Depression gone during first trimester of pregnancy. Want more of that.
April 15, 2018 1:52 AM   Subscribe

I'm currently pregnant with my first child. I suffer from moderate depression. I was prepared for my depression to get worse during pregnancy, but I don't remember ever feeling as happy and stable as during my first trimester. How come?

Looking back, the depression being gone was probably my first symptom of pregnancy, even though at the time I put it down to "Feeling Good" being such a brilliant book that reading the first ten pages cured me of pretty much all psychological issues. Now that I'm almost in my second trimester however, the depression is coming back. I would really like to find out 1. what exactly caused my depression to temporarily just go away completely, 2. whether I can learn anything about the nature of my depression from this, and 3. whether there is any medication that could help me achieve the same effect. Unfortunately, this is really hard to google, all I can find is information about how depression and moodiness are typical symptoms of first trimester pregnancy but obviously that's the exact opposite of what I experienced.

(FWIW, I'm not on any medication for my depression nor have I ever been and I don't currently have a therapist. I will address this with my gynaecologist when I next see them.)
posted by anonymous to Health & Fitness (8 answers total) 3 users marked this as a favorite
I was not particularly happy during first trimester, mostly exhausted and irritable, but like a lot of women I was very happy during second trimester (happier than normal, pregnancy is definitely a better than normal state for me - unfortunately post-partum is far worse).

There’s a lot of increased hormones during pregnancy (a list, and more on hormones through life) and it looks like progesterone increases a lot during first trimester (and likely causes irritability in most people). Your doctor may be able to pinpoint at what point which hormones were most elevated for you personally, since they do labs at each appointment. I think it’s likely something related to progesterone and estrogen, but since those hormones seem to relate to each other and the balance is the important factor it’s hard to say exactly what is going on with you.

Birth control can mimic some side effects of pregnancy. Have you had similar results from taking birth control pills? I have experienced both depression and better moods from birth control, depending on the levels of progesterone as far as I could tell. Doctors usually just experiment with different things so I’m not sure there is a magic bullet here. It seems like reaction to hormones is a fairly individual thing.
posted by rainydayfilms at 5:37 AM on April 15, 2018 [1 favorite]

I had huge emotional changes during pregnancy as well and was surprised since no one ever seemed to talk about that. I found that I did not achieve "normal" emotions again until about six months after my son was born so you might not really be able to assess the impact of any med changes you may make until then. Also, make sure you talk to your gyno about this. If nothing else, he needs to keep an eye out for any postpartum emotional issues. Congratulations, by the way.
posted by eleslie at 6:12 AM on April 15, 2018

Congrats! I wouldn't look a gift horse in the mouth. I felt really great during my pregnancies, but I think it's because I was so happy about the baby and really taking extra good care of myself -- which I should've done before the baby as well (yoga, eating well, napping, walking outside.) Perhaps you're practicing more self-care?
posted by caoimhe at 6:55 AM on April 15, 2018

I liked the pregnancy hormones’ effect on my mental health. I’ve also had good results with the progesterone based birth controls (depo provera, Mirena, etc).
posted by sadmadglad at 7:12 AM on April 15, 2018

I also felt great immediately when I became pregnant with my first: less anxious, I had more energy, it was amazing. (With my second, I had a toddler, so I was very tired and grumpy).

For me, it turned out that I have PCOS (polycystic ovarian syndrome) and was differently sensitized to hormones. (I couldn't handle hormonal birth control, fwiw). We figured this out when my milk production was very low after baby was born.

I was sent to a doctor that is involved in studying lactation. For women with PCOS, milk levels can be improved through taking metformin (a pre-diabetes drug, its function is to decrease insulin resistance in your cells, but it impacts a whole waterfall of hormone pathways). Apparently, milk increase when given metformin is really a key diagnostic sign of PCOS (which is really a collection of symptoms).

Cut to the chase: I still take metformin at every meal. It helps my mood, it helps my energy, and it stabilized my appetite. If you don't have PCOS, metformin would be useless. For me it was life changing. Hugs to you on your journey.
posted by Sauter Vaguely at 7:43 AM on April 15, 2018

IANYOB, but I am an OB. I can tell you even with all the vials of blood drawn, we do NOT routinely check hormone levels in pregnancy because they don’t predict anything for the pregnancy. (Aside from hCG maybe early on if you were spotting). The rule of thumb I was taught is that about 1/3 of women will be stable in their anxiety/depression, 1/3 will get better and 1/3 will get worse. Definitely bring it up as you are likely at increased risk of postpartum depression (not fated to get it, however!) and your doc/Midwife will want to know that to help you. Progesterone (pro-gestational, get it?) is definitely elevated in pregnancy, so you may respond well to progesterone-only pills, depo, nexplannon or mirena/skyla as sadmadglad mentioned above. I definitely believe that it was a hormonal shift which helped your frame of mind given that it started before you were pregnant, but aside from experimentation there is no way to pinpoint what shift that was that helped.
posted by eglenner at 11:59 AM on April 15, 2018 [3 favorites]

Can you see a reproductive endocrinologist and have them take a blood sample now for analysis? Then do the same thing after you get back to “normal”; prescribe hormones to supplement from there. So far there is no one rule fits all since some women are more sensitive to certain hormones so what is normal and healthy for one is depression City for another.

I too felt blissfully stable during pregnancy and it kind of stuck, with and without hormonal bc.

Are you having a boy?

Edit: I see the depression is already coming back. But at least it’s a huge clue that your depression is impacted by hormones. My OB told me this area is not well researched so it will be trial and error to mimic.
posted by St. Peepsburg at 1:47 PM on April 15, 2018

During both of my wife's pregnancies, she was very happy and great to be around during the pregnancy. But, she sure was not after the pregnancy. Be prepared for the crash when all those pregnancy hormones drain out of your system post birth.
posted by trbrts at 10:09 AM on April 16, 2018

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