Britney Spears says pregnancy is 'hard' because of past perinatal depression. What is it? - USA TODAY

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Britney Spears is pregnant – and getting candid about her prior experience with pregnancy. 

The pop singer, 40, announced Monday that she is expecting her third child. In the lengthy Instagram post, she explained her confusion regarding recent changes in her body weight, while also opening up about her mental health struggles during a previous pregnancy.

"It's hard because when I was pregnant I had perinatal depression … I have to say it is absolutely horrible," Spears wrote. "Women didn't talk about it back then … some people considered it dangerous if a woman complained like that with a baby inside her … but now women talk about it everyday."

According to the U.S. Preventive Services Task Force, perinatal depression is one of the most common complications of pregnancy and after childbirth, affecting as many as 1 in 7 women. 

But what exactly is it?

'I am having a baby': Britney Spears announces she is pregnant with her third child

What is perinatal depression? 

Unlike postpartum depression, which refers to depression after the birth of the baby, perinatal depression occurs during pregnancy and the first year after delivery. Common symptoms include:

• Loss of interest and energy.
• Depressed mood.
• Fluctuations in sleep or eating patterns.
• Reduced ability to think or concentrate.
• Feelings of worthlessness.
• Recurring thoughts of suicide.  

However, experts caution that this is different than the common "baby blues." While both refer to mood disturbances that can manifest as crying, irritability, fatigue and anxiety, perinatal depression lasts for more than two weeks while "baby blues" are usually gone within 10 days of delivery.

In addition to common symptoms of depressive disorders, such as hopelessness or social isolation, "women who experience symptoms of depression during the perinatal period often experience enormous guilt (and) shame that they are feeling this way," explains Karen Kleiman, the founding director of The Postpartum Stress Center, LLC, and author of several books on postpartum depression and anxiety.

"While some degree of emotional upheaval is expected, women should be encouraged to seek help if the level of distress feels too high or if it interferes with their ability to function the way they normally do."

Perinatal depression: Depression in pregnant women and new moms is preventable, experts say. Here's how

Can perinatal depression be prevented?

Treatment for perinatal depression is crucial for the health of both the mother and baby.  A 2019 report published in the Journal of the American Medical Association (JAMA) found that it can result in premature birth and low birth weight. In addition, children of mothers who had perinatal depression demonstrated more behavior problems, lower cognitive functioning and increased risk of developing psychiatric disorders.

Common prevention methods for perinatal depression include physical activity, medication, infant sleep training, education and yoga. However, the JAMA report found that counseling was most effective, reducing risks by 39%. 

In particular, cognitive behavioral therapy and interpersonal therapy were favored: Cognitive behavioral therapy addresses an individual's patterns of thought and behavior, while interpersonal therapy focuses on a person's relationships and actions with others.  

Kleiman also suggests taking advantage of your social support network.

"Let others know what your concerns are, what you may need, how they might help," she says. "A strong support system has been shown to make a significant difference in how women recover if they do develop symptoms of depression and anxiety."

Health providers should refer at-risk women to counseling

The good news? Screening for depression is covered at no cost for moms under the Affordable Care Act, according to the Kaiser Family Foundation. 

The bad news? 

Since there is no standard screening tool for medical professionals to check for perinatal depression, it is "more complex to perform a risk assessment" and accurately determine if a woman is at-risk, Harvard Medical School psychiatrist Marlene P. Freeman wrote in an editorial accompanying the JAMA recommendations. 

If you're thinking about suicide or know someone who is, can call the National Suicide Prevention Lifeline 24/7 at 1-800-273-8255. You can also text the  Crisis Text Line at 741-741 to connect with a trained crisis counselor right away.

Those looking for treatment for perinatal or postpartum depression should seek a women's health specialist with perinatal psychology training. Postpartum Support International can connect moms or loved ones with trained professionals. Connect with them online or by calling 1-800-944-4773.

Contributing: Rasha Ali, Sonja Haller