Depression during pregnancy and in the period after birth should be ‘actively managed', as taking a wait-and-see approach is likely to lead to more problems, a consultant psychiatrist has warned.

Perinatal depression (PD) refers to depression that occurs during pregnancy or up to one year after the birth. According to Prof Veronica O'Keane of Tallaght Hospital, who is also professor of psychiatry at Trinity College Dublin, depressive symptoms are common during pregnancy.

"Most women experience an increase in anxiety and depressive symptoms as pregnancy advances. These symptoms usually return to baseline by about six weeks postpartum," she said.

Rates of clinical depression also increase as pregnancy advances, from around 7% - the normal rate in women who are not pregnant - to 12% in the third trimester.

Prof O'Keane pointed out that all of the risk factors for depression outside of the perinatal period also relate to PD, however there are specific risk factors associated with pregnancy. These include:
-An unintended pregnancy - this is a major risk factor for PD, with unwanted pregnancies linked to a two-fold increase in the rate of depression
-Teenage pregnancy - Rates of depression are high among pregnant teenagers
-Hormonal factors - there are major shifts in concentrations of hormones during pregnancy, as well as exposure to pregnancy-specific hormones, which can increase the risk of depression in some.

Prof' O'Keane said that PD is a challenge to treat but unless it is actively managed during pregnancy, it is unlikely to go away after the child is born.

Those affected should be referred to either a perinatal psychiatrist or a general adult psychiatrist and treatment may include the use of antidepressant medication.

"Active management of PD is pivotal to the future mental health and wellbeing of the woman, her success as a parent and the development and future wellbeing of her baby," Prof O'Keane added.

She made her comments in Forum, the Journal of the Irish College of General Practitioners.

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For more information on depression, see our Depression Clinic here