I often struggle with how personal to get here on this blog and on social media but the last two years have shown me that whenever I open a wound or share a challenge, it seems to help at least a few people – and that’s enough for me. I don’t have a great deal of clinical insight or solutions, per se, but I can at least share what I’m going through in the hope that it makes someone else feel less alone.
I have been battling depression since I was a teenager and was diagnosed with clinical depression when I was in my early 20’s. For years, I self-medicated (in ways I wouldn’t recommend 😊) and it wasn’t until I prepared to become a mother that I got honest about taking care of myself from the inside out. During my first pregnancy, my depression got severely worse with extreme lows that I couldn’t shake.
I remember a weekend in February 2016 when I was about 24 weeks pregnant with Daisy – my Dad was visiting Philadelphia and we were on our way to dinner at a steakhouse I’d been dying to try. I’d been looking forward to this visit for months and I was so profoundly sad I felt like I couldn’t see straight in the car. There were so many days that should’ve been all sunshine and rainbows that instead felt so dark and alone – and I couldn’t explain why. I had the support of a loving partner, a family that was overjoyed to welcome a new addition, friends cheering me on from all over, a supportive workplace – none of it mattered. I couldn’t fix the sad.
When I became sick and we subsequently learned Daisy was unwell, the depression became so bad that I couldn’t leave the house or get out of bed for days (sometimes weeks) at a time. Luckily, my OBGYN saw the red flags and helped me recognize that what I was experiencing is something may women face: prenatal depression, also known as antenatal depression.
How Do You Know if You Have It?
According to the American Pregnancy organization, women with depression usually experience some of the following symptoms for 2 weeks or more:
Sleeping too little or too much
Loss of interest in activities that you usually enjoy
Recurring thoughts of death, suicide, or hopelessness
Feelings of guilt or worthlessness
Change in eating habits
Family or personal history of depression
Previous pregnancy loss
Stressful life events
Complications in pregnancy
History of abuse or trauma
Risks of Untreated Prenatal Depression
A woman who is depressed often does not have the strength or desire to adequately care for herself or her developing baby. What I've learned through many discussions with my OB and lots of research is that babies in utero are vulnerable to and affected by so much of what we as the carrying mothers are feeling and experiencing. Stress, anxiety and depression can have consequences far worse than just temporary emotional discomfort - so it's critical to face them head-on in every way you can.
How I Am Coping This Time Around
For me, coping with depression requires a multi-pronged approach: a lot of little things scattered around the house and scheduled throughout the day, a light dose of medication, a regular routine that includes generous doses of self-care, good nutrition and lots of sleep.
A Little Piece of Nature in Every Room
Bringing the outdoors in - particularly in the wintertime - is really important for my mood. I buy about $15 worth of flowers at Trader Joe's every weekend (you can get a LOT for that price at TJ's) and make a few large arrangements for places like the dining room table and my nightstand and a bunch of miniature bouquets in little bud vases for places like the windowsill by the kitchen sink, the table in our entry hall, Daisy's diaper changing area and all of the bathrooms. As I move through the motions of every day, seeing a bright bunch of flowers always cheers me up.
Creating Small Breaks During The Day
On the days I work from home, I try to work in a few twenty-minute windows for recharging where I disconnect from work and switch gears - whether it's a quick walk outside, prepping for dinner or watching half a House Hunters episode. On the days I'm in the office, I also build in breaks to rest at my desk with a mug of herbal tea - I have a little stash from home at my desk of favorites like peppermint and apple cranberry - the smell brings a sense of calm and I'm forced to take my hands off the keyboard to hold the mug and breathe a little.
Eating Many Small, Nutritious Meals
I try to do this all the time but it's especially helpful in pregnancy when the body struggles to maintain energy. The nights before I go into the office, I pack little mini-meals into these containers which are my absolute favorite (perfect size for a small meal, they're cute, safe for the environment & the lid is really strong!) for 2 snacks aside from lunch - one in the morning and one in the afternoon. My favorites are: a bowl of fresh strawberries with nibs or melting chips of dark chocolate, yogurt with berries, coconut flakes and chia seeds or carrot sticks dipped in tahini or tzatziki. These little healthy breaks give me something to look forward to and inject much-needed boosts of energy into the day.
I was resistant to the idea of taking medication to balance my moods for the longest time. There is such a negative stigma around the notion of "mental health" and I felt like if I took medication, I was admitting that I had an "issue" which made me weak or damaged. I wanted so badly to be able to fight through my dark moments on my own. It wasn't until my OBGYN pointed out that I wouldn't be the best possible mom to Daisy if I wasn't taking the best possible care of myself - that spoke to me. I've been on a low dose of Zoloft for the last two years and it has really helped with my anxiety and depression. It doesn't remove the dark times altogether but they are a lot fewer and farther between - and less debilitating. SSRI's are not for everyone and they do carry some risk so this is a choice you should make after research and careful consultation with your doctor.
A Routine that Revolves Around Regular Sleep
This is a big one. I find myself feeling so much more balanced when I'm well-rested and have a consistent routine. I like to start and end the day the same way. Morning is a light snack, a cup of coffee and reading the news so I can ease into the day. Evening is retreating to our room around 9 PM, taking the time to go through my nightly skincare routine slowly, silencing my phone, dimming the lights and reading until my eyes feel heavy. I take a mild sleep aid to ensure that once I'm asleep, I stay asleep (despite snoring husband who enters the picture some hours later). The last twenty to thirty minutes of unplugged relaxation really help prepare me for a good night's sleep.
To be clear: I have not cracked the code. These pre-baby blues don't ever seem to go away entirely, but, some of the above help distract me or brighten my mood even temporarily. It also really, really helps to talk about it with others. I had no idea so many other people I knew experienced this until I posted about it on Instagram. Turns out, we're in this together!
Here are some other great resources if you find yourself struggling:
@WhentheBoughBreaksdoc on Instagram
This feed was originally created to promote the documentary on Netflix about postpartum depression and psychosis narrated by Brooke Shields (on my watch list) but it's now a feed featuring individual women who experience pregnancy-related depression and their stories.
American Pregnancy Association
Coping with Anxiety and Depression During Pregnancy from Parents Magazine
Depression During Pregnancy from the March of Dimes
Depression During Pregnancy and After from Harvard Medical School
Why Prenatal Depression May be the Most Severe Form of Maternal Depression from the Washington Post
The Secret Sadness of Pregnancy with Depression from the New York Times
Hang in there mamas - know you're not alone and that there is sunshine on the other side. If you ever find yourself experiencing this, I'm always here ❤