Neha Arti 
It’s not uncommon to feel depressed or hopeless during pregnancy. The good news is that you can feel better.
Perinatal depression—depression before or after birth—affects 1 in 7 women (about 15% of pregnancies). Having a baby is a big life transition and you shouldn’t feel ashamed about having difficult emotions about it. The most important part is to know there’s help.
In this guide, you’ll learn about prenatal depression symptoms and treatment options.
Prenatal Depression Symptoms
Prenatal depression is depression while you’re pregnant. Symptoms can range from mild to severe and may include:
- A feeling of emptiness
- Extreme sadness
- Extreme Anxiety
- Fatigue
- Feeling hopeless
- Trouble staying still
- Difficulty focusing
- Feelings of guilt or shame
- Easy to cry, frequent crying or crying “sessions”
- Withdrawing from family and friends
- Loss of interest in activities that used to bring you joy
- Mood can interfere with everyday life, making it difficult to perform normal tasks
- Constant worrying about your baby or your ability to provide for her
- Thoughts of suicide or harming yourself. If you ever have thoughts of suicide or harming yourself, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). You can also use their Lifeline Chat.
Anyone pregnant can have prenatal depression. It is not your fault that you have it. Depression is thought to be caused by a variety of factors, including environment, trauma and genetics.
People with prenatal depression might feel ashamed they have it. In a time that’s traditionally thought to be exciting and joyful, you’re faced with difficult and intense emotions. Although this can make you feel guilty, remember that you’re not alone.
For those with prenatal depression, other factors can also contribute:
- Changing hormones
- The financial stress of having a baby
- The emotional stress of having a baby
- Problems in your relationship or marriage as you take on new roles as parents
- Pregnancy complications or health concerns
Consider that if you have depression, you may be more likely to experience prenatal depression. A family history of mental health disorders can also make you more at risk for prenatal depression.
Even if you or no one in your family has experienced depression, it can affect you during pregnancy. Even those who are emotionally balanced can feel jolted by life transitions, like leaving for college, moving, starting a new job and especially having a baby. Another point to consider is that some people are just more sensitive to large stressors—and that’s completely okay.
It’s important to know that depression is a clinical disorder and must be diagnosed. If you believe you’re experiencing depression, talk to your doctor.
Pregnancy Sadness vs. Prenatal Depression
You might be wondering about the difference between prenatal depression and being sad. Sadness is usually temporary and lets up. For example, if you’re sad, you might be really bummed out one day, making you feel tired and depleted. However, within the next day or so, you usually feel back to normal and can carry out daily tasks. Sadness is often based on a situation (ex. feeling sad after an argument with your mother).
On the other hand, depression happens for at least a period of time. It can make it difficult to do daily activities, like showering, going to work or taking part in hobbies. Unlike sadness, depression may not be based on a specific event. For example, you may be depressed because you feel like you have no support and you feel lost during pregnancy. Sometimes, you may have no idea why you feel depressed. This can be especially true during pregnancy, where you may feel expected to be joyful.
During pregnancy, you may choose to manage sadness yourself using self-help or other coping strategies. However, depression is a clinical disorder that requires professional treatment.
Prenatal Depression Treatment
It’s important to get help for prenatal depression. Getting help is the right decision for you, your baby and your family.
Several types of depression treatments may work during pregnancy. If you believe you have depression, talk to your doctor to form an appropriate and personalized treatment plan.
Therapy
Different types of therapy can help with prenatal depression. Two commonly recommended options during pregnancy include:
- Interpersonal therapy: This type of therapy focuses on your current problems and relationships. It can be a good choice for those dealing with relationship issues or navigating life transitions, such as becoming a parent.
- Cognitive behavioral therapy (CBT): When using CBT, you and your therapist are focusing on your thought patterns, which ultimately affect your behavior and mood.
It’s important to choose a therapist who you trust and that feels right to you. You can do an online search or ask your doctor for recommendations. You can also check your local community health center for free or low-cost therapy options. Also, consider that some therapists work on a sliding scale. This means that they adjust their rates based on your income, making therapy more affordable.
Self-help strategies and lifestyle changes
Self-help may be beneficial when you have limited resources or manageable sadness. In some cases, you can’t reduce depression with self-help strategies and you need professional help. Before considering these options, it’s a good idea to talk to your doctor about the best treatment approaches for your depression or sadness. Here are a few self-help and lifestyle strategies to consider:
- Mindfulness-based interventions. There’s a large body of research showing that mindfulness-based interventions (MBI) can reduce depression, including in perinatal women. Consider taking this free MBSR Online course by Jon Kabat-Zinn at the University of Massachusetts Medical School.
- Exercise. Exercise is a well-known mood lifter and it can work while you’re expecting too! One study showed that exercise during pregnancy may be useful for preventing and reducing prenatal depression symptoms. Although exercise can mean aerobic exercise, it can also include something lighter, like yoga. Consider that a 2022 review of research found that yoga significantly improved depression scores in pregnant women.
- Depression workbooks. There are a variety of mood-based workbooks you can try, including Mind Over Mood: Change How You Feel by Changing the Way You Think.
Seeking social support
The people around you affect how you feel. If you’re going through major life changes and you have no support, it can lead to sadness, anxiety and prenatal depression. In fact, research shows that your level of support during pregnancy can impact your mental health and the health of you and your baby.
Especially if you’re dealing with depression, you need extra support from your loved ones. Ask your partner and family for extra compassion and grace during this time.
You can increase your social support by:
- Staying connected. Try not to drift away from friends and family who want to be there for you.
- Repair or end relationships. Bad relationships take a mental toll, affecting your mental health. If a relationship is rough, can you do anything to repair it? Consider that sometimes it’s healthier to end a relationship, even when it’s difficult. This is the case when someone isn’t supportive of your pregnancy or is being disrespectful and worsening your mental health.
- Connect with other moms. Take a childbirth class and meet other expecting moms in your area.
- Online groups. Online groups, like forums or private Facebook groups, are a great way to increase social support, especially if you live in a rural area where it’s hard to meet others.
- Consider a midwife or doula. While doctors provide medical advice, midwives or doulas can provide emotional support along your journey.
Read:
- Partner Support During Pregnancy Boosts Health: 7 Ways
- Social Support During Pregnancy: Why It’s Critical & 10 Ways To Get It
- Domestic Violence During Pregnancy (Tips +Resources)
Depression medication during pregnancy
In some cases, medication may be used to treat prenatal depression. In many cases, a doctor will recommend other interventions before medication. Your doctor will weigh the benefits and risks to decide if medication is appropriate for you. Anti-depressants are commonly combined with therapy.
Some medications prescribed for depression are not safe to take while pregnant. If you’re on any type of medication and become pregnant, make sure to talk to your doctor about whether it’s safe to keep taking.
You should also consider that medication isn’t a quick fix. It often takes time to find the right type and dosage. Like most treatments for depression, it can take a few weeks or longer to see any results.
Summary: Prenatal Depression
Symptoms of prenatal depression include extreme sadness, anxiety, fatigue, feeling hopeless and a loss of interest in activities that used to bring you joy. The life transition of pregnancy and parenting can bring other stressors that contribute to depression, such as financial or relationship stress. Although everyone experiences sadness from time to time, if you believe you have depression, talk to your doctor about the appropriate way to treat it.
Although you may be able to regulate your mood with self-help and lifestyle strategies, sometimes professional help is needed. Your doctor can recommend a therapy or medication that’s best for you. Getting help is the right thing to do for yourself and your baby.
If you’re having suicidal thoughts or thoughts of harming yourself, speak to a crisis counsellor by calling the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). You can also use their Lifeline Chat.
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