Women With Depression During Pregnancy – Part 3

The women who have had anxiety and depression during pregnancy talk about their experiences.

Women in this study accounted for their experiences of depression in terms of symptoms, the events and circumstances that they perceived contributed to their depression, and the steps that they took to address their depression.

They told of an inability to function, an overwhelming anxiety, an inability to organize their thoughts, and trouble making decisions: tasks that “normally seemed easy, seemed huge” so that “getting through the day was horrendous”.

Overwhelmed and exhausted, the women confront their depression, and in the circumstance of their pregnancy, the depression was conceived as threatening to themselves, to their developing baby, and to their ability to mother the coming baby.

The problems confronting women in this study were a loss of control, an altered perception of self, and doubts about their maternal ability. The basic process for these women was becoming the best mom that I can.

From the women's perspective, becoming the best mom that I can was the process of “doing everything I could” to implement control over the perceived threat to their pregnancy and their ability to care for the baby after birth.

What the women do to regain control and reground the self, and how they do it, is juxtaposed with what they perceive to be the optimum situation for the developing fetus and 'soon-to-be' baby. They search relentlessly to find the most acceptable answer; they reflect upon the self, acknowledge the problem, and embark upon a journey to “put things into place before I have the baby”.

This process consists of four major categories:

Traveling into despair (causal conditions).

Conceiving the threat (phenomena).

Confronting and confining the threat (actions)

Regrounding self and regaining control (consequences).

Causal conditions of phenomena - Traveling into despair.

The conceptual category of traveling into despair describes the women’s experiences as symptoms of depression invaded their lives. Symptoms occurred at different stages of pregnancy for each woman; however, all described arriving at a point where they could not envisage themselves being any lower.

They used phrases such as: “traveling down into blackness”, “downward spiral”, “wandering around in a blur”, “constant state of despair,” “downhill”, “teetering”, “going crazy”, “falling apart”, “crash and burn” “sliding into a depression”, “into the pit of hell”, and “over the edge”.

The five properties that comprised traveling into despair were: Irrational emotions, Inability to function, Invasive thoughts, Pervasive anxiety, and Social withdrawal.

Irrational emotions
Women spoke of frequent episodes of sadness, anxiety, irritability, anger, crying, and worry which led to feelings of “low self-worth, low self-esteem” and guilt. They were at a loss to understand or to explain their emotions which seemed to occur for no apparent reason and often without warning.

One woman reported “just tears so close to the surface that anything would, I would just fall apart, and not just, it's not that sad, but it's almost irrational.” (#7) (Note: As mentioned in Part 1, confidentiality was maintained by assigning each participant a code number).

Inability to function
The inability to function invaded every aspect of their lives. From the simplest of activities such as personal hygiene to the more complex tasks required in the performance of the work-day role, inside and outside the home, the women told of impaired performance. One woman, who had an older child, told of her inability to care for her son, “I felt bad because I wasn’t at a point where I could take care of him how I usually take care of him.” (#3)

Invasive thoughts
Some women spoke of being unable to imagine their baby or imagining the baby “as this thing growing inside of me”. A number of women had what they described as invasive thoughts:

Like, I had a thought of a woman stabbing me in my stomach when I was pregnant, you know. A woman that I saw in the elevator one day, you know, so, those weird passive thoughts. (#16)

Many women spoke of the fear of losing their mind or going crazy, and, while none attempted suicide, some had thoughts of suicide due to the intense pain their feelings were causing:

I wasn’t planning to kill myself, or I hadn’t thought of ways to do it, but I just wished every single day that I was dead, you know, I didn’t want to live. (#21)

Pervasive anxiety
Many of the women were anxious; they felt that something bad might happen but were at a loss to explain this feeling.

It’s hard to explain this anxiety, because it’s like something horrible is wrong, like something horrible happened to you. But nothing horrible happened to me. I don’t know how to explain it. The anxiety was always there.

Social withdrawal
Women withdrew from their world as they had known it. They did not maintain old friendships, nor did they establish new connections. Instead, they retreated into their homes which one woman described as becoming a “hermit”. For some, interaction with others served only to highlight the intensity of their misery. Perhaps most illuminating was the following statement:

Even going to the [baby] showers is withdrawal, you know,balloons, and happy, and presents and friends, and nothing but people wanting to smile at you and you're just standing there like miserable, for no reason you can put your finger on. (#20)

Part 4 will be published soon - The women try to make sense of their feelings and are unable to do so.

Related articles:

Dealing with Depression during Pregnancy – Part 1

Depression During Pregnancy – Part 2

Depressed? Drink Tea

The researchers were Heather Bennett, Heather Boon, Sarah Romans and Paul Grootendorst. The above is a partially modified reproduction of their research. Also their references have been omitted for ease of reading.

Reference:

Bennett HA, Boon HS, Romans SE, Grootendorst P. Becoming the best mom that I can: women's experiences of managing depression during pregnancy – a qualitative study. BMC Women's Health 2007, 7:13 (11 September 2007). © 2007 Bennett et al., licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.