I knew exactly what was happening. I'd had recurring problems with clinical depression since I was 19, so the wild mood swings, the feelings of despair and the physical lethargy were all, sadly, familiar. What I didn't understand was why now. I'd got good at identifying things that triggered my depressive episodes, but none of them applied. I was pregnant, and delighted to be so.
A lot of my pregnancy-related reading had highlighted the risk of postnatal depression. I knew that my history suggested I might be more susceptible to it, and it was something I would have to be vigilant about in the first few months of motherhood, but I'd never read anything about prenatal depression. I'd never even heard the term.
The mental-health charity Mind says an estimated one in ten women suffer from depression during pregnancy, a figure that echoes the rate of depression among the wider population. But for many it will be the first time they have encountered the disease, and no one is entirely sure why it should strike first during pregnancy.
"The exact reasons are complex," says Beth Murphy, the head of information at Mind. "The hormonal changes which occur during pregnancy are a factor, as is the fact that many pregnant women feel isolated and discriminated against. There is a widespread assumption that pregnant women should be happy, so they may be reluctant to talk about their feelings or seek help, which, of course, can make the problem worse."
Help, however, is there. As soon as I felt I was losing control of my moods, I spoke to my midwives, and I have nothing but praise for the treatment I got. I was sent to my GP that afternoon, he promptly informed local mental health officials, and within days I was visited and assessed at home.
Treatment varies from person to person and depends on the severity of the depression. Milder episodes respond well to talking therapies and to better diet and more exercise. But more severe attacks may require medication. Doctors avoid putting pregnant women on antidepressants, as the jury is still out as to whether they harm the foetus or not, but a balance has to be struck, because the environment in the womb will also affect the baby's development. By the time I reached the second trimester, I began to feel the sense of equanimity that can come with imminent motherhood. And since my daughter's birth a year ago, there hasn't been a whiff of depression. But for many women the path to motherhood can go awry early on, with serious consequences for both mother and baby.
