Pregnancy is a time of excitement and giddiness, right? The answer is that yes, it certainly can be. But it’s also normal for pregnancy to accompanied by fears, worries, sadness, and so much more. (And it’s common to feel combinations of these lows and highs, all at once.) Let’s talk about pregnancy depression, anxiety, and stress.

Estimated reading time: 8 minutes

Everyone Else Seems Happy. Why Am I Not?

First, let’s start off with some numbers.

• Around 1 in 7 women — or about 14% — are affected by depression during pregnancy or during the postpartum period (shortly after giving birth) (1).
• More than 10% of women are afflicted with anxiety during pregnancy (2).
• Some studies even show that closer to 25% of pregnant women have some degree of depression and that 10% experience major depression (4).

Those may not seem like huge numbers, but they reveal that depression during pregnancy is far from uncommon. And keep in mind that those are just the numbers for women who are actually diagnosed as having depression or anxiety in pregnancy. Anecdotally, we can say that a great many more have symptoms that they didn’t talk to their doctors about, or at least periods of time when they may struggle at least mildly.

Getting Hung Up On How You “Should” Feel

So, if these challenges are common in pregnancy, why don’t people talk more about them? Well, for starters, people are still somewhat hesitant to talk about mental health difficulties in general. Our society has come such a long way in recognizing that these are common, shared experiences — often with biological causes — and that there should be no shame in openly talking about them. There is still a long way to go, though.

Pregnancy adds a whole new dimension to the idea of open discussion. There is such a focus on pregnancy being a happy time that it may send the message that if you’re feeling anything but happy, your motherhood is in question. Many women seem to believe that they’re not supposed to feel depression, anxiety, or stress during pregnancy and feel guilty if they do.

It’s a Wild Ride

When you become pregnant, your body is suddenly strapped into a hormone roller coaster. While these hormones are doing what they’re supposed to (making changes to your body to support your pregnancy and grow your baby), they also result in all kinds of side effects. One of the things that happens is that estrogen and progesterone upset the balance of chemicals in your brain (3). When these neurotransmitters surge or wane, you end up feeling lows, highs, or mood swings.

The teen years are some of the moodiest and most difficult in terms of emotional regulation, because of the changing hormones. Some women struggle with their emotions during different parts of their menstrual cycle. (Which is so common that everyone is familiar with PMS, premenstrual syndrome.) This is, again, because of changing hormones. If you think about it from a hormone standpoint, it makes absolute sense that pregnancy could bring about emotional changes such as depression, anxiety, stress, and more.

Depression During Pregnancy

Depression can show up at any time during your pregnancy. It may come early, with the very first hormone changes, or it may show up at any other point. Or, it can occur after your baby is born, known as postpartum depression.

And it’s not just your hormones that can contribute to depression during pregnancy. You also may feel physically unwell. There may be a feeling of isolation from some of your friends or family as you assume new responsibilities and expectations. You may feel sad about the loss of your figure as your body changes. There are so many potential factors at play.

Recognizing Depression in Pregnancy

Let’s take a look at some symptoms of depression, including:

• Feeling sad or empty most of the time
• Having a down or depressed mood most of the day, nearly every day
• Losing interest in work or hobbies
• Feeling irritable or restless
• Having difficulty falling asleep or staying asleep
• Feeling sleepy or fatigued much of the time
• Having no appetite, or wanting to eat all the time
• Finding it difficult to concentrate
• Feeling guilty, hopeless, or worthless
• Having thoughts of harming yourself (4, 5, 6)

It can be tricky to know when there’s a problem since some symptoms of depression are similar to those that often come along with pregnancy. Things like fatigue, sleep changes, appetite changes, etc. can be totally normal. While there’s no definitive line, depression is more intense and longer-lasting. If you experience any of these things in a way that really impacts your life, or they persist for longer than two weeks, talk to your doctor or midwife. And if you have thoughts of harming yourself, call or go to the hospital immediately.

Anxiety or Stress During Pregnancy

If we’re being honest, it can be stressful to be pregnant and on the cusp of huge life changes. Studies have shown that on a scale of life’s most stressful events, pregnancy is #12 (7). Just like depression, anxiety may have a chemical/biological/hormonal root. But there are also a lot of changes that come along with pregnancy, and it would be hard to not feel at least somewhat anxious and/or stressed about them. You may not feel physically well. There may be stress about work, what may happen during your leave, or whether you should stop working when baby is born. You may feel worried about what kind of parent you’ll be, or if you already have kids, you may worry about how the new baby will affect family dynamics.

Recognizing Anxiety in Pregnancy

Let’s look at some symptoms of anxiety in pregnancy, including:

• Feeling anxious and/or out of control much of the time
• Feeling restless
• Worrying excessively (about your baby, the future, something else specific, or just nonspecific worry)
• Feeling a sense of doom or dread
• Feeling agitated, irritable, or on edge
• Having trouble falling asleep or staying asleep
• Having symptoms of panic attacks (8)

Again, it is normal to feel more anxious during times when life is changing. However, it’s not normal if you find that your worries are taking over your life or persist for longer than two weeks.

Treatment

The good news is that your healthcare provider will be very familiar with pregnancy depression, anxiety, and stress. He or she can help you come up with a treatment plan.

Things You Can Try

You can first try some behavior modifications and activities that may help. The self-help activities are mostly the same for both depression and anxiety. You may find that your mood improves if you:

• Get some fresh air and sunlight
• Do some exercise — even just a short walk may help
• Get enough sleep
• Have a healthy snack (no one is at their best when they’re “hangry”)
• Journal about your feelings
• Give time to your hobbies, or take up a new hobby
• Read or listen to quiet music
• Practice slow, deep breathing or try meditation
• Practice mindfulness (being aware of your body, your emotions, and your surroundings)
• Try using essential oils, fragrant flowers, or scented candles
• Talk to friends, your partner, or find community in a support group (8, 4)

If You Need More Help

Your caregiver can help you come up with a plan to treat your depression, anxiety, stress, or combination. You may be referred to a therapist or counselor. Sometimes talking through things may help you feel better, or a therapist may be able to give you coping tools or strategies to use in tough moments. If you find that you’re still struggling, there are medications that are safe to use during pregnancy. Just remember to never use medications or supplements without asking your provider if they’re safe.

Pre-pregnancy Depression or Anxiety

While we’ve been discussing what happens when you struggle with new depression, anxiety, or stress during pregnancy, we also want to touch on the fact that many women enter pregnancy with an existing mental health diagnosis. In fact, nearly 20% of the population live with a mental illness.

If you have come into your pregnancy with an existing mental health condition, the best thing you can do is talk about it at your very first prenatal appointment. Your doctor or midwife will work with you on a plan to manage your symptoms in a way that is safe for your baby. That may include stopping or changing certain medications, but it is vital that you don’t try to make any changes without first consulting your provider.

It Takes a Village

I’m sure you’ve heard the saying that it takes a village to raise a child. While your “village” — or the people around you — are important when it comes to raising your child, they’re also essential in supporting you, personally. (Just as you are an essential part of their support systems.) Talk to your friends and family. Lean on your partner, if you have one. Find support groups — in person or online — so that you can communicate with others who are in a similar circumstance. You’ll find that the people who love you will embrace the opportunity to help you stay healthy and well. And in turn, your experiences will enable you to be an excellent support to others down the road.

Kopa Birth’s online birthing classes allow you to prepare for a natural hospital birth from the comfort of your own home, 24/7. Enroll today in our free online childbirth class and start preparing for your natural birth!

References:

1. The American College of Obstetricians and Gynecologists Committee Opinion no. 630. Screening for perinatal depression. (2015). Obstetrics and gynecology, 125(5), 1268–1271. 
2. Anxiety and panic attacks in pregnancy. (n.d.). 
3. Barratt, J., Cross, C., Steel, S., & Biswas, C. (2016). The pregnancy encyclopedia: All your questions answered. London: Dorling Kindersley Limited.
4. Glade, B.C., Schuler, J.  (2011).  Your Pregnancy Week by Week, 7th edition.  First Da Capo Press.
5. The American College of Obstetricians and Gynecologists.  (2010).  Your Pregnancy and Childbirth Month to Month, 5th edition.
6. Depression during and after pregnancy. (2020, May 14). 
7. Mcleod, S. (1970, January 01). Stress and life events. 
8. Anxiety and panic attacks in pregnancy. (n.d.). 
9. Mental illness. (n.d.).

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