If you've ever had morning sickness, you know it doesn't just happen in the morning. It can occur any time during the day, and it can make you miserable. It may affect your emotional well-being and can lead to depression.
What is morning sickness?
Morning sickness is the common term for nausea and vomiting in pregnancy (NVP). You can have nausea alone or nausea with retching, gagging, dry heaving, or vomiting. The symptoms may be caused by particular odors or foods.
Although morning sickness can happen any time of the day or night, it usually appears and goes away in a predictable pattern:
- It usually appears about four to nine weeks into a pregnancy.
- Symptoms usually peak around 12 to 15 weeks.
- It usually disappears around 20 weeks.
Morning sickness occurs in over half of all pregnancies. Some researchers estimate that it happens in up to 90% of all pregnancies. The severity of the symptoms can vary greatly.
Severe morning sickness
A severe form of morning sickness, called hyperemesis gravidarum (HG), appears in up to 3% of pregnancies. In HG, symptoms are so severe that mothers may:
- Lose 5% or more of their pre-pregnancy weight
- Become dehydrated
- Become deficient in vitamins and minerals
In the United States, HG causes around 195,000 hospital visits a year. Some of these visits result in the mother being admitted to the hospital for treatment.
Psychological effects of NVP and HG
The misery of morning sickness can also cause psychological symptoms. These may happen even if your symptoms are not severe. You may experience feelings of:
Isolation. You may stay at home out of fear of vomiting in public, or you may not feel well enough to socialize.
Guilt. You may feel guilty because you can't cook for your family or keep up with household chores.
Confusion. You may wonder why you are suffering these symptoms, and your doctor may not have taken the time to explain.
If you work outside the home, you may miss work because of nausea and vomiting. One study found that women with NVP lost an average of 62 hours of work during their pregnancies. Missing work can cause stress, financial difficulties, and family conflict.
Symptoms of depression during pregnancy
The physical and psychological effects of morning sickness can cause you to be depressed. Symptoms of depression include:
- Feeling sad or blue
- Losing interest in doing things you'd usually enjoy
- Loss of appetite
- Changes in sleep patterns
- Lack of energy
- Difficulty thinking or making decisions
- Feelings of worthlessness
- Feeling that life is not worth living
When you are pregnant and depressed, you may not care for yourself as well as you should. You are also at higher risk for depression after your baby is born, called postpartum depression. That's why it's important to seek treatment.
Cause or effect?
Researchers disagree about whether morning sickness causes depression, or whether depressed women are more likely to have morning sickness. Most research has focused on women with hyperemesis gravidarum. Some have found that HG causes depression. Others have found that women with a history of psychological problems are more likely to have HG.
In one study, researchers looked at the emotional distress of pregnant women with and without HG. They found higher rates of distress among those with HG. When they surveyed the women 18 months after their babies were born, researchers found no difference between the groups. They concluded that HG caused the women's emotional problems.
A smaller study found that women with psychological problems had a higher rate of HG than a control group. Most of the women in this study said that their symptoms began before pregnancy, suggesting that they weren't caused by HG.
Getting help for depression and morning sickness
If you have nausea and vomiting and depression during pregnancy, you probably don't care about cause and effect. You just want an end to your morning sickness misery and to your depression.
Your doctor may prescribe a drug for nausea, especially if it is severe. You may also find that changing your eating and drinking habits can help. What works for one person may not work for another, so you may have to experiment a bit. These steps may help:
- Eat several small meals so that your stomach doesn't get completely empty.
- Find which fluids you tolerate well and drink plenty of them.
- Avoid spicy and fatty foods.
- Avoid the smells that trigger your nausea.
If you feel depressed, ask your doctor about treatment. Some antidepressants are safe for pregnant women. Other options for depression include psychotherapy and support groups. Taking good care of yourself and asking for support from family and friends can also help.
Health Solutions From Our Sponsors
Archives of Women's Mental Health: "Hyperemesis gravidarum and the risk of emotional distress during and after pregnancy."
The British Psychological Society: "Nausea and vomiting in pregnancy."
Centers for Disease Control and Prevention: "Pregnancy Complications."
General Hospital Psychiatry: "Is hyperemesis gravidarum associated with mood, anxiety and personality disorders: a case-control study."
MGH Center for Women's Mental Health: "Hyperemesis Gravidarum and Depression: Which Comes First?"
March of Dimes: "Depression During Pregnancy," "Morning Sickness and Pregnancy."
National Organization for Rare Disorders: "Hyperemesis Gravidarum."
Obstetrics and Gynecology International: "Review of NVP and HG and Early Pharmacotherapeutic Intervention."
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