Just the pre-baby blues?

When you're pregnant you soon find out that you can literally cry over split milk. In fact, there are days when the tears spring forth for seemingly no reason whatsoever.

For most women these emotional outbursts are a result of the normal roller coaster changes in the levels of the hormones estrogen and progesterone during pregnancy, particularly in the first trimester.

Also natural are the anxieties that accompany such a huge life-change and the self-questioning: "Will I be a good mother? And why can't I stop eating TimTams?"

But according to statistics from the Post and Antenatal Depression Association Inc (PANDA), for about 10% of mums-to-be these emotions will become a real problem. They can lead to antenatal depression that is, depression during pregnancy, as opposed to "postnatal depression", which is after the baby is born.

In 2009, the National beyondblue Perinatal* Mental Health Program was launched – with the government's involvement – to implement a plan and address difficulties and depression in women during pregnancy and early parenthood.

Associate Professor Marie-Paule Austin, Director of the beyondblue project, says, "The basic aim of the project is to put a plan in place so that women's emotional well-being is assessed routinely by health professionals from the moment they begin their pregnancy and on an ongoing basis."

Austin adds that professionals now believe it's important to see antenatal and postnatal depression as part of a continuum, rather than separately. Around one in seven women suffer from postnatal depression, and a quarter of them would have had it start during pregnancy.

Sounds familiar

So how can you tell the difference between normal mood swings and depression? Prof Austin says if your mood doesn't pick up you need to ask yourself if this is more than just being pregnant.

She says, "If you have persistent and strong feelings of ambivalence about being a parent, and an ongoing inability to enjoy this phase or are feeling severely anxious, it could point to antenatal depression, not just a bad week."

According to PANDA, women suffering from antenatal depression would have some of the following symptoms:

• Inability to concentrate and difficulty remembering
• Difficulty making decisions
• Anxiety and feeling emotionally numb
• Extreme irritability and sleep problems
• Avoiding family and friends
• Extreme or unending fatigue
• Wanting to eat all the time or not at all
• A sense that nothing's fun any more or persistent sadness
• Feelings of failure and guilt
• Thoughts of death or suicide

There's a diagnostic self-test for antenatal depression on the site of the Black Dog Institute.

Who is at risk?

Antenatal depression can affect absolutely anyone.

Just as perinatal disorders vary in symptoms, severity and when they start, the causes and risk factors also vary. Experts agree that hormone swings can affect some women more intensely than others but have also identified other significant risk factors.

These may include such things as a previous history depression or abuse, or stressful life events like divorce and job loss. Problems in your relationship or a lack of support from people around you may also put you at risk.

How is it treated?

As with all forms of depression there are successful treatments – from practical support and counselling to medication. The resounding cry from professionals is to get help early and tell people how you feel.

Seeking help early is the critical thing and if you feel anxious or depressed for more than a week you should talk to someone; your partner, family and friends, or your midwife or doctor.

Austin says that good social support can help enormously with mild to moderate cases.

Obviously, if it's more serious and you're constantly crying, can't get out of bed, feel hopeless and helpless then you would need to talk to your midwife or doctor about counselling.

In some cases anti-depressants may be required and your doctor or midwife would discuss any risks and which ones are safe to take.