Depression During Pregnancy: Signs, Symptoms, And Treatments

Pregnancy can be a time of great joy and excitement for many expecting parents. For some, however, this period of life can involve stress, anxiety, and depression. An estimated 9% of women meet the criteria for major depression during pregnancy, which can be referred to as prenatal or antenatal depression. Women living with prenatal depression may experience intense sadness or changes in mood that extend beyond the typical symptoms of pregnancy.

For pregnant women, the early identification of depression can play a key role in reducing symptoms and improving overall well-being. Although depression can be a serious mental health condition that may impact both the mother and her unborn child, it is possible to treat depression using a variety of techniques and coping strategies. Self-care, mindfulness, and therapy with a licensed mental health professional may all prove to be helpful. 

Understanding depression during pregnancy

Women typically experience an increased risk of developing depression both during and after pregnancy. This type of depression is usually called “perinatal depression,” and it includes both prenatal and postpartum depression. 

Prenatal depression (also called antenatal unipolar depression) can be described as a type of major depression that occurs as a direct result of pregnancy. In general, depression is a mood disorder involving a deep, persistent sense of sadness and a lack of interest in previously enjoyed activities. 

Although women may have an increased risk of developing depression both before and after pregnancy, some specific factors may increase that risk. Understanding the following risk factors for developing depression during pregnancy can help individuals identify depression sooner, which may improve treatment outcomes. 

• Personal or family history of depression: Individuals who have experienced depression or who have family members living with depression may have an elevated risk of perinatal depression. 
• Hormone dysregulation: During pregnancy, a woman’s body typically undergoes hormonal changes. For some women, hormonal dysregulation may occur, meaning that hormone levels may exceed expected ranges. This may impact a person’s mental health and could lead to depression symptoms. 
• Stress and anxiety: Pregnancy can be a time of increased stress and anxiety as parents prepare for a new baby. The physical changes in a woman’s body, along with the added stress of preparing for a major life change, may contribute to the development of depression. 
• Isolation or lack of support: Pregnancy can be challenging to manage without the support of friends and family. Experiencing a sense of isolation may contribute to depression symptoms during pregnancy. 
• Unplanned or high-risk pregnancy: When a pregnancy is unplanned or high-risk, it can be stressful and may lead to higher levels of anxiety, potentially contributing to depression symptoms as well.

Symptoms of depression during pregnancy

Symptoms of depression during pregnancy can vary, but in general, symptoms can be divided into the following categories.

• Emotional symptoms: Persistent sadness or hopelessness can be common emotional depression symptoms. Pregnant women may also experience an increase in anxiety, which may not subside without treatment. Emotional symptoms can be useful as early warning signs of depression, but they can also be challenging to identify because some level of emotional change is usually expected during pregnancy.
• Physical symptoms: Depression can impact the body physically and may be linked to a sense of low energy or lethargy that extends beyond what is expected during pregnancy. Depression may also contribute to changes in eating, personal care, and sleeping habits, which can impact a woman’s overall physical health. 
• Behavioral symptoms: Women who are experiencing depression during pregnancy may also experience behavioral symptoms, such as social withdrawal or a lack of interest in activities they used to enjoy. 

Impact of depression on pregnancy and fetal health

Untreated depression can impact both the pregnant woman and the fetus. When a pregnant person is experiencing depression, they may not seek necessary prenatal care, and they may find it challenging to engage in healthy habits. For example, an expecting mother who is experiencing depression may not attend scheduled prenatal care visits, get the proper amount of sleep, or eat nutrient-rich foods. A lack of nutritious eating habits and sufficient sleep may negatively impact fetal development and can be linked to preterm birth, low birth weight, and intrauterine growth restriction.

In general, pregnant women living with mental illness may be more likely to experience substance use disorder, which usually increases rates of postpartum depression as well. Substance use during pregnancy may be linked to increased rates of stillbirth, sudden infant death syndrome (SIDS), and neonatal abstinence syndrome (NAS), a condition in which the baby experiences substance withdrawal upon birth.

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

Prevention and early intervention

Although the impact of depression during and after pregnancy can be significant, early identification and intervention measures can improve conditions for both the mother and her unborn child. 

Preventative measures may include early screenings and detection from a mother’s healthcare providers, which can identify symptoms and help families recognize the signs of depression. In addition to formal screenings, education through new parent programs can provide valuable resources for soon-to-be mothers and their families to aid in recognizing and providing support for depression. 

There are also more general steps that an expecting mother may take to reduce the chances of developing depression while pregnant. These may include lifestyle changes, such as regular exercise and prioritizing nutrient-rich eating habits. It may also be beneficial for expecting mothers to engage in self-care practices, such as mindfulness meditation, yoga, or reflective journaling, to identify negative thought patterns and become more aware of underlying emotions. 

Treatments for depression during pregnancy

The treatments for depression during pregnancy may involve several healthcare providers, depending on the duration and severity of depression symptoms. In some cases, treating depression during pregnancy can be similar to treating depression more generally. However, medical and mental health professionals usually also consider the impact of treatment options on the fetus. Common treatment options usually include lifestyle changes and self-care strategies, therapy, and prescription medication.

Medication

In some cases, antidepressant medications may be used to treat depression during pregnancy, and the risk of these medications impacting the growth and development of the child appears to be low. With that said, it can be important for any woman who is pregnant or planning to be pregnant to discuss the impact of antidepressant medications with a doctor before treatment. Never start, stop, or change the way you take medication without consulting your prescribing provider, and always inform them if you experience any side effects or other concerns.

Lifestyle changes and self-care strategies

Pregnant women should work with their healthcare providers to develop an exercise routine that is effective and safe for their unique situation. In addition to getting enough exercise, it may be important for expecting mothers to prioritize nutritious eating habits and get plenty of sleep.

It also may be beneficial for expecting mothers to practice self-care strategies, such as mindfulness or other relaxation techniques, to reduce depression. Meditation, yoga, and deep breathing exercises can calm emotions and reduce stress and anxiety. Self-care strategies can be built into a daily routine or may be used during periods of high stress. 

Therapy 

Expecting mothers who are living with depression may benefit from various types of therapy. However, for expecting mothers, doctor’s appointments and other responsibilities can make it challenging to find time for regular therapy sessions. Online therapy may be a helpful and convenient alternative, as it can empower an individual to attend sessions from the location of their choice at a time that suits their schedule.

Research suggests that online therapy can effectively treat depression symptoms. According to a 2019 study, “Users of BetterHelp experienced significantly reduced depression symptom severity after engaging with the platform. Study findings suggest that this intervention is equally effective across gender, self-reported financial status, and self-reported physical health status and particularly effective for individuals without a history of psychotherapy.”