Depression or hormones?

[TeFiTheMountain]

I'm 16 weeks pregnant and struggling to tell if how I'm feeling is antenatal depression or hormones.

Why I'm getting confused is mostly because I keep crying, which is not like me even when I am depressed. I spent yesterday hiding from my DH and DS because I kept crying.

I generally feel extremely low, wake up every day feeling miserable and it gets worse as the day goes on. I have no energy, I'm conscious I'm basically withdrawing from my family, feigning headaches so I can stay in bed. I'm really struggling at work, I have no motivation whatsoever. I've just been promoted so this is adding to my guilt that they're going to be disappointed in me. I work full time in a full on job and I'm just struggling to even get up in the morning.

I've not really connected with this pregnancy. It doesn't help that it's still too early to feel anything. It's my second and was planned but I've had a feeling of ambivalence since the beginning. That said I am absolutely terrified of anything being wrong and dreading my 20 week scan. I spend a lot of time reading threads here about late miscarriage and still birth.

I spend no time with my DH and go to bed at the first opportunity to be alone. He can see I'm struggling but I'm not really letting him help. I don't really want him near me.

So how can I tell the difference? I didn't feel like this in my last pregnancy but it was years ago and I can't remember it very well anyway.

I had ante-natal depression which I only realised when I was diagnosed with PND. It doesn't really matter what is causing it- the fact is that you've been feeling this way for a while and you're noticing an impact on your day to day life. Your midwife will be able to support you and I would encourage you to discuss this with them.
I really hope you're ok xxx

Thank you. I'm actually with the perinatal team as a precaution (I have a diagnosis of bipolar disorder but have successfully managed without medication for years so I query it tbh) but I'm afraid if this is just hormones and it'll settle down that they'll overreact and make me take medication, which because of my condition wouldn't just be antidepressants. It took me such a long time to get off them. But I'm struggling to identify how I feel and what help I do need.

I'm bipolar too and had a mild depressive episode from ~4 to 24 weeks then it lifted. I have stayed on quetiapine throughout my pregnancy but I didn't want to increase the dose for the depression. My bipolar is quite classical in presentation in that I get low in the winter months and high in the summer. I edged my bets that if I could tolerate the low mood until spring it would lift on its own. It was slightly off and my mood lifted in May when it usually lifts late march.

I would work with the assumption it is depression and see if things that would usually make a difference help now. Even if it's hormones they may well be causing some antenatal depression too. I would speak to the perinatal team too, there are none medication options they can help with too. I was referred for some cbt unfortunately it was too basic a service to help me as I had done a proper cbt course in the past. The only positive I got out of it was the reminder that when I'm low I need to plan to do things that are relaxing otherwise I won't do them. I now have a support worker through the perinatal team although I'm not seeing them frequently until after the birth as my mood has stabilised.

What has helped in the past when your mood has been low? Do your episodes lift on their own or do you usually have to be medicated out of them?

I was on quetiapine throughout my last pregnancy - this time I'm trying to go without anything but they're already talking about quetiapine as psychosis prophylaxis before delivery which I desperately don't want - quetiapine makes me so so sleepy and I can barely function on it.

I do tend to get a depressive episode in the autumn, so this is a bit early. In the past I've had a hospital admission and 2 months with the crisis team due to depressive episodes in the autumn. But not for almost 10 years now! I've had some mild episodes since but I tend to just ride them out.

I hear you! I have been in it for 8 years at various doses and there are times when it is super sedating. Thankfully at the moment I'm going through a period where its not too bad but we have already discussed a plan if it is too sedating after birth.

If you were to look through the list in your first post is there anything that you could tweak to improve your mood?

One thing that massively impacted on my mood earlier in my pregnancy was pregnancy fatigue which stuck around through out my 2nd trimester. Learning to move my expectations more in line with my energy levels helped.

I've been very fatigued but there's not much I can do in terms of what I do in the day. I work full time, my husband has to work at night (from home) as he looks after DS in the day, so when I finish work I take over. When he goes to sleep I go to bed. I am barely coping at work and the place is a tip, I don't think I can cut back on anything else.

Sorry I poorly explained myself. It was more my expectations of how I felt rather than what I did. "I shouldn't be tired after a day at work because I'm wfh and not even commuting" the fatigue is causing tiredness the negative self talk by not acknowledging the fatigue fed the depression which made the fatigue worse.
The same with the house work, the place got into a state my head was full of "shoulds" I need to accept that what I could manage in a day didn't extend to housework. Once the self talk was more in line with my ability and I was expending less effort berating myself there was more energy doing the things I was berating myself for not doing. I'm nor sure I've explained myself very well....

Saw the perinatal psychiatrist- they weren't concerned at all. Just said to keep an eye on it.

It's good they weren't concerned. How are you doing?