What to Know About Prenatal Depression

Medically Reviewed by Poonam Sachdev on January 18, 2023

Postpartum depression is a common and sometimes severe mood disorder that develops after the birth of a baby. Prenatal depression — a similar mood disorder that occurs during pregnancy — is also common but not as well known. Learn more about prenatal depression, how to tell the difference between this condition and others, and what to do if you need help.

Prenatal depression symptoms don’t look the same for every woman who experiences this condition. It can be difficult to diagnose for two reasons. First, pregnancy is idealized in the media and in real life. Many women feel guilty for feeling anything negative during pregnancy. Second, depression is sometimes hard to separate from “normal” pregnancy symptoms like fatigue, appetite changes, and mood swings. 

Some symptoms of depression — like feeling tired — overlap with normal pregnancy issues. Talk to your doctor to determine why you’re feeling off and get prenatal depression help if you’re experiencing the following symptoms:

  • Feeling overwhelmed, unhappy, or apathetic
  • Having trouble concentrating
  • Not experiencing joy or wanting to do what normally interests you
  • Having low energy
  • Having thoughts of harming yourself or ending your life

Depression is one of the most common mental health issues for adults. Around 15% of women experience depression at some point, and it’s common to experience mood changes during and after pregnancy. 

You’re more likely to struggle with a mood disorder like prenatal depression if you have one or more of the following risk factors:

  • You live in a low-income household: Statistically, many more women in low-income countries struggle with prenatal depression than those from affluent countries.
  • You didn’t plan the pregnancy: Unexpected or unwanted pregnancy is a common and understandable trigger for prenatal depression.
  • You have a history of mental health issues: You might reactivate a previous struggle with depression, obsessive-compulsive disorder, bipolar disorder, or panic disorder when you become pregnant.
  • Your life is stressful: Everyone experiences stress. However, if you’re dealing with high-stress situations while pregnant — like a conflict-ridden marriage, job loss, or a health problem in the family — you’re at higher risk for prenatal depression.
  • You’re dealing with a diabetes diagnosis: Many women develop gestational diabetes during pregnancy, while others go into the pregnancy with a diagnosis. This condition (and other chronic medical conditions) can put you at risk for prenatal depression.

You likely already know that postpartum depression puts new mothers and their babies at risk. Women with postpartum depression might avoid their new babies, stay in bed, or struggle with unwanted anger.

Prenatal depression is similar in that it can compromise your ability to take care of yourself during pregnancy. During this time, your baby relies on you for nourishment. If your depression interferes with your ability to take your prenatal vitamins, eat a healthy diet, or attend medical checkups, your baby’s health is put at risk. 

At the mild end of this disorder, you might feel anxious and hopeless about the future (or your pregnancy itself). At the severe end, prenatal depression might cause panic, insomnia, self-harm, and rage.

If you suspect that you have prenatal depression, it’s important to ask your doctor for an evaluation as soon as possible. Prenatal depression is probably more common than you think, and there are many science-based prenatal depression treatments available that are safe for you and your baby.

Medication. Many people who aren’t pregnant take antidepressant medication to ease symptoms of depression. It’s possible to safely treat depression with certain medications during pregnancy, but they should be prescribed based on your current condition, your medical history, and your baby’s health risks. Some antidepressants, like paroxetine, can cause heart problems in babies, while others, like sertraline, are generally safe.

You may wish to avoid medication during pregnancy, but it’s still important to address your depression. Stay away from antidepressant herbs like St. John’s wort that have not been cleared for safety during pregnancy. 

Exercise. While exercise might not alleviate more severe forms of prenatal depression, it can help lift your mood. It’s important to get your doctor’s OK before beginning a workout program and to use caution if you have risk factors like preterm labor, previous pregnancy issues, or problems with your placenta. Try easing into exercise during pregnancy — perhaps walking for around 30 minutes a day to start — if your doctor is fine with this.

Counseling. Mental health counseling is a great option for treating prenatal depression, as it does not carry physical risks for you or your baby. You might wish to attend counseling alone or with your partner.

Depression is caused by a number of factors, so it’s impossible to say whether someone’s prenatal depression will spontaneously resolve. It’s not a good idea to count on depression going away — especially when your baby’s health is also involved. 

If you notice anything that feels off during pregnancy, be sure to talk it over with your provider. Your symptoms could be caused by pregnancy hormones, or they could point to something more serious. The faster you reach out for help, the sooner you’ll begin feeling better.

Experts recommend both cognitive behavioral therapy and interpersonal therapy (to help you identify problems in your relationships that might be contributing to your depression) to help prevent depression during pregnancy. However, prenatal depression involves many factors that are out of your control, like life stress, medical status, and hormonal shifts. Currently, it's not possible to prevent all cases of prenatal depression.

Prenatal depression can be mild or severe. Avoiding treatment might seem like the easier option, but you could be putting your own health, as well as your unborn baby’s, at risk if you ignore this mood disorder. Speak with your doctor, nurse midwife, or mental health counselor as soon as possible to learn more about your condition and its treatment options.

Show Sources

SOURCES:
Canadian Pediatric Society: “Depression in pregnant women and mothers: How it affects you and your child.”
Cedars Sinai: “Pregnancy, New Motherhood and Mental Health — What You Should Know.”
Centers for Disease Control and Prevention: “Depression During and After Pregnancy.”
Cleveland Clinic: “Prenatal Depression.”
Frontiers in Public Health: “Prenatal Depression and Its Associated Risk Factors Among Pregnant Women in Bangalore: A Hospital Based Prevalence Study.”
March of Dimes: “Depression during pregnancy.”
Mayo Clinic: “Pregnancy and exercise: Baby, let’s move!”

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