Prenatal Depression: When ‘That Pregnancy Glow’ Is Blue

My first pregnancy had been easy. It was everything women have been taught to believe pregnancy should be: weekly bump pictures comparing my growing baby to exotic fruits, prenatal yoga on Tuesday nights with my pregnant friends, plenty of ice cream, and no complications. Expecting the same kind of experience, I became pregnant with my second child without hesitation.

Around month 5, I developed what I later learned is called antenatal depression. I began to resent my pregnancy, to fear becoming a mother to my second child. I grew irritable, snapping at my fiancé for no reason. I ran out of energy and patience, and found myself avoiding social outings because I didn’t have the energy to pretend I was happy and because I wanted to avoid conversations about my very visible pregnant belly. I didn’t want to have to pretend I was happy or try to fake a glow that I so clearly lacked.

During my morning showers, I would check in with myself and try to gauge how I was feeling that day. The answer was never words. It was always just tears, visually indistinguishable from the streaming water, but feeling so much hotter, seemingly burning my face as a reminder that my depression was still present, refusing to let me out of its grasp.

I work as a middle school special education teacher, and I became unable to teach effectively. Many days, I was too drained to walk around the classroom for five hours, to check in with each of my students to make sure they grasped the concepts I was trying, clumsily, to teach.

On days when students misbehaved, throwing crumpled up papers at each other or talking to each other instead of listening to directions, I knew they were testing my limits because they could tell that I had grown tired, but I didn’t have the stamina to redirect them using positive reinforcement. Instead, I was short-tempered, grumpy, and destroying the relationships I had spent the first half of the school year building. After my last class of the day, I would close the door to my classroom, sit at my desk, and cry.

Sunday nights were unbearable. I became anxious knowing that I was about to enter another week of failing my students. The anxiety was paralyzing. I couldn’t plan engaging lessons to help prevent misbehaviors. I couldn’t enjoy time with my 2-year-old daughter. I couldn’t have a productive conversation with my fiancé. Instead, my mind played out hypothetical scenarios that I might encounter throughout the week that I would be unable to handle. I envisioned a fight in my classroom, students arguing me if I tried to get them on task, students yelling curses across the room at each other. I could feel my heart pounding at the thought of these imaginary conflicts and at my inevitable impotence.

Yet I told no one. I was embarrassed that I did not feel radiant, that I was not full of joy the way pregnant women are expected to be. And there was no reason for me to be depressed; I had a beautiful, easygoing daughter already, another healthy daughter on the way, a supportive fiancé, and a job that I loved. And I had never heard of anyone becoming depressed during pregnancy. I knew that it was because there was something wrong with me.

I also knew that my depression was bad for my growing daughter and that I was probably condemning her to a life of struggling with depression herself. Doctors often advise women with depression to stay on their medication during pregnancy because the side effects of antidepressants are far less damaging than the baby being exposed to extensive stress in the womb. But having had depression for years, I was already at the maximum dose of Lexapro to manage it. What else was there to do? Now my daughter would suffer the effects of prenatal exposure to an SSRI and the effects of depression. I was failing her already.

And I would only continue to do so. When I envisioned delivering her, despite how easy delivering my first daughter had been, I knew that I would not be able to do it. I knew that as soon as labor started, I would not have the energy to withstand contractions. I would not have the strength to push. I wanted only to be a passive participant, to have an elective C-section; really, it was all I was capable of doing.

Beyond that, I was frightened of becoming my new daughter’s mother. Part of me believed that pregnancy itself was the culprit — that as soon as I had the baby, I would be fine. I would bask in the glow of new motherhood, relishing the sweetness of the milk on my new baby’s breath, losing entire days staring into her violet eyes and memorizing the feel of each and every one of her fingers. But another part of me feared that the depression would linger after delivery, evolving into postpartum depression, that I wouldn’t be able to love or care for my child.

A few months after I had my first daughter, a friend of mine had her first child and I had watched, helpless and pitying, while she struggled with postpartum depression. She could not breastfeed her child because it felt to her like her baby was suffocating her, taking away part of her being with each suckle. She refused to hold the baby, would lock herself in her bedroom for hours so she did not have to face the child who longed to nestle against her breast. Throughout her illness, I longed for her to recover, grieving on her behalf the lost months of bonding with her child. Now I faced having a similar experience, except that if I developed postpartum depression, I would know what I was missing, and surely, I would resent myself for missing it.

At an appointment at the beginning of my eighth month, my midwife asked me how I was feeling. My heaving chest and cascade of tears answered for me. After speaking to the midwife about how I had been struggling silently for months, I asked, nervously, whether what I was experiencing was normal.

“Absolutely,” she assured me. “It’s from all of the estrogen your body produces when you’re pregnant. Some women experience it starting as early as the first trimester.”

She recommended that I speak to my psychiatrist about increasing my antidepressants, even if that meant adding another one, and that I see a therapist who specializes in women who are either pregnant or new mothers.

Since my diagnosis, I have added another antidepressant, doubled the dose of it, and begun weekly therapy sessions with a doctor who specializes in maternity. I have also started maternity leave six weeks before my due date to try to minimize external stressors. These steps combined have helped to make my antenatal depression more bearable, but it certainly has not disappeared entirely.

And still, I do not talk about it frequently. I have told only my closest, most trusted friends, whom I can count on to support me instead of judge. I am still embarrassed to suffer from a disease that no one talks about, whose name I didn’t know until I had already been its victim for months.

While postpartum depression has come into the spotlight in recent years with celebrities speaking out about their experiences with it, antenatal depression still hides in the shadows of pregnancy, along with its victims. So I am stepping out to talk about it now in the hopes that other women won’t feel as alone as I did, and so they will know that this disease doesn’t mean they are failing their children before they are even born. Rather, trying to fight through it, even in your most dispirited moments, is evidence of how much you love your child and what a good parent you already are.