Up to one-third of women who develop postnatal depression first begin to experience symptoms of depression during their pregnancy, Irish psychiatrists have warned.

According to the doctors from the Dublin North Psychiatric Services, the term postnatal depression ‘may be something of a misnomer', given the high amount of women who actually start feeling depressed during pregnancy.

They noted that while in general, pregnancy is a time of ‘emotional and psychological wellbeing, in which mental health symptoms, such as panic and anxiety, typically improve', postnatal depression affects between five and 15% of mothers.

"Traditionally, mental health difficulties have been viewed as having a higher prevalence in the postpartum period, rather than during pregnancy itself. However, a growing literature suggests that late pregnancy may also be associated with a higher risk of depression," they explained.

The doctors pointed out that it is ‘not uncommon' for women to experience mild symptoms of depression and anxiety during pregnancy. This can be brought on by, for example, concerns about whether they will be able to look after a new baby.

However symptoms of full-blown depression may include significant anxiety, increased irritability and increased fatigue, even above what would be expected with a new baby.

"A fear of being unable to fulfill impending duties as a mother is common. Self-confidence and self-esteem can decrease, alongside feelings of inadequacy, loss of self-worth and feelings of guilt," they explained.

An excessive focus on the baby and frequent tearfulness are also common.

"The future may be viewed as bleak. In severe episodes, pregnant women may present with ideas of self-harm or suicide," the doctors warned.

They said that it is important to identify mothers who are at risk during pregnancy and in the months after having a baby and where depression occurs, treatment is essential. This may include different types of therapy, such as cognitive behavioural therapy, and in some cases, medication.

"For mothers, pregnancy is a crucial time in the life course and the maintenance of good mental health at this time should be regarded as a priority in maternal and infant care," the doctors added.

The psychiatrists made their comments in the Irish journal, Psychiatry Professional.

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