What Every Woman Should Know about Mental Health During Pregnancy

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Note: The Pregistry website includes expert reports on more than 2000 medications, 300 diseases, and 150 common exposures during pregnancy and lactation. For the topic Depression, go here. For the topic Anxiety, go here. For the topic Post-Traumatic Stress Disorder (PTSD), go here. These expert reports are free of charge and can be saved and shared.

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Pregnancy changes a lot of things about your life. It can make you feel terrible, amplify worries about your job, and change your relationship with your partner. Plus, there are hormonal shifts that make it hard to sleep and completely mess with your emotions. Then there are the societal expectations of what pregnancy will be like—perhaps you’re not having the time of your life growing another person. It’s no wonder then that people experience mental health challenges during pregnancy. If you feel yourself struggling with poor mental health, take heart! There is help out there and you don’t have to suffer. Read on for ideas about what to look out for, as well as coping strategies.

How common are mental health struggles during pregnancy?

 You’ve probably heard about postpartum depression and anxiety, and may even be prepared for your mental health to suffer after your baby is born. Though it’s not often discussed, depression and anxiety during pregnancy are also common, with between 10 and 50 percent of pregnant people affected in some way. If you’ve been experiencing any mental health struggles during your pregnancy, you’re definitely not alone.

What are the symptoms of poor mental health?

 When your mental health is suffering, it can be tough to get perspective or see your life and feelings clearly. Here are some things to watch out for that might warrant a conversation with your doctor, midwife, or mental health professional:

Irritability: some of this is normal, but if you start to feel like you want to smack your loved ones, it might be time to seek help. This is one of the most common symptoms of anxiety and depression in pregnant people.

Trouble remembering things or focusing: some of this is normal, but if it starts to interfere with your life, talk to someone about it.

Sadness or hopelessness: this is one of the most well-known symptoms of depression, but even if you’re not sad, you might still be depressed.

Lack of motivation: you might not want to see friends or family, work, or participate in activites you’ve enjoyed in the past.

Intrusive thoughts: some thoughts that worry you (about your or baby’s health, about your upcoming birth, for instance)  are normal, but if you can’t turn them off or imagine how anything could go right, you might need help.

Panic attacks: these episodes of extreme fear can take over your body and make you feel completely out of control, like you’re having a heart attack, or like you want to shut down.

Other physical symptoms: extreme fatigue (even more than normal pregnancy tiredness), headaches, gastrointestinal issues (especially if your nausea improves after early pregnancy and then gets worse again), tension in your muscles, chest tightness, changes in your appetite that seem outside the realm of normal for pregnancy, and difficulty breathing can all be manifestations of depression and anxiety.

What can be done about mental health challenges during pregnancy?

 You might think there’s nothing that you can do if you’re pregnant and depressed or anxious, but that’s not true. Talking to your care provider (your doctor or midwife) is a great thing to do first and as soon as possible. They will want to know how you’re doing for one thing, but they also can recommend pregnancy-safe coping strategies.

Talk therapy may also be a good place to start, as it is evidence-based and safe during pregnancy. Exercise and paying attention to your diet (what foods make you feel good? What foods exacerbate your issues?) are other things to take a look at if you’re not feeling your best mental health wise. There are also medications that are safe for pregnant people and may really help you. If your doctor or midwife is not comfortable prescribing something, try to find a psychiatrist or psychiatric nurse practioner with expertise in treating people prenatally.

If all of these things feel too overwhelming, just talk to someone: your partner, a trusted friend, another safe family member. Let them know that you’re struggling and ask them to support you as you get help. You deserve to feel good as your baby grows and there is help out there to keep both you and baby safe and healthy.

Abby Olena
Dr. Abby Olena has a PhD in Biological Sciences from Vanderbilt University. She lives with her husband and children in North Carolina, where she writes about science and parenting, produces a conversational podcast, and teaches prenatal yoga.

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