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Is pregnancy an optimal time to treat maternal depression?

Maternal depression affects both mother and child and has significant long-term negative effects on infant development and child mental health.

During pregnancy, an estimated 8.5 to 11% of women meet diagnostic criteria for major or minor depression (Gaynes et al., 2005), and even more women report elevated levels of prenatal depressive symptoms (Marcus, Flynn, Blow, & Barry, 2003).

Rates of depression among high-risk samples of pregnant women, such as those exposed to contextual risk factors (e.g., poverty, racism, and violence), may be as high as 25% (Hobfoll, Ritter, Lavin, Hulsizer, & Cameron, 1995).

Prenatal maternal depression affects both mother and fetus with long-term implications for offspring vulnerability to psychopathology through alterations to brain development, stress physiology, negative emotionality, and cognitive control.

Consider Melissa’s story:

During a prenatal appointment in her first trimester, Melissa disclosed to her doctor that her current pregnancy was unplanned and she was experiencing conflict with, and receiving little support from, the father of her baby, who had wanted her to terminate the pregnancy. She reported depressed mood, excessive guilt, and crying spells, which she tried to hide from her son, and she had reduced interest in her usual activities, although she felt pressure to “put on a smile” for her son.

She was unemployed and had missed recent job interviews as well as her prior prenatal appointment because she was struggling to get going and get out of the house in the morning. She was fatigued, spent much of the day napping, and struggled to make herself eat regular meals. Indeed, her doctor noted her failure to gain expected weight.

This article details Melissa’s experience throughout pregnancy and treatment, describing psychotherapeutic interventions that are used to mitigate prenatal maternal depression and thus, may positively impact infant and child development.

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