If you have depression or another mental health condition, you might worry at some point that you’ll never be able to have children. However, this is not the case for all people who have or are at risk for conditions like anxiety.
Women can make symptoms manageable through consistent treatments. And although current mental health issues before pregnancy and childbirth can definitely increase your chances for a condition called postpartum depression, there are ways to help prevent the condition or at least minimize the symptoms.
In the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), postpartum depression is considered to be an “unspecified depressive disorder” with peripartum onset. The onset of depressive symptoms would have to occur during pregnancy or within four weeks following childbirth to be considered peripartum depression.
So what puts you at risk for postpartum depression?
Dr. Linda Burke-Galloway, the author of “The Smart Mother’s Guide to a Better Pregnancy” said in an email that the following situations can be risk factors for postpartum depression:
1. “Women who experience marital conflicts.”
2. “Stressful life events in the past 12 months.”
3. “Lack of financial or emotional support from a partner or spouse.”
4. “Previous history of childcare related stressors.”
Women with those risk factors should be monitored closely if they decide to have children so they can be treated for any further mental health complications. She said currently there are no studies she’s aware of that show having a child would improve any previous mental health conditions.
“If the woman has anxiety about childcare issues, the answer would probably be no,” Burke-Galloway said. “Certainly women who have family support will fare better than women who don't.”
“In my own clinical practice, I have observed improvement of women who had mental disorders once the baby is born provided they have good family and partner support and are compliant in taking prescribed medicine,” she added.
Dr. Nivea Briggitte Calico, a New York psychiatrist, said in an email that women who already have a mental health condition should work with a psychiatrist before getting pregnant, to make their symptoms manageable.
“Practice good self care (before pregnancy and beyond),” Calico said. “Being adept at finding ways to relax and care for yourself, whether through deep breathing exercises, meditation or exercise can greatly impact your ability to cope in times of distress.”
“Maintaining good nutrition with a balanced diet (ie. diets high in folic acid, iron, omega-3 fish oils containing EPA/DHA, calcium and vitamin D) is of utmost importance as well,” she added.
Mothers also need to remember to have realistic expectations for themselves, and it’s important to be patient and flexible, she said. No one is perfect, and all pregnancies and children are different.
Shoshana Bennett, Ph.D., author of “Postpartum Depression for Dummies,” a clinical psychologist and survivor of two life-threatening postpartum depressions, said in an email that it’s imperative that mothers get as much sleep as possible without interruptions, because chronic sleep deprivation can lead to postpartum depression.
A strong support system with people who are non-judgmental can deeply help new moms. Making time to do hobbies can also help prevent postpartum depression.
Nerina Garcia-Arcement, a licensed clinical psychologist, said in an email that she suggests attending new mother support groups.
“Having support from other mothers that are struggling with managing sleep deprivation, growing demands on their time, and worries about how to parent will help reduce feelings of insecurity and isolation,” she said.
She added that although children can bring joy to mothers, there is also a lot of stress involved, and there are hormonal shifts during pregnancy and nursing as well to deal with, making it likely that prior mental health issues will continue after childbirth.
Cindy Liu, a clinical psychologist and researcher at Harvard Medical School, said in an email that women with mental health issues who are considering having children should make treatment a priority.
This could include attending individual or group psychotherapy, as well as mindfulness-based cognitive therapy. Medication is also an option for women who need it.
She suggested making a preconception counseling session so professionals can assess their risk of developing postpartum depression, and create an action plan to manage any symptoms.
“Introducing a major life change -- however positive it may seem -- can have an adverse effect on mood and functioning, especially for those who may already have trouble managing their mood,” Liu said.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorder: Fifth Edition. Arlington, VA: American Psychiatric Association, 2013.
Burke-Galloway, Linda. Email interview. August 27, 2013.
Calico, Nivea Briggitte. Email interview. August 28, 2013.
Bennett, Shoshana. Email interview. August 28, 2013.
Garcia-Arcement, Nerina. Email interview. August 28, 2013.
Liu, Cindy. Email interview. August 26, 2013.
Reviewed August 29, 2013
by Michele Blacksberg RN
Edited by Jody Smith