Pregnancy is the happiest time of a women’s life. But during this important phase of life, many women suffers from fear, stress and depression. Studies have reported that around 14-23% women show symptoms related to depression during the gestation period. Depression is a type of mood disorder. Almost 25% women experience it once in a lifetime so it’s not surprising that it will not be touched by pregnant women. Most of the time it is correlated with hormonal changes during pregnancy and are ignored or not diagnoses properly. But in reality, it is somewhat related to it but with a different view. Rapid hormonal changes actually disturb the brain chemistry which leads to depression or mood disorders. The other possible reason could be the acknowledgment of depression by the pregnant woman. Depression in pregnancy is an illness and need to be treated to avoid the dangerous problems for the mother and unborn baby. It has to be kept on the priority and need to be solved as pregnancy is the greatest joy of the women’s life. Pregnancy is a major psychological and physiological event with an excess of chronic stress so that women fail to cope up the additional demand during pregnancy. Women living in poverty or already having many dependent children may look at it with a negative feeling. The steroidal sex hormone activity during pregnancy stimulates the hypothalamic-pituitary-adrenal axis which is related to depression. Research has also revealed that cortisol level may affect fetal development and be associated with changed temperament and behavior. Many women stop antidepressant therapy due to the fear of potential harm to the fetus. Epidemiology: 7% of women are depressed outside the perinatal period. 10-15% of women in developed countries are depressed in pregnancy. 19-25% of women are depressed in economically poorer countries. 10% of women are depressed postnatally. Rates of relapse in pregnant women with a history of recurrent mood disorder may be up to 50%. Symptoms: Pregnant women under depression generally show fatigue, trouble during sleeping. They fail to manage the day to day activity. Following is the list of symptoms should be observed in pregnant women. Persistent sadness Difficulty concentrating 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 The panic attack showing racing heart, lightheadedness or faintness, sweaty palms, breathlessness depicts anxiety. The excessive caring nature also a symptom related to anxiety. Common risk factors: The women with social and economic diversity are mostly experienced the antenatal depression and anxiety. The common risk factors include History of mood and anxiety disorders History of postnatal depression History of premenstrual dysphoric disorder Family history of perinatal psychiatric illness History of childhood abuse Low income and poor social support Unplanned pregnancy and young age Single motherhood Large number of existing children Domestic violence or relationship conflict Screening Screening of women with depression is one of the tough jobs for physicians. Women generally don’t acknowledge that they are having depression or mood disorder. The successful screening could be possible with the help of questions mentioned in NICE guideline for the health professionals. They should ask following two questions to the pregnant woman. During the past month, have you often felt bothered by feeling low, depressed or hopeless? During the past month, have you often been bothered by having little interest or pleasure in doing things? If the answers are affirmative then a third question should be asked: Is this something you need or want help with? The suggestions in guideline could possibly screen the women with antenatal depression. Management Antidepressants: The management of antenatal depression with antidepressant drugs has always been on the controversy. The problems with newborns like pulmonary hypertension, physical malformation, heart disease and low birth weight are found to be associated with the antidepressant therapy. A woman with mild or moderate depression may manage her symptoms with the help of support groups, psychotherapy and light therapy. The woman with severe depression needs to be managed with a combination of psychotherapy and medication.

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