Britney Spears is putting an important health topic in the center of the ring: perinatal depression. In an Instagram post on Monday, the singer — free from her conservatorship and apparently her IUD — announced she’s expecting her third child. And in the same post, she opened up about the struggles she faced in her previous pregnancies, specifically with depression.
Spears wrote that perinatal depression “is absolutely horrible.”And that “women didn’t talk about it” when she was pregnant with her sons more than a decade ago.
She continued, in her staccato Insta caption style, that “some people considered it dangerous if a woman complained like that with a baby inside her … but now women talk about it every day … thank Jesus we don’t have to keep that pain a reserved proper secret.”
It’s true: In recent years there’s been more discussion about pregnancy-related depression. But a lot of that talk has focused specifically on postpartum (aka post-birth) depression. So we called up Dr. Lucky Sekhon (no relation to the song), an OB-GYN and fertility doctor. She helped us break down what perinatal depression is, why it’s long been stigmatized, and how you can treat it.
Remind me: What is perinatal depression?
Perinatal depression describes “depressive symptoms that occur during or shortly after pregnancy,” Dr. Sekhon said. An estimated 10% to 20% of women develop a pregnancy-related mood disorder. And Dr. Sekhon — who gave birth during the pandemic — thinks that the uncertainty of the last couple years has likely made perinatal depression even more common.
What are symptoms of perinatal depression?
They’re similar to signs and symptoms of depression. Think: appetite changes, frequent crying, increased anxiety, trouble sleeping. But symptoms can range from mild to severe. “In some cases, the symptoms can be severe enough that this can actually risk the health of the mother and even the unborn baby,” Dr. Sekhon said.
Thing to know: Perinatal depression is more intense than the “baby blues,” which is the term people often use to describe the subtle mood changes caused by postpartum hormone fluctuations and exhaustion, Dr. Sekhon said.
What causes perinatal depression?
When it comes to depression after birth, hormones can clearly play a part. At that point, the body is withdrawing from progesterone — which is also what happens during PMS — and that can impact your mood. But for depression during pregnancy, Dr. Sekhon said she’s not aware of any hormonal mechanisms that cause it, “although one could exist.”
Genetic and environmental factors can play a part. But in general, “pregnancy impacts every aspect of the way your body functions,” Think: the fact that your blood volume increases and lungs can get compressed. So depression during pregnancy “could have a physiological root,” Dr. Sekhon said.
Why has the topic of perinatal depression been taboo for so long?
One major reason: guilt.
“A lot of pregnant women have so much guilt because they feel like it’s [supposed to be] a very selfless time and they should be focused on their baby,” Dr. Sekhon said. “So there’s a lot of negative self-talk. And I think a lot of pregnant women hide how they’re truly feeling from their family members.”
But when celebrities like Britney Spears come forward with their own perinatal depression experiences, it can be “an incredibly amazing thing,” Dr. Sekhon said. “It normalizes something that’s traditionally associated with a lot of stigma and shame. It just makes it feel like it's not so rare. And there's nothing wrong with you.”
How can perinatal depression be treated?
First: If you’re experiencing symptoms of perinatal depression, talk to your OB about diagnosis and next steps. Treatment can include medication, talk therapy, or both.
As for medication, Dr. Sekhon said “there’s a lot of misconceptions” about what you can take while pregnant. Read: Not all meds are off-limits. In fact, she said there are many cases where it makes sense for a patient to stay on their pre-pregnancy antidepressant. Or be prescribed something new to deal with depression while they’re pregnant. Because often “the benefits of treating the perinatal depression are going to far outweigh any of the theoretical risks or unknowns,” Dr. Sekhon said.
When it comes to therapy, there are plenty of different styles to consider, Dr. Sekhon said. See: psychotherapy, cognitive behavioral therapy, interpersonal therapy. You can even work with a therapist who has a perinatal specialty.
If you’re feeling depressive symptoms while you’re pregnant or postpartum, you’re not alone. Perinatal depression is common. And, as Britney put it, should no longer be a secret. It’s something worth bringing up with your doctor. Because it’s important to care for yourself as your body goes through major changes to carry and take care of a baby.
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