Is it common to suffer from depression or anxiety during pregnancy?
Although pregnancy is often portrayed as a time of great joy, that’s
not the reality for all women. At least one in ten pregnant women
suffers from bouts of depression.
For years, experts mistakenly
believed that pregnancy hormones protected against depression, leaving
women more vulnerable to the illness only after the baby was born and
their hormone levels plunged. They now believe that the rapid increase
in hormone levels at the start of pregnancy can disrupt brain chemistry
and lead to depression.
Hormonal changes can also make you feel
more anxious than usual. Anxiety is another condition that can and
should be treated during pregnancy.
Depression and anxiety may go undiagnosed because women often dismiss their feelings, chalking them up to the temporary moodiness
that often accompanies pregnancy. So don’t be shy about letting your
doctor or midwife know if you feel low. Your emotional health is every
bit as important as your physical health. And in fact, it can affect
your physical health.
Research has shown, for instance, that
depression and anxiety can increase your risk for preterm labor.
Untreated, these conditions can hamper your ability to care for
yourself and your developing baby.
How can I tell if I’m at particular risk for depression or anxiety during pregnancy?
Some common risk factors are:
• Personal or family history of depression or anxiety.
If you’ve struggled in the past with depression or extreme anxiety (or,
to a lesser extent, if depression runs in your family), you’re more
likely to become depressed now that you’re expecting. Even if you’ve
never experienced a full-blown bout of depression or anxiety but have a
tendency to get down or anxious during stressful or uncertain times,
you may be more susceptible to depression now.
• Relationship difficulties.
If you’re in a troubled relationship and talking things out as a couple
isn’t working, get counseling. Don’t make the mistake of assuming that
your baby’s arrival will make everything rosy. A newborn will only add
to the strain on your relationship — so don’t put off seeking
professional advice on repairing your relationship now, particularly if
you’re the victim of abuse.
• Fertility treatments.
If you had trouble getting pregnant, chances are you’ve been under a
lot of stress. And if you’ve gone through multiple fertility
procedures, you may still be dealing with the emotional side effects of
months or even years of treatments and anxiety-laden waiting. On top of
that, now that you’re pregnant, it’s not uncommon to be terrified of
losing the baby you worked so hard to conceive. All of these make you
more prone to depression.
• Previous pregnancy loss. If
you’ve miscarried or lost a baby in the past, it’s no wonder you’re
worrying about the safety of this pregnancy. And if the loss was recent
or if you’ve miscarried several times in the last year, you may not
have had time to fully recover emotionally or physically. And as with
fertility treatments, if you’re dealing with health restrictions you’re
more vulnerable to depression and anxiety.
• Problems with your pregnancy. A complicated or high-risk pregnancy can take an emotional toll, particularly if you’re enduring weeks of bedrest
or numerous genetic tests. (Women who are pregnant with twins or more
often fall into this category.) The strain of having to endure
difficult procedures combined with fear about your baby’s well-being is
often difficult to shoulder. Likewise, not being able to work or do
other things you’re used to doing makes it tougher to maintain your
emotional balance. Talk to your caregiver about caring for your
emotional well-being. Taking proper steps now will also reduce your
risk for problems after giving birth — and help you to better enjoy the
baby you’ve worked so hard to bring into the world.
• Stressful life events.
Financial worries? Relocating? Contemplating switching jobs? Planning
to stay home after years of working? Any major concerns or life changes
such as these — as well as a breakup, the death of a close friend or
family member, or a job loss — can send you into a serious funk.
• Past history of abuse.
Women who’ve survived emotional, sexual, physical, or verbal abuse may
have low self-esteem, a sense of helplessness, or feelings of isolation
— all of which contribute to a higher risk for depression. Pregnancy
can trigger painful memories of your past abuse as you prepare for
parenthood, and the loss of control over your changing body may mirror
the helplessness you experienced when you were abused.
• Other risk factors. If you are young, are single, or have an unplanned pregnancy, your risk of depression is also higher.
Some of the symptoms below, such as fatigue or trouble sleeping, are
common among healthy women during pregnancy. But when they’re combined
with a sense of sadness or hopelessness or they interfere with your
ability to function, depression is probably at least partly to blame.
If you feel unable to handle your daily responsibilities or are having
thoughts of harming yourself, call your doctor or midwife immediately
for a referral to a counselor. Seeing a therapist or psychiatrist isn’t
an indication of weakness. On the contrary, it shows that you’re
willing to take the steps necessary to keep your baby and yourself safe
If you’ve experienced three or more of the
following symptoms for more than two weeks, talk to your healthcare
provider about whether you should see a therapist:
• A sense that nothing feels enjoyable or fun anymore
• Feeling blue, sad, or “empty” for most of the day, every day
• It’s harder to concentrate
• Extreme irritability or agitation or excessive crying
• Trouble sleeping or sleeping all the time
• Extreme or never-ending fatigue
• A desire to eat all the time or not wanting to eat at all
• Inappropriate guilt or feelings of worthlessness or hopelessness
Finally, mood swings with cycles of depression alternating with periods
of an abnormally high spirits — including increased activity, little
need to sleep or eat, racing thoughts, inappropriate social behavior,
or poor judgment — are signs of a serious condition called bipolar
disorder, which requires immediate attention. Call your caregiver if
you have those symptoms.
What are the symptoms of anxiety?
Call your doctor or midwife for a referral to a therapist if you feel overwhelmed and nervous every day or are having:
attacks. These can come on with no warning and include a racing heart,
lightheadedness or faintness, sweaty palms, breathlessness, and feeling
like you’re having a heart attack or are about to pass out.
recurrent concerns about your or your baby’s health or a frequent
feeling that something terrible is about to happen.
How are depression and anxiety treated during pregnancy?
Both psychotherapy and antidepressant medication
can be used to treat these conditions during pregnancy. Ask your doctor
or midwife for a referral to a psychologist or psychiatrist, or check
with your insurance company for a list of mental health providers.
Don’t try to treat yourself by taking St. John’s wort or other
remedies. The safety of these remedies during pregnancy is unknown, and
they’re not an effective substitute for professional help.
Depression and anxiety are biochemical conditions, so you may not be
able to avoid them altogether if you’re prone to them. But taking care
of yourself emotionally can help ease your symptoms and keep your
• Take it easy. Resist the urge to pack in
as many chores as you can before the baby comes. You may think you need
to set up the nursery, clean the house, or work as much as you can
before you go on maternity leave, but you don’t. Pencil yourself
in at the top of your to-do list. You won’t have as much time for
yourself once the baby’s around. Read a book, have breakfast in bed, or
go for a nice long walk around the neighborhood. Choose something that
makes you feel good. Taking care of yourself is an essential part of
taking care of your baby.
• Bond with your partner. Make
sure you’re spending plenty of time with your partner and nurturing
your relationship. Take a vacation now if you can. Do what you can to
strengthen your connection so that once the baby comes, you’ll have
that bond to rely on.
• Talk it out. Air out your fears and worries about the future with your partner, friends, and family.
• Manage your stress.
Don’t let frustration build up in your life. Find ways to take care of
yourself emotionally. Take breaks, get plenty of sleep, get some
exercise, and eat well. If you find anxiety creeping in, try taking a
pregnancy yoga class or practicing meditation.
What can I do to ward off postpartum depression?
About half of women who suffer from depression during pregnancy go on to develop postpartum depression, but getting treated during pregnancy can reduce your chances dramatically. Here are a few other things you can do:
in the habit of taking care of yourself now so it becomes part of your
routine. Plan ways to take breaks and get time off to rest once the
• Talk with your partner about how you’re going to
divide the household responsibilities and care for each other as well
as for your baby.
• Build a support network now (made up of
friends, family members, your partner, healthcare practitioner, or
therapist) so that your helpers will already be in place when the baby
• Start lining up help with cooking, cleaning, or baby
care so you’ll be able to can grab some much-needed time to shower,
nap, or take a walk after the baby arrives.