Depression During Pregnancy: What It Is & How to Cope

What is Depression During Pregnancy? 

It’s an understatement to say people go through many physical and mental changes during pregnancy. Even when pregnancies are planned, uncomplicated, and/or when it’s not your first go-around, becoming pregnant is an enormous and constant adjustment. When a pregnancy is not planned or there are complications, there are even more decisions and emotional rollercoasters to encounter. Each stage of every pregnancy journey includes new and often challenging changes and disruptions to your prior existence. For some, all of this upheaval can be accompanied by an increase in depression symptoms. These symptoms might feel new or they may have returned after a long period of feeling okay.

 

Occasionally feeling down, frustrated, or emotional is a normal part of pregnancy adjustment, but if these symptoms occur almost every day for a lot of the day, and have been going on for longer than 2 weeks, that’s when they are classified as depression. 

 

What are the Symptoms of Depression During Pregnancy? 

Everyone’s experience of depression during pregnancy is a little different. Below are the most common symptoms of depression during pregnancy:

• Depressed mood or severe mood swings
• Excessive crying
• Anxiety about your pregnancy or the health of your baby
• Feeling disconnected or detached from the pregnancy 
• Withdrawing from family and friends
• Loss of appetite or eating much more than usual
• Inability to sleep (insomnia) or sleeping too much
• Overwhelming fatigue or loss of energy
• Reduced interest and pleasure in activities you used to enjoy
• Intense irritability and anger
• Fear that you're not a good mother or are not going to be a good mother
• Hopelessness
• Feelings of worthlessness, shame, guilt or inadequacy
• Diminished ability to think clearly, concentrate or make decisions
• Restlessness
• Thoughts of harming yourself or your baby
• Recurrent thoughts of death or suicide

How common is depression during pregnancy and why is it hard to recognize? 

About 10% of women experience depression during their pregnancy. These symptoms can appear at any point in pregnancy. For some, depression symptoms appear during the early adjustment to the pregnancy, but for others, the symptoms emerge as the pregnancy progresses and they get closer to labor and delivery.

 

Some of the common symptoms of depression are really similar to the symptoms of pregnancy! Things like changes in your sleep, energy level, appetite, and libido are all common during pregnancy, but can also be signs of depression. Sometimes providers are so focused on your physical health during pregnancy that these depression symptoms can be missed or misattributed to expected physical changes.  It is never too late to seek help for depression during pregnancy. 

 

What Causes Depression Symptoms During Pregnancy? 

Depression during pregnancy can be caused by a combination of the following genetic, biological, environmental, and psychological factors:

• Brain chemistry: Pregnancy leads to many hormonal and physical changes in the body, which directly impact the brain. During pregnancy, progesterone and estrogen levels increase dramatically. These changes in hormone levels are important for preparing the body for pregnancy, but they can also lead to feelings of depression and anxiety. Research has also shown that a first time pregnancy directly changes the structure of the brain and these changes continue to progress for up to two years postpartum. In particular, the gray matter of the brain tends to shrink. The function of this is to optimize the brain structure for parenthood, but sometimes this process can also cause emotional changes.
• Genetics: If you have a relative with depression during their pregnancy, postpartum depression, or just more general depression, you may be more at risk of depression yourself.
• Life events: Life events can trigger depression symptoms including stress, the death of a loved one, upsetting events (such as a prior traumatic birth experience or a history of pregnancy complications), isolation, lack of support, intimate partner violence, moving into a new home, unintended pregnancy, loss of a previous pregnancy, fertility struggles, etc. 
• Medical conditions: Medical conditions and physical illness can cause depression, including ongoing physical pain (caused by the pregnancy or otherwise), illnesses, hyperemesis gravidarum, diabetes, and medically complex pregnancies, such as being pregnant with multiples.
• Medication: Some medications have depression as a side effect. There are many medications that are safe for pregnant people to take, but the side effects may still lead to an increase of depression symptoms. 

The symptoms of depression during pregnancy can continue or are maintained by the way we think and the way we behave. 

 

The way we think can keep us stuck in depression: 

• • Unhelpful thoughts like “I will never be a good parent,” or “What if something terrible happens,” or “I’m not cut out for parenthood,” can keep us stuck and make it harder to get out of the depression cycle.
  • At Prospera, we call these thoughts “thinking traps” 

The way we behave can keep us stuck in depression: 

• Doing or avoiding things (i.e. staying in bed, ignoring calls, not showering, not attending prenatal appointments, not going out with friends) that feel good in the short term (but make us feel worse in the long term) can also keep us stuck in the “depression cycle”.
• At Prospera, we call these behaviors “behavior traps”