What Happens to Your Brain During Pregnancy?
Summary
TLDRIn this interview, Dr. Don Kingston discusses the importance of prenatal mental health, highlighting that many women face mental health challenges during pregnancy. She emphasizes the lack of focus on prenatal mental health compared to postpartum depression and the need for better screening and support. Kingston's book, 'Your Brain on Pregnancy,' provides guidance for managing mental health during pregnancy and busts myths about the impact of stress and mental health issues on babies. She stresses the importance of acknowledging mental health issues during pregnancy to prevent long-term damage.
Takeaways
- 🤰 Mental health issues during pregnancy are common, with one in four women experiencing problems.
- 🔍 Postpartum depression is well-known, but prenatal mental health struggles are often overlooked.
- 👶 Prenatal mental health challenges can affect not only the mother but also the baby's development.
- 🧠 Stress, depression, and anxiety during pregnancy can lead to prematurity and impact child development.
- 🏥 There is a lack of routine mental health screening during prenatal care in North America.
- 🌐 In contrast, countries like the UK and Australia have had national screening programs for over a decade.
- 📚 The book 'Your Brain on Pregnancy' provides screening tools and resources for mental health during pregnancy.
- 🚫 Societal expectations and stigma can prevent women from discussing mental health issues during pregnancy.
- 🔑 Key risk factors for prenatal mental health issues include lack of social support, partner conflict, high stress, and previous mental health problems.
- 🌱 Intergenerational trauma and genetic factors can contribute to mental health challenges.
- 💊 While medication is sometimes necessary, many women prefer to start with self-management strategies for mental health.
Q & A
What is the focus of Don Kingston's book 'Your Brain on Pregnancy'?
-The book focuses on understanding and protecting mental health during pregnancy and beyond, highlighting that mental health challenges during pregnancy are common and often overlooked.
What is the ratio of women experiencing mental health problems during the prenatal period?
-One in four women will experience mental health problems during the prenatal period.
What led Don Kingston to research the intersection of mental health and pregnancy?
-Her work as a neonatal nurse and the discovery of a link between stress and prematurity led her to research further into mental health challenges during pregnancy.
Why is there more awareness around postpartum depression compared to prenatal mental health issues?
-There has been an overemphasis on postpartum issues, particularly postpartum psychosis, which has overshadowed the importance of prenatal mental health.
Why do pregnant women hesitate to discuss mental health issues with their healthcare providers?
-Women may hesitate due to societal expectations of happiness during pregnancy, fear of judgment, or lack of awareness that mental health support is available.
What are some risk factors for mental health challenges during pregnancy?
-Lack of social support, high partner conflict, high stress, and a history of mental health problems are significant risk factors.
How can healthcare providers better address mental health during pregnancy?
-Providers can incorporate routine mental health screenings into prenatal care and be prepared to offer support and resources for those who screen positive.
What are some self-management strategies for dealing with prenatal mental health issues?
-Strategies include seeking social support, practicing stress management techniques, maintaining a healthy lifestyle, and when necessary, considering professional help or medication.
What are the potential long-term impacts on the child if a mother experiences untreated mental health challenges during pregnancy?
-Untreated mental health challenges can potentially affect the child's development, emotional well-being, and physical health.
How can women tell the difference between normal mood swings and serious mental health issues during pregnancy?
-Screening tools can help identify if a woman is struggling more than average. Persistent symptoms beyond a situational event that last for an extended period are a cause for concern.
What is the importance of addressing mental health issues during pregnancy for both the mother and the baby?
-Addressing mental health issues can lead to better emotional and physical outcomes for both the mother and the baby, and can prevent long-term complications.
Outlines
🤰 Mental Health During Pregnancy
The paragraph discusses the prevalence of mental health issues during pregnancy, which are often misunderstood and under-researched compared to postpartum depression. The author, Don Kingston, highlights her research and book 'Your Brain on Pregnancy', which aim to guide women and their partners on understanding and protecting mental health during pregnancy. Kingston, a neonatal nurse and associate professor, emphasizes the link between stress, depression, and anxiety during pregnancy and outcomes like prematurity and children's development. She points out the lack of attention to prenatal mental health within the healthcare system and the societal expectation that pregnant women should be happy, which can lead to feelings of guilt and self-blame when they experience mental health challenges.
📚 Advocacy for Prenatal Mental Health Screening
This section focuses on the advocacy for prenatal mental health screening. The author contrasts the common prenatal checks for physical conditions with the rarity of mental health screenings, despite the latter being more prevalent. She mentions that countries like the UK and Australia have had national screening programs for over a decade, while North America lacks such initiatives. The author has included screening tools in her book and on her website to address this gap. She also discusses the reluctance of healthcare providers to conduct such screenings due to perceived awkwardness and the challenge of addressing any identified issues within the North American healthcare system, which is not well-prepared to handle perinatal mental health problems.
🧬 Risk Factors and Intergenerational Trauma
The paragraph delves into the risk factors for mental health problems during pregnancy, such as lack of social support, high partner conflict, high stress, and previous mental health issues. It introduces the concept of intergenerational trauma and how mental health challenges can be passed down through generations, affecting not just the mother but also the child. The author discusses the societal pressure on pregnant women to feel happy and the internalization of negative emotions when they don't, which can exacerbate mental health issues. The paragraph also touches on the difficulty in distinguishing between normal mood swings and serious mental health problems during pregnancy.
🤱 The Impact of Maternal Mental Health on Child Development
This section discusses the impact of a mother's mental health on her child's development. It addresses the societal expectation that pregnant women should naturally know how to care for their babies and the lack of focus on the mother's well-being. The author brings up research on interpersonal biology, which shows how emotional well-being is regulated through interpersonal relationships, emphasizing the importance of a mother's emotional health for her child's emotional regulation. The paragraph also covers the risks associated with untreated mental health challenges during pregnancy, such as chronic depression, anxiety, or stress.
💊 Balancing Self-Management and Professional Help
The final paragraph addresses the balance between self-managing mental health symptoms and seeking professional help. It discusses the stigma surrounding prenatal and postnatal mental illness and the fear of being judged as incompetent parents. The author encourages mothers to view mental health symptoms as red flags that require attention, similar to physical symptoms of illness. She also mentions a study showing that nurturing a child can reverse the effects of prenatal stress and depression, highlighting the brain's neuroplasticity. The author concludes by emphasizing the importance of education and understanding to combat stigma and the need for further research to improve treatments based on a better understanding of women's brains during pregnancy.
Mindmap
Keywords
💡Postpartum Depression
💡Prenatal Mental Health
💡Mental Health Challenges
💡Prematurity
💡Stigma
💡Self-Management
💡Neuroplasticity
💡Intergenerational Trauma
💡Epidemiological Research
💡Screening Tools
💡Pandora's Box
Highlights
Postpartum depression is well-known, but research shows that many women also struggle with mental health during pregnancy.
One in four women will experience mental health problems in the prenatal period.
Don Kingston's new book, 'Your Brain on Pregnancy', aims to guide understanding and protection of mental health during pregnancy and beyond.
Kingston is an associate professor in the faculty of nursing at the University of Calgary.
Research began with a focus on neonatal care and the risks of prematurity, leading to a discovery of the link between stress and prematurity.
Mental health challenges during pregnancy affect not only prematurity but also a child's development and well-being.
There is a lack of attention to mental health in pregnancy despite its significant impact.
Awareness of postpartum depression overshadows the importance of prenatal mental health.
Prenatal mental health problems are the biggest risk for postpartum mental health issues.
During prenatal visits, physical conditions are screened, but mental health problems are less commonly addressed.
Healthcare systems in North America have not implemented national screening programs for mental health during pregnancy.
Healthcare providers may feel awkward discussing mental health or unsure of how to address it.
Self-management is a preferred starting point for most women dealing with mental health challenges.
The four biggest risk factors for mental health challenges in women include lack of social support, high partner conflict, high stress, and previous mental health problems.
Intergenerational trauma can affect mental health and may be passed down through generations.
It's important to distinguish between normal mood swings and serious mental health issues during pregnancy.
Screening tools can help identify if a woman is struggling more than average with her mental health.
70% of women are hesitant to talk to their prenatal provider about their mental health.
Education and understanding can help reduce stigma and encourage women to seek help for mental health issues during pregnancy.
Not addressing mental health challenges during pregnancy can lead to chronic depression, anxiety, or stress.
Strategies for mitigating symptoms can be effective, but if they are not working, it may be time to seek professional help.
Nurturing a child can reverse the effects of prenatal mental health issues, demonstrating the brain's neuroplasticity.
A recent study shows that nearly every part of a woman's brain is affected by pregnancy, indicating the need for further research.
Transcripts
while there is some understanding of
postpartum depression research shows
that just as many if not more women
struggle with their mental health during
pregnancy one in Four Women will
experience mental health problems in the
prenatal period but this is still widely
misunderstood Don Kingston examines that
and more in her new book your brain on
pregnancy a guide to understanding and
protecting your mental health during
pregnancy and Beyond she is also an
associate professor in the faculty of of
nursing at the University of Calgary and
she joins us on the line from Edmonton
Alberta hi Don good morning thank you
for having me it's so nice to connect um
I've had two kids my kids are pre-teens
11 and 13 I've read a lot of pregnancy
books a lot of baby books and I have to
say that your book in my view is um if
not one of the most important books for
women to read and their Partners to read
excellent thank you so much um what
brought you to research the intersection
of mental health and
pregnancy ma' it really started in my
neonatal days as a neonatal nurse
understanding the risks of prematurity
and uh when I started to do graduate
work I really wanted to think about how
can we prevent pre-term birth small
babies being born and I discovered a
real link between stress and prematurity
and then as we researched it more I
realized it's not just stress it's de
depression anxiety any form of Mental
Health Challenge in pregnancy and it
wasn't just prematurity it was also CH
children's development emotional
well-being physical development and so
that really led us on a train of
discovering uh what was pre pre you know
prenatal mental health about and then
secondly really understanding that we
had a system that wasn't paying any
attention to mental health and pregnancy
and that really started
uh our advocacy Journey as well um I
think there's this idea that when
someone becomes pregnant they are so
happy they're excited and when you're
pregnant you um you are told that
everything that you do everything that
you eat impacts the baby that if you get
stressed out there's a lot of guilt
about you know I can't be stressed and
it's really hard to do over the period
of nine months well actually 10 months
because it's 40 weeks um but you write
that there is much more awareness around
Mental Health health problems after
giving birth like postpartum depression
so if you are experiencing anything
during pregnancy sometimes you uh you
blame yourself um so why has there been
so little focus on mental health
problems like during pregnancy when
people are
pregnant I think n it's been an O an
over Focus to be honest that started on
in on the postpartum period which
started really I think with post
postpartum psychosis you know it was
wonderful to bring awareness to
postpartum psychosis postpartum
depression and there were lots of media
and and stars that did that for us but
what it did is I think it overshadowed a
little bit what happens in the prenatal
period And when we started really
studying the data and looking at our own
work we realized that three out of four
women who had postpartum depression had
depression or anxiet Y in
pregnancy and so prenatal mental health
problems are actually the biggest risk
for postpartum mental health problems
and so it really it really to us showed
a disparity in where the focus was and
so again while I think that postpartum
depression awareness was a wonderful
thing and very needed I think we just
need to now broaden our understanding of
the perinatal period in total pregnancy
and postpartum um I want to read uh a
passage from your book you write women
see healthc care providers during
pregnancy more regularly than almost any
other time in their lives during
prenatal visits women undergo physical
exams ultrasounds and laboratory tests
that screen from physical conditions
such as diabetes high blood pressure
infection and Fetal anomalies but these
are far less common than mental health
problems yet rarely are a few minutes
devoted to asking simple screening
questions that would identify the most
common mental health problems in
pregnancy um you know when you are
pregnant you are tested for diabetes
blood pressure and you write uh that
those uh conditions are actually less
likely to happen than mental health
problems uh why isn't depression
tested you know it it's a North American
thing in the UK and Australia they have
had screening National screening
programs during pregnancy and postpartum
for well over a decade they have good
policies they have a great health care
System they have trained their midwives
nurses Physicians to do screening so
there has been a call for screening in
North America in the US and Canada but
we haven't lifted it off the ground and
I think in some ways it's because there
isn't a central way of doing that and
that's in part why we have put screening
tools in the book and why we put them
also on our website which is which has
free resources hope for mentalhealth.com
but we really um this is a North
American uh blockage in some ways why we
don't screen women I think the other
piece of it is there is This Feeling by
health care providers that this is
awkward it's a difficult conversation
women don't want this but actually our
research shows that well over 98% of
women want to be screened for emotional
health and then the other piece of it is
what do you do when you open Pandora's
Box and you discover that you have a
patient who has a mental health
challenge our North American system
isn't all that well set up to address
mental health problems in the perinal
period again it's also why in our book
we wanted to really focus on
self-management because actually it is
the place most women want to start um
you mentioned Pandora's Box and I think
a lot of um if you're pregnant you're
looking for this information and if you
don't find it because we still live in a
society that says that when you're
pregnant it's the best time of your life
you're supposed to be happy but if
you're feeling any kind of uh emotions
opposite that you internalize them but
you know what are the gaps did you
identify in the healthare system in
terms of Mental Health Care during
pregnancy yeah our team is going to
phrase it so women don't tell and
providers don't
ask uh again if you have routine
screening as part of a well woman's
checkup as part of one of the 13
prenatal visits then you don't have to
rely on a particular physician asking
questions or a woman having to bring it
up most women will not bring up men
mental health challenges however again
in our work the vast majority of women
women have identified if a provider asks
me how I'm doing I would tell them
honestly um you do say in the book that
one the most important thing to keep in
mind is that if we don't acknowledge
there is a mental health issue that's
the thing that's going to cause
long-term damage I want to talk to you
more about that but um what are some of
the factors that would make someone more
likely to experience mental health
problems during
pregnancy yes I'm so glad you ask about
those n because without those women feel
like there this is a random thing you
know postpartum depression that's the
impression we have and and I think it
will carry on over into pre prenatal
mental health problems if we're not
really clear the four biggest risk
factors that lead a woman to have a
mental health challenge at any point in
her life not having enough soci social
support so not having friends that love
and care and nurture nurturing
relationships having high partner
conflict and we're not talking about a
single argument we're talking about a
constant tension and fighting in a in a
close relationship with a partner having
high stress you know we've known that
for 30 years that high stress can cause
challenges in unborn um animals unborn
babies and then finally um really having
a previous mental health problem and
that's an important point
because we are starting to put a picture
together in our research team that says
it's not postpartum depression or
anxiety prenal depression anxiety it
really is about what's happening across
a woman's life so the book focuses in
pregnancy but the more we uncover this
work the more we see long-term
struggle as brain and nervous system
disregulation that probably started way
before pregnancy and has existed across
a woman's life is that uh what you would
call intergenerational trauma in part
intergenerational trauma is more about
you know something being passed down
from Grandma to the mother to the baby
and that can happen when it comes to
mental health problems and there can
be genetic t eggs that can be sort of
added on to our DNA and that are we're
born with we think we're born with a
clean slate of DNA but we're not and
mental health problems are one of the
things that can add a little tag now
that tag is impermanent it can be taken
off by good support and nurturing and
all of the good things that uh that lead
to good mental health can take those
tags off but you have to acknowledge
that there's a there it's there right
yeah you have to be um intentional yeah
um there's a joke around when you're
pregnant you know you're eating all the
foods um you are going through the mood
swings but on the serious side how can
you tell the a difference between
someone who could just be experiencing
mood swings versus something that's
really serious mental healthwise during
pregnancy right I think that's where the
screening tools can really help because
then we're not having to guess we just
do a screening tool it tells us if we
score above a certain level then you
know we're we're struggling more than
average but in general we're really
concerned about women who so so if let
let's use a situation someone's cat dies
and sort of a situational thing right I
feel kind of crummy sad grief loss angry
angst but it doesn't last now in the DSM
you know kind of our Bible of psychology
it would say six months but that's a
long time in pregnancy in general
something that is goes beyond a
situation and lasts for a period of time
is where we start to think this is just
a little be Beyond normal Beyond yeah
healthy normal but if someone is
experiencing symptoms how can they tell
the difference between depression
anxiety and toxic stress or does that
matter often they come together and
especially in pregnancy often they come
together and that's actually why it
makes it a little bit hard to diagnose
but in general if uh and and so you know
we can actually put that all under brain
and nervous disregulation too so what
does that look like trouble sleeping
Beyond a physical discomfort uh sleeping
too much not sleeping enough eating too
much not eating enough a sense of loss
of Joy a sense of dread not not worry
about a particular situation that's more
worry but kind of this anxious dread
that something terrible is going to
happen something terrible is happening
to me and where it really tips over into
unhealthy is where a person feels
immobilized by the
situation really you know that there
there there is no hope it is in
escapable and it's never going to be
different and that's impacting
themselves and the baby yes mhm um I
want to take a look at some of the
statistics in the book regarding how
women feel about reaching out to their
health care providers for help um 70%
are hesitant to talk to prenatal
provider about their mental health
that's a big number uh 44% worry about
being put on anti-depressants 46%
believe symptoms will just get better on
their own we seem to live during a time
where we're having a lot of open uh
discussions about a lot of different uh
topics that might have been taboo 20 30
40 years ago even 10 years ago why is it
still so hard for us to talk about
mental health
challenges I think Ma because it speaks
to the very heart of who we are as a
person to our identity to our sense of
Competency to our sense that we are a a
broken
person and that's where in the book we
are really and our team is really really
starting to focus on the idea about
isn't it just brain and nervous system
disregulation we've been Jarred we've
been Jarred Often by circumstances in
our lives as children or as adults that
we had no control over but it affects
how we see ourselves and depression
anxiety stress are symptoms that are
kind of oozing out of those experiences
that have become embedded in our nervous
system but if we can think about it like
that and take it away from the fact that
we are broken and
wounded and um you know we're in trouble
because of that it's a very different
look at what we're
experiencing um maybe this is just my uh
experience but even just talking to some
of my friends who've had kids when
you're pregnant there's so much uh
there's a lot of concern about the baby
uh there are rarely any questions asked
about the mom and even after you have
the baby as soon as the baby is born it
just kind of feels like okay you know
here you go and if your first time Mom
it's like oh gosh I have to keep this
person alive for the like what did I do
um do you think it's there's a little
bit of a that societal expectation that
you're supposed to know what to do and
maybe it makes it harder for women to
talk about the difficulties they have
with their mental health during
pregnancy yeah it's a really good point
um
you know and I think many women who have
not been nurtured as children you know
in a loving nurturing
home also feel uh a bit um unable to or
are they going they've lost confidence
about whether they'll be able to nurture
and love their child as well so I think
that plays into it too but I agree and I
I I think I'm going to bring in at this
point n um some of the research that's
been done on on Dan seagull Dr Dan seag
is a big um proponent and um researcher
in the area of interpersonal biology and
it's the idea that we regulate each
other uh Partners regulate each other
our nervous systems we regulate each
other mothers and children regulate each
other it's why we put babies on a
mother's chest after birth right we know
that it regulates the heart rate and
breathing but there is a bigger picture
to this which is it regulates emotions
as well and so that really speaks to me
about the importance of mothers being
emotionally healthy so that they can
regulate the emotional well-being of
their children as well is that danle did
he write the book uh zebras don't get
ulcers no no that was Robert
sapolsky such a big fan of
him love I think one of the things that
I um I found really helpful in your book
is that um once you identify it the most
important thing is to identify it
because then you can actually address
what's happening um but if you don't do
that what are the risks if a mother is
experiencing these mental health
challenges while she's pregnant yeah
yeah the biggest risk is chronic
depression anxiety or stress that is not
doing anything about it and I'll go back
to that statistic 44% perc of women
don't want to talk to their doctors
because they fear going on
anti-depressants and what most women our
research showed most women don't
understand that there are actually lots
of ways
of dealing with uh depression anxiety
and stress that don't involve
medication and so the main issue with
not identifying it a challenge is yes
not being able to take steps to do
something about it and then the dread
that exists right when you don't know
there's a dread but when you have the
facts then you're able to kind of draw a
line in the sand and you can create a
plan and you can go forward and with
mental health it's just like I in the
book I talk about it's just like
diabetes it's just about managing you
know you you mentioned medication and
there is this kind of I know when you're
pregnant you um you you shouldn't be
taking any medication at all um but
sometimes medication is needed yes yeah
it is and um I I wouldn't say it's the
first thing unless a person has left
their Sy so long that it really is
needed to sort of begin the process of
getting
well but most women really want to start
with something else they want to start
with some kind of
self-management and that's completely
reasonable and then if that isn't
helping go forward and consider
medications and yes sometimes
medications are needed yeah um in the
book you described strategies that
people can use to mitigate symptoms uh
when they might be experiencing how do
you know when these strategies are
enough versus when it's time to seek
professional
help I put a put together a bit of a
list sort of five items in the book that
women can use questions to ask about is
it is it time to get help if you are
using strategies and they are helping
and your symptoms are lessening and
you're feeling better and you're feeling
confident about managing your own mental
health that's the Place most women want
to be in but if if that's those are not
working if you're feeling like I'm
getting worn out from doing this on my
own if you feel that it would be helpful
to have talk with someone who is
compassionate um then then it is time to
get help and you know it doesn't have to
be an all in you can you know try a
couple of sessions with a professional
and if it's not helpful you can turn
around and go
back um we only have a few minutes left
I want to sneak in a couple more
questions uh we talked a little bit
about stigma um but we kind of danced
around a little bit around it what would
you say to mothers who don't want to
talk about prenatal or postnatal mental
illness because they worry others will
question their competency as a
parent I would go back and really have
them focus on what is it that started
this journey a a woman wasn't born
broken she's not
broken what has happened in in her life
that has led to this point where she is
experiencing these symptoms that they
are symptoms they are like a cold or a
flu they're like a fever they tell us
that something is going on inside that
needs some attention ention and so they
are red flags and symptoms much like a
uh fever is a symptom of a
virus and so I
would I I would encourage women I think
it's partly education being able to
educate others and say you know what
it's a symptom it's not me it's not that
I'm broken what if they think that
they've damaged their
child right you know there was a I I
love this I'll just share this one study
it I love it because it shows how
neuroplasticity is the root of of our
brain health our brains change our
nervous systems change and even if a
woman had depression or anxiety or high
stress and pregnancy that does not mean
that the baby's future is sealed and
it's it's the baby's going to be in
trouble going forward there was I love
this study it showed that women who had
depression um the women who held their
babies after they were born their brains
basically
healed and so they they measured the
amount of time that women held their
babies and the women that held their
babies more their brain baby's brains
looked different and so when we talk
about those impermanent changes to the
brain that's what we're talking about
then holding and nurturing the baby
takes those epigenetic tags off and I
love that because it's such a story of
hope that the simple things of nurturing
a child can reverse these effects isn't
that a good news story that's a great
news story I think it uh makes a lot of
women feel much better uh in a recent
study published in Nature Neuroscience
scientists in California took MRI scans
of one woman before she got pregnant
until two years postpartum they found
that nearly every part of the brain was
affected by pregnancy this was a review
of just one person uh but will studies
like this help others learn about the
brain and pregnancy in the
future yes and in fact we just got uh a
$100,000 Grant which is small probably
by comparison for what this work
requires to start looking at scans of
multiple multiple multiple women so
we'll be doing that here in Alberta and
our goal really is to create a database
of what women's brains look like so that
we can really
start um embracing and improving Upon
Our brainbase
treatments Don it was really nice to
connect with you thank you so much for
spending time with us um I think this
book is going to help so many it has it
answers questions that a lot of women
want to ask but maybe are too ashamed to
ask so thank you for that uh I
appreciate your time thank you very much
for having me on today
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