Perinatal Anxiety & Depression

Recent research has shown that women who have complications during pregnancy, such as HG, have a greater risk of Perinatal Mood and Anxiety Disorders (PMAD). The longer and more severe her symptoms, the greater her risk. About 1 in 3 mothers with HG will face PMADs which are exacerbated by the psychosocial stress and complications resulting from HG, including prematurity and neurodevelopmental issues in the child(ren). Factors such as hormonal changes also may cause PMADs and should be evaluated and monitored by a health professional for at least the first year postpartum.

Awareness

Every woman with HG should be aware of the symptoms of PMADs and make sure those around her are as well. Self-diagnosis is very difficult. Signs of PMADs should prompt a call to her OB/GYN or primary care practitioner, or a mental health specialist. If an office visit is too difficult, telemedicine options are available for postpartum support and may be covered by medical plans.

Early Intervention

Early intervention for PMADs is important, and safe treatments are available even if a mother is breastfeeding. Research finds a healthy, nutrient dense diet with essential fatty acids and extra vitamins including B vitamins, along with regular exercise to be very effective in treating mood disorders in some people. Women with HG need extra help regaining strength and eating healthy to recover. Some may require medication as well. 

Fathers

Fathers often suffer from depression and stress during and after HG pregnancies due to fear of harm to mother and child, feelings of helplessness watching a partner suffer, and the physical and financial strain of pregnancy complications.

mother baby

Risk Factors for PMADs

History of prior postpartum depression

History of depression or bipolar disorder during or before pregnancy

History of severe PMS (premenstrual syndrome)

Pregnancy complications and traumas

Family history of depression or bipolar disorder

Recent stress such as loss of loved one, family illness

Inadequate social support or marital instability

Ambivalence towards the pregnancy

Child with health issues or special needs

Difficulty with breastfeeding

Multiple gestation pregnancy

PPD Support and Information

Offsite Research

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Symptoms of PMADs

Exhaustion, insomnia

Trouble motivating oneself to do normal everyday tasks

Difficulty making decisions

Strong feelings of sadness, anxiety, panic, or irritability

Emotional stress which interferes with taking care of self or family

Diminished interest in self-grooming (dressing, bathing, fixing hair)

Sleeping too much or inability to sleep when tired

Loss of pleasure or interest in things which used to be fun or interesting

Hopelessness, tearfulness

Trouble concentrating, making decisions, remembering things

Rapid mood swings

Obsessions, frightening recurring thoughts

Overly intense worries about the baby

Lack of interest in the new baby

Self-doubt, low self-esteem

Diminished interest in food (or compulsive overeating)

Feeling distance from or lack of love for baby and/or partner

Thoughts of harming self and/or baby

Postpartum Issues After HG

25% had depression and 28% anxiety 
58% had difficulty caring for themself
67% had a negative mental experience

30% lost their employment 
32% had marital difficulties
56% felt negatively towards others

Tian, R., et al., Analysis of pre- and post-pregnancy issues in women with hyperemesis gravidarum, Auton. Neurosci. (2016).