Speaker 1: 0:09

Hey guys, welcome back to this week of the Preview Alliance podcast. This is Sarah, and I'm here to give you a little special insight of a episode that is a fan favorite with over 5,000 downloads already. It is depression during pregnancy. If you've been with us for a little bit, you may recognize this episode from early 2023. This is our most downloaded episode and we're bringing it back from maternal mental health month. We have moms reach out to us about this topic frequently. So if you are listening to this and you are experiencing signs and symptoms of depression yourself or a loved one who is pregnant is experiencing these symptoms please know that there is help, there is treatment and to reach out to their provider and their support system. Okay, guys, on to the episode. Hey guys, welcome back to Preview Alliance Podcast.

Speaker 2: 0:57

It's.

Speaker 1: 0:58

Sarah and Whitney. Okay, so we're going to do. This is one of two series that's going to be aimed towards our pregnancy moms, and this is just educational more. But you know, and it's good to just even hear it, because you may be postpartum now and think like, oh my gosh, that was me.

Speaker 2: 1:16

No one ever told me.

Speaker 1: 1:17

So the first one we're doing is yes, you can be depressed in pregnancy, it's true. Now let's go back and say what is depression.

Speaker 2: 1:28

Correct. So depression is going to be more along the lines of a lack of motivation. You can be feeling hopeless, like there is not a way out. Imagine like you're almost down in this pit or in this well, and you just look up around you and you think I can't get out of this Right, like I'm going to die here, yeah, which I know that sounds very harsh. Depression can be harsh, harsh, and so I don't say that to discourage people, I say that as a reality, that to discourage people, I say that as a reality. I do also want to put a clarifier out there that it is not inevitable for you to be depressed during pregnancy, right, just that it can occur prenatally. And we're going to be here to kind of talk about the risk factors, contributing factors for that, what that can look like, things of that nature.

Speaker 1: 2:23

And let's let's break it down too. It's saying depression is not your fault correct? Yes, none of these mental health conditions are your fault. It's a medical condition.

Speaker 2: 2:31

It's like you didn't go out and seek it. You didn't choose to feel this way, so this is.

Speaker 1: 2:35

If you're saying yes, this sounds like me. You did nothing to cause this correct. So let's just put the shame out the out the door here and the sadness, the loss of enjoyment of the hopelessness and being like it takes over. It does so. It's not like something you can control it or wish it away. So let's get that out. So depression and pregnancy can be missed, because they can be similar in their signs and symptoms.

Speaker 2: 3:05

That is true, because more so in the first trimester, but it can be in any trimester you are going to have a decrease in your appetite because of the hormones, because you're throwing up, you don't feel like it.

Speaker 1: 3:15

You don't want to eat.

Speaker 2: 3:17

That nausea is there, so depression. Another one of kind of the textbook symptoms is a loss of appetite or even sometimes like a loss of taste.

Speaker 1: 3:25

Right, hello, yeah, yeah.

Speaker 2: 3:30

It changes everything.

Speaker 1: 3:31

So if someone's asking you that and you're like yeah, they're like, oh, okay, Cause you're the hormones.

Speaker 2: 3:36

Yeah, so I could see where, you know, a patient brings it up to their OB and they say you know, my appetite is just next to nothing, which really kind of bums me out. And the OB is probably going to say well, you know what, you're nine weeks, you're in the first trimester, that is not alarming to me. And then they may say are you vomiting a lot? Are you able to drink things? You know things of that nature. They're going to make sure that you're getting some nutrients and some fluids to avoid dehydration, but otherwise, isolated the appetite and lack thereof, an OB may not necessarily pick up on, that being a red flag for depression, which the patient may not either.

Speaker 1: 4:15

Right, and then you have lack of sleep.

Speaker 2: 4:20

Yep, because everything's uncomfortable.

Speaker 1: 4:22

Okay, pregnancy that can be all throughout that pregnancy.

Speaker 2: 4:25

And because of that fatigue, we almost have like that lack of motivation or that lack of drive that goes along with it, because you're so tired you don't Exactly, so it's all kind of messy there at libido You're throwing up.

Speaker 1: 4:37

Yeah, you know your body's changing. You don't feel like yourself. Third trimester, you're just like don't touch me, yeah, get away from me.

Speaker 2: 4:43

So yeah, you know all those things excessive or maybe spontaneous crying without a trigger that you can say. This is why I feel this way. Well, your ab may say, well, you know, has anything happened in your life? To cause you to feel that way. You may say no. They may say well, again you're nine weeks, you, your progesterone is really skyrocketing right now. It's your hormones and again, you know that's true. Right, I can't say that that's not true.

Speaker 1: 5:12

No, so it's all kind of blurred lines.

Speaker 2: 5:14

It is.

Speaker 1: 5:15

And then you yourself don't know why.

Speaker 2: 5:20

Okay is this pregnancy or is this something more Exactly? So some other factors that I think are more depression as opposed to pregnancy would be you do find yourself withdrawing or isolating from people that you normally want to spend time with Friends or family, Exactly, and there's not again a particular situation or something that was said that makes you want to back off.

Speaker 1: 5:43

So you're saying you're losing your normal support?

Speaker 2: 5:47

You're not going to talk to him about it.

Speaker 1: 5:49

And that's not a question probably that's going to be asked of you in the OB office. So this is something that you need to know and that your friends and family kind of need to be like okay, Whitney's kind of not herself.

Speaker 2: 6:01

She's withdrawing.

Speaker 1: 6:02

She's not wanting to engage with me. She's not attending what normally does, yeah.

Speaker 2: 6:07

So those can be red flags, you know, for people who are not pregnant. But hear this and you think you know what my friend that's you know, 25 weeks. They really haven't been coming as frequently or they haven't been texting as often. Maybe I should check in on them and just kind of see how they're doing. Yeah, so that one, I would think, is a little bit more on the depression side as opposed to pregnancy, and at this point in time with COVID, we're not isolating, we're not hunkering down like we were three years ago, so that reason has kind of gone out the window.

Speaker 2: 6:38

Now that being said, it is still a really bad flu. Rsv, covid season, so we get it. So you know, if someone is like, hey, I'm newly pregnant, I did IVF to get pregnant, I'm not comfortable with a large gathering of people, that can be appropriate, that I can understand, and I would not attribute that to depression. No, if it's one of those you're like I'm really looking out to not get sick right now, okay, fair enough. But then you know, a few months down the road when we get into spring and hopefully out of this terrible flu, surge and it's still saying it.

Speaker 2: 7:06

And then we still see. No, I just don't really feel like it. No, thank you, and it's consistent.

Speaker 1: 7:14

So check on yourself and check in and say, well, why is it? Or if loss of enjoyment of things Okay, is it because you are an avid hiker and you're throwing up? And you're like I don't want to hike anymore. Yeah, is it because you physically have a limitation?

Speaker 1: 7:30

yeah, versus you can and you just don't want to, you want to want to, uh-huh, and you just can't get it and you're just like it's not happening, yeah, so all those things you need to start turning into and you may be hearing this and you're going okay, I'm fixing to be pregnant, I'm pregnant. What are my like, what's, risk factors?

Speaker 2: 7:51

So I always tell everybody this is that if you've ever experienced depression, anxiety, ocd, bipolar, anything, anything mental illness related prior in your life, you are at a greater risk for that, prenatally and postpartum. Now, does that mean it is inevitable and a guarantee? Absolutely not. No, but it does mean that you need to be aware of what your depression looks like, what your anxiety looks like, because you know you the best. Amen, because my anxiety may not present like yours, sarah, and vice versa, right, but we know, okay. Well, when I really get anxious, this is what I tend to do or this is how I tend to feel. So be aware of what your prior symptoms have looked like and felt like. Now, that being said, if you've never experienced depression, anxiety, any type of mental illness prior to your pregnancy, if there is anyone in your family that has had, any type of family history, a diagnosis in the past, especially immediate family, so we're talking your biological parents, siblings and even your grandparents.

Speaker 2: 9:00

So, those closer knit blood genes. Now if you have a twice separated great uncle that has bipolar disorder, the genetics they are not as strong. So look, so I wouldn't be like I have it because they have it, I have it because something else, okay.

Speaker 1: 9:17

So look at. So your own history, your mental health history, your family's history, which is good to this is good to know our family history medically and mental health. If you have a history of physical or sexual abuse, any history of trauma, trauma. If this pregnancy Was not planned.

Speaker 2: 9:34

Not planned, it was a surprise, surprise.

Speaker 1: 9:37

If you have a high-risk pregnancy, including your own or your child's medical issues so hyperemus gravida, gestational diabetes, a history of preeclampsia Placental problems.

Speaker 2: 9:53

History of help syndrome.

Speaker 1: 9:54

Those are all things. Those are big ones.

Speaker 2: 9:57

Any major changes in your life, even if they are positive. So let's just say you got married or you moved into your dream house or you got your dream job.

Speaker 2: 10:07

Those are positive things. They are still stressors, they are still transitions in your life that you're adapting to while adapting to pregnancy. It is and I will throw this out there too Thyroid problems. Yes, I have hypothyroidism and for the longest time I never really knew why I had heart palpitations. Went to a cardiologist. They said you have an arrhythmia, be mindful of your caffeine intake. Okay, fine. Well, several years later, when I was dealing with infertility guess what? I had a thyroid problem and while it has not resolved my anxiety completely, my anxiety is much better managed now that I'm on a thyroid medication. So, if you notice, almost like a sudden onset and we don't have an external trigger for it Right?

Speaker 1: 10:52

So it's not. We're not talking about a death, a loss, Exactly.

Speaker 2: 10:55

Or you know losing your job or you know any number of things, or financial difficulties. You know we don't have an external source that we can say. This is why I feel this way and all of a sudden you feel like you almost have a sudden onset of this. Get your OB to pull thyroid labs.

Speaker 1: 11:10

Just see what it is.

Speaker 2: 11:11

And most, most OBs do thyroid panels in pregnancy anyway, it never hurts to advocate for yourself and say can we pull those again? Yeah, most obese are going to be on board with that.

Speaker 1: 11:22

yeah, because they don't. I mean, they want to know just as much as you do.

Speaker 2: 11:25

Well, and it's not unheard of to have a pregnancy induced thyroid problem.

Speaker 1: 11:29

That's? Oh, that's, that's valid. So there is risk factors, right, there is things that can put you more risk, but it doesn't mean you have them, it's not inevitable, but it's something that just needs to like.

Speaker 1: 11:39

It's like okay, let's wake up a little bit. Let's put it on our radar. Yes, just be aware of those things. Let's know our symptoms, let's look more into them. Are they extreme? Are they past causes that we can name Like yes, I'm not eating as much because I'm throwing up, or no, I'm not throwing up and I still don't want to eat my favorite?

Speaker 2: 12:00

Yeah, I have no desire.

Speaker 1: 12:01

Okay, so that's a thing. And people are now saying okay, so what if I am depressed? What does that put me at risk for? Well, we know depression in your pregnancy can lead to preterm babies, which now you know, that's a huge thing is preterm birth, which we want to do everything we can to keep the baby in womb and some things. You can maybe be saying I had a preterm baby. Was I depressed? No, it's not your fault.

Speaker 2: 12:25

No, not at all.

Speaker 1: 12:26

This is never saying that this is knowing that what we can be aware of to try to help you.

Speaker 2: 12:32

But again, you think you know if you're depressed and you know nausea, vomiting HG, those things aside taking care of yourself. Well that. But also you may not be eating as much as you could or want to, and so you may have a lower birth weight baby sometimes, and that can also lead to preterm delivery. And so to those mamas who really struggle to have an appetite, that is not nausea, vomiting based think about drinking your calories instead of eating them.

Speaker 1: 13:00

so protein shakes, yeah good smoothies, put some peanut butter avocado smoothies, acai bowls are really good options.

Speaker 2: 13:08

Love those um do snacks instead of meals because you know what a granola bar probably might sound better to you than an order of chicken nuggets from chick-fil-a. You may be like I can't. I can't do that right now, but I could. Something small. Something small, maybe a little bit more carby. Yeah, carbs are easier to digest, yeah, and so play to your strengths, the path of least resistance right now.

Speaker 1: 13:32

And we know too, depression in your pregnancy leads to higher odds of postpartum depression. Absolutely, and with so any so, Depression during pregnancy leads to higher odds of postpartum depression Absolutely. And so what we're wanting you to do is look at this, look at your pregnancy, look at your symptoms and know let's figure out if there's something that you need help and support to. Because, good news here, yep, it's been really researched, been studied. Therapy that's right Is a proven way that they can treat depression during pregnancy and postpartum.

Speaker 1: 14:03

That's right, and let's say this again If you need a medication, that's okay, that's fine, no shame.

Speaker 2: 14:09

There are researched safe medicines for pregnancy and breastfeeding, so throwing it out there.

Speaker 1: 14:14

We want you to know. The biggest takeaway is know what is to be expected and not expected and how to reach out for help. So how to help If you're a pre-veal woman, you just email us.

Speaker 2: 14:28

Yes, you hit your button on your dashboard for therapy and we get you connected.

Speaker 1: 14:32

That's right Now, if not Postpartum Support International.

Speaker 2: 14:36

We've said this before I love them.

Speaker 1: 14:37

They are a great way Having an open conversation with your provider and saying I'm struggling because of this. Do you have any resources?

Speaker 2: 14:47

Exactly what would you recommend?

Speaker 1: 14:49

And you can always I would always say, and I told this to my patients as a nurse start early. The start of something feels off to you. Absolutely nurse, start early. The start of something feels off to you. Absolutely.

Speaker 1: 14:59

Say it now because it's always easier earlier to intervene absolutely it is, once we've kind of reached this mountain, we got all the way to go back down absolutely that now, you know, actually, the us task force recommends which we follow this with previa that if you have these current risk factors, that you start therapy in pregnancy absolutely they recommend current signs and symptoms of depression which we've talked about. So if you're showing this during pregnancy, they say let's get you into therapy now's the time to get on board that's what we do with previa is because we know it works.

Speaker 1: 15:34

History, like we said, of depression that even if you have a history of that, they think you can benefit and it help you so much to start, even if you're not showing signs Teen or single mom low income, because we know that's going to put you at a harder disadvantage. Stressful life circumstance, hello, pregnancy alone can qualify for that. And so they know therapy works Absolutely.

Speaker 2: 15:58

And, I would think, a lack of a support system too.

Speaker 1: 16:01

Oh, huge because you feel like you're alone and your therapist is going to give you validation processing. That's right hoping techniques. So yes, depression in pregnancy happens yes yes, there's help. Yes, you do not have to always feel this way.

Speaker 2: 16:17

Correct and it's not your fault. Yeah, you don't have to live in misery.

Speaker 1: 16:21

No, and you're not a bad mom. You did nothing for this Correct, and we want you to hear this and be aware. If none of this is, if you're like, okay, that's great. None of that fits me Absolutely.

Speaker 2: 16:34

We love that. We know that you're aware of it.

Speaker 1: 16:35

Yes, maybe you can use this information and be aware to help your friend.

Speaker 2: 16:39

Absolutely.

Speaker 1: 16:39

Or continue the conversation so that moms know we're not in this alone.

Speaker 1: 16:43

That's right. All right, guys, stay tuned. We're going to cover anxiety in our next episode, and this will be great, that's right. See ya Bye. Maternal mental health is as important as physical health. The Preview Alliance podcast was created for and by moms dealing with postpartum depression and all its variables, like anxiety, anger and even apathy. Hosted by CEO founder, sarah Parkhurst, and licensed clinical social worker, whitney Gay, each episode focused on specific issues relevant to pregnancy and postpartum. Join us and hear how other moms have overcome mental health challenges, as well as access tips and suggestions on dealing with your own challenges as moms. You can also browse our podcast library and listen to previous episodes at any time. Please know you're not alone on this journey. We're here to help.