Exercise can help expectant moms in mind as well as body. A new study suggests that women who stay active and are more positive about their changing shapes might protect themselves from depression both during and after pregnancy.

 “Our study supports the psychological benefits of exercise to improve body image and lessen depressive symptoms,” said lead study author Danielle Symons Downs, Ph.D., associate professor of kinesiology and obstetrics and gynecology at Penn State University.

Downs and colleagues surveyed 230 Pennsylvania women throughout pregnancy and the postpartum period about their symptoms of depression, exercise habits and feelings about weight, appearance and other aspects of body image. Their findings appear in the August 2008 issue of the journal Annals of Behavioral Medicine.

As expected and consistent with previous research, women who experienced depressive symptoms early in pregnancy tended to report later pregnancy and postpartum depression, the authors found.

What is new, though, are the findings about the role of body image and exercise behavior in relation to pregnancy and postpartum depressive symptoms. Women who experienced higher levels of depression symptoms also reported less satisfaction with their appearance throughout the trimesters of pregnancy.

“If someone is depressed and not very happy with how their body looks, especially with regard to the physical changes that occur during pregnancy, it can influence depression later on,” Downs said.

Women who reported more depressive symptoms during the first trimester tended to engage in less exercise behavior in early pregnancy. In addition, women who exercised more prior to their pregnancy had greater body satisfaction during the second and third trimesters and less depressive symptoms in the second trimester, which suggests that avid pre-pregnancy exercise might protect women from negative depressive symptoms and body dissatisfaction during mid-to-late pregnancy, Downs said.

“There is no question that pregnant women, in consultation with their health care providers, should try to maintain a regular and moderate exercise regimen,” said Michael O’Hara, Ph.D., professor of psychology at the University of Iowa.

However, O’Hara said that the study design — especially the classification of exercise frequency and intensity and the arbitrary cut-offs used to classify women — “did not give a strong endorsement for the protective effects of exercise during pregnancy, at least with regard to depression.”

Beginners should take it easy when exercising, he advises: Women could keep up with what they were doing beforehand physically, but they should not go all-out during pregnancy if they were sedentary before.

“There is increasing evidence that anxiety and stress during pregnancy are bad for the mother and for the fetus. The take-home message is that pregnancy is a time when women need to be given permission to slow down their pace and focus on taking care of themselves with good nutrition, moderate exercise and plenty of rest and relaxation when possible,” O’Hara said.

The American College of Sports Medicine recommends that healthy pregnant women without obstetric complications engage in 30 minutes of moderate exercise most, if not all, days of the week.

Annals of Behavioral Medicine is the official peer-reviewed publication of The Society of Behavioral Medicine. For information about the journal, contact Alan J. Christensen, Ph.D., at (319) 335-3396. Visit the Society of Behavioral Medicine at http://www.springer.com/public+health/journal/12160.

Downs DS, DiNallo JM, Kirner TL. Determinants of pregnancy and postpartum depression: Prospective influences of depressive symptoms, body image satisfaction, and exercise behavior. Annals of Behavioral Medicine 36(1), 2008

About Depression

Depression is a mental health disorder that can affect the way you eat and sleep, the way you feel about yourself, and the way you think about things. A depressive disorder is more than a passing mood.

Depressive disorders come in different forms. Three of the most common are Major Depression, Dysthymia, and Bipolar Disorder. Even within these types of depression there are variations in the number of symptoms, their severity, and persistence.

• Persistent sad, anxious, or "empty" mood
• Feelings of hopelessness, pessimism
• Feelings of guilt, worthlessness, helplessness
• Decreased energy, fatigue, being "slowed down"
• Difficulty concentrating, remembering, making decisions
• Insomnia, early-morning awakening, or oversleeping
• Appetite and/or weight loss or overeating and weight gain
• Thoughts of death or suicide; suicide attempts
• Restlessness, irritability
• Loss of interest or pleasure in hobbies and activities that were once enjoyed
• Reduction in sex drive
• Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain