All adults should be screened for depression, but this type of screening is especially important for new and expectant mothers. That’s what the U.S. Preventive Services Task Force, an independent panel of medical professionals, recently recommended.
Depression is the most common mental disorder in the U.S., but depression during and after pregnancy has historically been underreported and undertreated, perhaps in part due to the stigma that still surrounds mental health issues and the expectation that childbirth should be a joyful experience. Estimates for the rates of antepartum and postpartum depression vary; according to NPR, approximately 10% of women experience a major depressive episode after giving birth, and according to an article in The New York Times, depression affects up to 15% of pregnant women.
There is no one cause for antepartum and postpartum depression, but researchers say that stress, genes, and hormones are all likely to play a role. Some women may be genetically predisposed to experience depression during times of hormonal fluctuation, such as pregnancy.
Although depression during and after pregnancy is relatively common, some women are still hesitant to seek treatment. Many women are concerned about taking an antidepressant drug during pregnancy, since some of these medications have been linked to a small increase in the risk for miscarriage, preterm delivery, and low birth rate. However, untreated depression has also been linked to miscarriage, preterm birth, pre-eclampsia, and neonatal complications, according to The New York Times.
The U.S. Preventive Services Task Force recommends cognitive behavioral therapy as the first line of treatment for women who have been diagnosed with depression before and after pregnancy. Cognitive behavioral therapy, which seeks to change negative patterns of thoughts and behaviors, is recognized as an effective treatment for clinical depression.
In response to the question of whether or not the benefits of antidepressants outweigh the risks during pregnancy, the panel said that some antidepressants could cause “potential serious fatal harms” but that “the likelihood of these harms is low”.
Financial assistance is available to pregnant women and new mothers with health insurance seeking mental health services. The Affordable Care Act expanded mental health coverage, and almost all insurance plans must offer preventive services, including screening for depression.