Mood and Anxiety Disorders During Pregnancy Pt1, Pregnancy's affect on anx/pan/dep
Q.Pregnancy has long been associated with emotional well-being in the woman and her family. Recent research, however, has shown that for many women, the experiences of pregnancy and motherhood are times of increased vulnerability to psychiatric conditions such as depression, panic disorder, and obsessive-compulsive disorder.
A.During pregnancy, depressive symptoms such as changes in sleep and appetite are often difficult to distinguish from the normal experiences of pregnancy.[34] Although up to 70% of women report experiencing negative mood symptoms during pregnancy, the prevalence of pregnant women who actually fulfill the diagnostic criteria for major depression is between 10% and 16%.[35] The course of depression varies throughout pregnancy: most studies report a symptom peak during the first trimester, improvement during the second trimester, and an increase again during the third trimester.[1,36] Several controlled studies have reported that between 12% and 16% of women experience a postpartum depressive episode,[37] and this rate is as high as 26% in adolescent mothers.[38] However, there is some disagreement over the defined time frame of the postpartum period. Although the DSM-IV defines postpartum depression (PPD) as a major depressive episode occurring within 4 weeks of childbirth, other studies of PPD report that symptoms manifest themselves most often in the 6-12 weeks following delivery,[39] and several researchers have defined the postpartum period as extending from 6-12 months after the birth. Biological risk factors that contribute to the development of PPD include: A previous history of depression -- up to 30% of women who have experienced a major depressive episode prior to conception will develop PPD.[40] A history of depression in previous pregnancies or postpartum period -- these women are at a 50% to 62% increased risk of recurrent episodes with subsequent pregnancies.[35] A history of depression in blood relatives -- especially postpartum depression.[36-37] In addition, several other psychosocial risk factors may contribute to a heightened risk of depression in both pregnancy and the postpartum period for some women, including poor social support, adverse life events, marital instability, and ambivalence towards the pregnancy.[36-37,40-41] In very rare cases, (1-2 per 1000 births), a woman may develop psychosis in her postpartum period.[42] Postpartum psychosis has a rapid onset, occurring within the first 48-72 hours and up to a few weeks after delivery. Postpartum psychosis of the bipolar type is characterized by elated mood, disorganized behavior, mood lability, and the presence of hallucinations or delusions. In extreme cases, the risks of suicide and/or infanticide are high, thus these women often require hospitalization.[42] My wife was psycho during pregnancy. I'm glad the whole post partum thing is over with too. Cut my anxiety in half. I guess anybody would have twice the anxiety if they were running down the hall getting chased by a pregnant wife with a knife. After my son was born, she said "let's have another one." I fainted.
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