plans to that end. Sure, it may or may not work out that way, but let’s not tell people they’re doing something wrong to have preferences! I… Read more »

MR
Guest
MR

Thank you for that, Amy! Shelly, I am sure you were well intentioned, however, saying that the only thing that matters is a live baby is completely, utterly dismissive of the mom. Baby is NOT all that matters. A healthy baby at the expense of mom is NOT the goal. A healthy baby AND mom are the goal. And in order to get a healthy, happy momma she has to feel respected. Dismissing her feelings about her birth is disrespectful. If a positive birth experience matters to her, then it MATTERS. Her feelings are her feelings and they are never… Read more »

Sam M
Guest
Sam M

Hello. I just wanted to write in and let you know how incredibly proud of you I am. I’m 29, 38 weeks pregnant, and in graduate school as well and I’m just a little bit emotional while writing this response because- wow, I totally understand another side of this for you, which is the complete professional stress and fear you must be feeling. Our pregnancy was planned, but I don’t think I suspected how much my emotions would swing to abject fear and just well, sad, during this pregnancy (in the last week I’m been pretty much the most horrible… Read more »

mart
Guest
mart

Hello, I am 26 weeks pregnant and my feelings are pretty mixed. Sometimes I am happy, sometimes I feel like shit. I want the baby, the whole thing was planned, but this 40week experience is terrible, although I don’t have any health problems… I sometimes feel like everything I used to love about my life is over. It is a big change. But millions of women did it before us, we will have to do it too… Just try to survive it and it will be ok again. I believe so.

J
Guest
J

Pregnancy was absolutely the most miserable time of my life. It was planned but I’m 36 and we were so ready for it to take a while that getting pregnant the first month really threw us- by the time we told people we were trying, I was already pregnant and didn’t know it! Add relationship problems, work stress, gaining weight and getting bigger than I ever thought I could, horrific acne, and feeling like an elephant in a glass house for TEN months and it just all around sucked. My pregnancy ended with an awesome 2 1/2 weeks of extended… Read more »