Many women approach motherhood with a cautionary knowledge of postpartum depression. Yet many expecting mothers are completely unprepared when they start experiencing mental distress during pregnancy, despite the fact that pregnancy or antenatal depression is the most common pregnancy complication.

A ton of bricks

Holleigh was no stranger to depression. Similar to one in five Canadians who experience mental illness each year, Holleigh had suffered on and off since age 15. She wasn’t prepared for the fact that the physical and hormonal changes caused by pregnancy can increase the likelihood of developing a mental illness. She was caught completely off guard when her symptoms hit her full force during her pregnancy.

“When I got pregnant, it just hit me like a ton of bricks,” she says. “I was worried about postpartum depression because you hear so much about that, but I had no idea that depression and anxiety during pregnancy was a thing.”

Holleigh couldn’t understand why she wasn’t enjoying being pregnant with a baby she had spent years wishing for.

Why aren’t you happy?

“You expect to be exceptionally happy and I wasn’t,” Holleigh says.  “I was just going through the motions. I was very happy and I couldn’t wait to have a baby but I found everyday tasks and just life was very overwhelming.”

Lisa had suffered from panic disorder as an adult but as soon as she became pregnant she found herself visualizing driving her car off the road.

“I was trying to hide it. My husband knew something was off because he is very perceptive, but I don’t think he knew how bad I was,” she says.

Lisa was able to hide her symptoms because she was working from home. If she stayed in bed and didn’t get dressed or shower there was no one to notice except her husband.

“He would take and physically put me in the shower come in with me and wash my hair for me because I wasn’t physically capable of doing it myself.”

Holleigh’s symptoms were picked up by a co-worker she had a close relationship with. Although she would confide in her, it took two separate breakdowns for her to really reach out for help.

“I think there is a perception that pregnancy is wonderful and marvelous and is the best thing ever and you are happy and glowing and when that doesn’t actually happen it is kind of hard to deal with,” she says.  

Counting Sheep

Both Holleigh and Lisa were also suffering from insomnia which was adding to their mental distress. Although Holleigh considered going on medication during pregnancy, she found that once she stopped working and was able to rest she could better manage her symptoms.

“I was still struggling with depression but it wasn’t to the same extent as when I was working,” she says. “I have a stressful job as well and at the time I had a very stressful caseload. There were several factors that were compounded.”

The breaking point

Lisa’s distress came to a halt after a routine parenting class offered her an olive branch. She spotted a public health nurse and finally asked for help. She ended up with the crisis team and an appointment to see a psychiatrist the next day. A week and a half later she was back again.

Lisa’s insomnia was so bad she was staying up for three or four days at a time. After her second trip to the crisis team, her medications were changed to address her sleeping issues. After that, she was able to get more rest, especially when she was let go from her job at seven months pregnant.

Sweet relief

Holleigh found relief from her symptoms with the birth of her son. Friends and family were surprised at how well she was able to adapt to parenthood. Despite her fears about postpartum depression, she was able to transition to motherhood without any major hiccups.

Lisa had a similar experience after the birth of her daughter. Although she didn’t sleep for the first three days, once she was able to rest at the insistence of a concerned nurse, she was ready to take on the challenge of parenthood.

“It was like a cloud had lifted. I was confident,” she says. “I didn’t feel like a first-time parent.”

The aftermath

Despite the fact that Lisa did not have any depression for the next six months, she put herself on a waiting list to see a psychiatrist regularly.

Lisa waited almost three years before getting pregnant again.

“One of the reasons we waited was because I wanted to have a psychiatrist in place. We knew it was a possibility it could happen again.”

Second time around

Both Lisa and Holliegh experienced mental illness in their second pregnancies; but with supports and doctor’s monitoring in place, both were able to have better outcomes. Although both women needed to stop working earlier in their pregnancies in order to cope.

“I made myself a plan to pull the plug for work. Work was my first thing to go if I felt things were starting to get bad,” Holleigh says.

“This time around I had the same OB so I had conversations with her, in the beginning, preparing for possible mental health concerns this pregnancy. Of course, it manifested itself quite differently this time around.”

In her second pregnancy, Holleigh was happier but found herself easily irritated and bothered by loud noises.

“I found a noisy room bothered me. You just get that ants under your skin, bugs crawling all over you feeling where you just need to get away. I had that a lot.”

Lisa also experienced anxiety during her second pregnancy. With closer medication monitoring, seeing her psychiatrist and cognitive behaviour therapy, she was able to avoid getting to the point of spending her days crying.

“My second pregnancy was so much better because I knew to get treatment and get my meds managed when they need to be managed. I also went off work at 16 weeks,” she says.

Lisa says she now speaks out about mental illness in pregnancy to help other women seek help.

“It felt like it stole something that should have been very special and should have been very happy. I waited way too long without treatment,” she says. “If I can save anybody from going through that to the extent that I did, I would welcome talking about it.”

Holleigh wants to spread the message that there is nothing abnormal about suffering from a mental illness.

“I really wish I had someone to say, this is a normal thing in pregnancy and this happens. I didn’t have any knowledge of it,” she says. “It is important to talk to the supports in your life. It is very important to not dismiss what you are feeling. We need more discussion we need more openness.”

When it’s time to get help

It’s a good idea for all expectant mothers and their partners to monitor their mental health and wellbeing. Keep a lookout for signs that you may need help, and be ready to take action if you need to.

While pregnancy has its ups and downs, it’s time to seek advice from a health professional if:

• you’ve felt consistently bad (e.g. sad or worried) for longer than 2 weeks
• negative thoughts and feelings are starting to affect your ability to function normally
• you’re showing signs of depression, such as losing interest or feeling hopeless or unable to cope
• you feel anxious or worried most or all of the time
• you start having panic attacks or develop obsessive or compulsive behaviours.

If you or someone you know is experiencing these symptoms please reach out to your healthcare provider, support systems or visit The Canadian Mental Health Association.