What Is Prenatal Depression?

In general, depression causes ongoing sadness and loss of interest in things you used to enjoy. It’s the most common mood disorder, affecting women twice as often as men. Often, the onset of depression is the highest during a woman’s reproductive years.

In the U.S., about 1 in 20 women will experience depression while pregnant, and an estimated 10% to 20% of women will develop a pregnancy-related mood disorder. Similar to postpartum depression, which affects 1 in 7 new mothers, there is also no particular cause of prenatal depression.

It's important to remember that depression and anxiety during pregnancy or after birth aren't caused by anything you do or don't do — they are medical conditions, and are the result of various physical, emotional, and environmental circumstances.

The pandemic — and the isolation that came with it — caused an uptick in women suffering from perinatal depression. “Pregnancy very much shifted to a lonely experience,” Amber Parden, who manages perinatal psychiatric services for Woman’s Hospital in Baton Rouge, told the Washington Post. “And that took a huge toll on moms, who are going to find some way to feel guilt no matter what’s happening in the world. Mom guilt is a very real thing.”

While anyone can get prenatal depression, you’re more predisposed if you or your family members have a history of:

• Anxiety or panic disorders
• Mental illness (including obsessive-compulsive disorder)
• Mood disorder (e.g.: depression or postpartum depression)

Additionally, according to a Rutgers study, pregnant transgender men are at increased risk for depression and difficulty receiving proper medical care as a result of health care providers being inadequately prepared. In addition, prenatal depression is more common when you are:

• Carrying a child with special needs or a health problem
• Under a lot of stress (e.g.: divorce, health problems, financial difficulty, work-related problems)
• Not well supported by your family, friends, or community
• Having an unplanned pregnancy
• Expecting multiples
• Pregnant after having difficulties due to infertility
• Experiencing intimate partner violence

Truthfully, a lot of prenatal depression symptoms overlap with pregnancy symptoms. You’re likely to be tired, gain weight, have some insomnia, or experience mood swings and emotional changes. As a result, prenatal depression often goes undiagnosed.

Here are some of the symptoms of prenatal depression:

• Heightened anxiety
• Crying or weeping a lot
• Difficulty sleeping or staying asleep (but not because you need to pee)
• Appetite changes and unexpected weight loss or gain (unrelated to pregnancy)
• Exhaustion and low energy
• No longer finding enjoyment or pleasure in activities you used to love
• Trouble connecting to your developing baby (poor fetal attachment)

“Help when experiencing prenatal depression is critical because your depression may impact how you care for yourself and your baby during pregnancy,” Marcie Beigel, Ed.D. BCBA-D told Mom.com. “It also puts you at greater risk for postpartum depression.”

It is particularly important for pregnant people with prenatal depression to get the appropriate support and medical care.

“I should have gone into a treatment center,” mom of three Lisa Arrow told us. “I was suicidal. My midwife finally told me to see a counselor, and she gave me some medication. I don’t think I would have known to go in otherwise. I was too far gone to realize something was wrong, and my husband was panicked.”

The treatment of prenatal depression is very similar to that of other kinds of depression. Some medical providers ask screening questions at various points during your pregnancy, but if at any point you think you may have depression, don’t wait.

“If you suspect you have prenatal depression, ask your doctor. If you suspect a loved one has prenatal depression, ask them lovingly,” suggested Dr. Beigel. “Mental health has a stigma that will only change when we are bold enough to bring up the subject. Asking about prenatal depression will not cause depression, it may however help you or a loved one get the help they need.”

Below are some ways you can manage prenatal depression. As always, please consult your medical provider for your individualized treatment plan.

Medications
Thankfully, approximately 80% to 90% of pregnant people and new moms with perinatal depression are treated successfully by drugs, talk therapy, or a combination of both. According to several U.S. and U.K. studies, selective serotonin reuptake inhibitors (SSRIs) are generally considered safe for pregnant and chestfeeding people. Doctors most commonly prescribe these antidepressants for perinatal depression, and your medical provider may suggest you continue the medications even after the birth of your child.

However, many people prefer alternative treatments because while there is no evidence that antidepressants taken during pregnancy are harmful to your pregnancy, there is a chance newborns may have drug withdrawal symptoms of jitters, irritability, and a rare risk of seizures. Please remember that prolonged depression may ultimately be more harmful to you and your baby. You and your medical provider will make a joint decision of how to best treat your perinatal depression.

Therapy and alternative treatments
Many people also find that other treatments such as talk therapy are also helpful either in conjunction with medication or alone. According to a Stanford University study, of the women who received acupuncture that was depression-specific, 63% responded well.

Natural treatments and lifestyle
Additionally, there are lifestyle choices you can make to help improve your mood. For example:

• Get plenty of exercise
• Take your prenatal vitamins
• Eat nutritionally balanced foods
• Avoid smoking and alcohol
• Try meditation or breathing exercises
• Find and use a support network
• Go to your prenatal care appointments

Ultimately, it is not your fault if you experienced perinatal depression of any sort. You did not do anything wrong — and you are not a bad parent because of it.

If you are having thoughts of self-harm or suicide, or thoughts of harming your unborn baby, please call the National Suicide Prevention Lifeline at 1-800-273-8255. This national network of local crisis centers is free, available 24/7, and provides confidential support.