Prenatal Depression

What is prenatal depression?

Prenatal depression is depression that happens during pregnancy. Depression causes ongoing or extreme sadness. It can also cause anxiety, fatigue and trouble sleeping. If you have this mood disorder, you may withdraw from family and friends. You may not have any interest in activities you once enjoyed.

Prenatal depression can affect you at any time during pregnancy. Postpartum depression (PPD) is depression that develops after you have the baby. It’s important to note that prenatal and postpartum depression are different from the “baby blues." The “baby blues” usually resolve within two to three weeks. Meanwhile, prenatal and postpartum depression don’t go away without treatment.

Symptoms of depression sometimes get better with lifestyle changes. But if they don’t, providers treat this condition with therapy and medications. If you have prenatal depression, you are not alone. Depression is a common medical condition, and treatments can help.

Who might get prenatal depression?

Anyone can get prenatal depression. You’re more likely to have this condition if you or your family members have a history of:

• Anxiety disorders.
• Panic disorder.
• Mental illness, including obsessive-compulsive disorder (OCD).
• Mood disorders such as depression and postpartum depression.

Prenatal depression is more common among people who:

• Are carrying a child with a health problem or special needs.
• Are dealing with stressful life events. These could include divorce, health problems, financial issues or trouble at work.
• Are expecting twins or triplets.
• Didn’t plan to become pregnant.
• Don’t have a supportive partner or network of friends and family during pregnancy.
• Had trouble getting pregnant due to infertility.

How common is prenatal depression?

This condition is very common. Researchers believe depression is one of the most common issues pregnant people face. Around 5% of adults in the United States have persistent feelings of depression.

What causes prenatal depression?

Many factors play a role in who gets depression during pregnancy. One of the main factors is having a history (or family history) of mood disorders. During pregnancy, hormone levels shift, which can affect mood. Depression can result from an imbalance of chemical levels in the brain.

Many people also feel sad or anxious about changes happening to their bodies. They may experience pregnancy discomforts. They may have financial concerns and worry about taking on new responsibilities. For those with a higher risk of depression, these changes can be overwhelming.

What are the symptoms of prenatal depression?

Everyone feels sad, anxious or worried occasionally. It’s normal to feel this way sometimes, especially during pregnancy. But depression symptoms don’t go away after a few days. They can last for weeks or months, and they can worsen over time. Symptoms of depression during pregnancy include:

• Anxiety, excessive worrying and irrational thoughts.
• Changes in appetite and unexplained weight loss or weight gain (not due to pregnancy).
• Decreased interest in activities you once enjoyed. Or withdrawing from friends, family and social interactions.
• Fatigue, sleeping more than usual, or difficulty getting to sleep or staying asleep (insomnia).
• Feelings of sadness, hopelessness, numbness, “emptiness” or guilt.
• Irritability, excessive crying or other mood changes or mood swings.
• Loss of interest in sex and difficulty connecting with your partner.
• Physical symptoms that don’t result from a health condition or other cause. These may include headaches, muscle aches and gastrointestinal (GI) problems.
• Problems concentrating, remembering things, reasoning or making decisions.

In severe cases, people with this disorder have thoughts about harming themselves or the developing fetus. If you have self-harm thoughts or thoughts of suicide, call the Suicide and Crisis Lifeline at 988. This national network of local crisis centers provides 24/7 free and confidential emotional support to people in suicidal crisis or emotional distress.

How is prenatal depression diagnosed?

If you have signs of prenatal depression, it’s important to get an evaluation. Your healthcare provider will ask about your symptoms They’ll want to know when they started and how often they occur.

They may recommend seeing a mental health professional (like a psychologist, therapist or counselor). This specialist can offer a complete evaluation and treatment. Tell them if you have a history or family history of depression or other mood disorders.

How do providers treat prenatal depression?

Healthcare providers treat prenatal depression with:

• Cognitive behavioral therapy (CBT), a type of therapy that helps you think about your concerns and behaviors in a different way. Over time, you develop new thinking patterns. You’ll discover how to react to certain situations in a more positive way.
• Interpersonal therapy (IPT) allows you to improve the way you interact with others. It also helps you develop relationships and gain support from social groups.
• Medications to treat depression. Ask your provider which ones are safe to take during pregnancy and while breastfeeding.
• Psychotherapy, or talk therapy, which allows you to talk through your emotions and develop ways to cope. An experienced therapist can help you manage mood changes and feel better.

How can I manage prenatal depression?

There are several things you can do to improve your mood and outlook. These include:

• Finding a supportive network: Connecting with other expecting parents allows you to share your concerns. You’ll learn from people who know what you’re experiencing. Call your local hospital and ask if they can recommend a support group or other resources.
• Making health a priority: Get plenty of exercise during pregnancy. Focus on good nutrition, take prenatal vitamins and try to get enough sleep. Quit smoking and avoid alcohol, since these are dangerous for both you and the developing fetus. Drinking alcohol while pregnant can cause fetal alcohol syndrome. Better physical health often goes hand-in-hand with improved mental health.
• Preparing for your baby: Keep up with your appointments for prenatal care. Learn about fetal growth and milestones and take time to get ready for your baby’s arrival. You’ll feel better knowing you’re prepared for childbirth and beyond.
• Staying active: Make it a point to spend time with friends or go out with your partner. Interacting with others and getting out of the house can have a major impact on your mood.
• Trying meditation: If you’re feeling lots of stress or anxiety, try yoga, meditation and breathing exercises. There is a connection between stress management and emotional health. Learning some relaxation techniques can help you feel better.

How can I reduce my risk of prenatal depression?

You may not be able to prevent depression during or after pregnancy (postpartum depression). If you’ve had depression or anxiety before or you have a family history of mood disorders, you have a higher risk. Talk to your provider about the signs to look for so you can get help.

What can I expect if I have prenatal depression?

For most people, symptoms of prenatal depression get better with treatments. Therapy, medications and lifestyle changes can significantly improve your outlook. Keep in mind that you may need a combination of medications and therapy for symptoms to improve. You may also need to try different types of therapy or medications.

How does prenatal depression affect fetal development?

Untreated, depression can be dangerous for a developing fetus. Prenatal depression can make it difficult for you to care for yourself while pregnant. You're more likely to make unhealthy choices, like drinking alcohol, smoking or avoiding exercise. All of these choices impact fetal health.

In severe cases, people with prenatal depression may harm themselves or the developing fetus.

When should I seek care for prenatal depression?

If you have signs of depression during or after pregnancy, get help right away. Safe, effective treatments are available. Get emergency medical help if you have thoughts of harming yourself or the fetus developing in your uterus.

A note from Cleveland Clinic

If you’re pregnant, it’s normal to feel anxious, worried or emotional from time to time. But if sadness or anxiety is affecting your daily life, see your provider. Be open and honest about your symptoms, feelings and concerns. Treatments for prenatal depression can help, and they’re safe for you and the fetus. You may need a combination of therapy, medication and lifestyle changes to help you feel better. If you think you may harm yourself or your the fetus, get emergency help.