Prenatal Depression: Causes, Symptoms, and Treatment for Mental Health During Pregnancy

Finding out that you’ll be welcoming new life into the world is an exciting moment. However, once the initial excitement has dissolved and the reality of pregnancy and all the physical and mental changes that come with it starts to settle in, excitement can boil down, condensing feelings of nervousness and worry. 

As beautiful as pregnancy is, the journey can be turbulent, marked by emotions that precipitate unexpectedly and thoughts that cloud even the clearest moments. Finding clarity on which mental health changes are a normal stress response to pregnancy and which are symptoms of prenatal depression that may require professional help can be difficult. Although this can be scary to think about, seeking help for your prenatal depression is not only a courageous act of self-care, but it can benefit the health of your baby. 

Here’s a look at what prenatal depression is, what can trigger it, and treatment for pregnant individuals that can put you on the path toward better mental wellbeing, sooner. 

What Is Prenatal Depression? Distinguishing Between Different Pregnancy-Related Mood Changes

Prenatal depression — also known as antenatal depression — is a clinical depressive disorder that’s characterized by persistent and abnormal feelings of sadness, loneliness, worthlessness, and loss of interest in activities during pregnancy up until childbirth. Diagnosing prenatal depression presents unique challenges as parents may feel pressure to welcome this period with joy and hope, and feelings that contradict this sentiment can bring about shame.

However, it’s fairly common to experience depression before childbirth. According to a study published by March Of Dimes, research suggests one in seven women experience depression during the prenatal period ¹. This statistic underscores the need for early intervention and mental health treatment among expecting mothers and fathers alike. 

Perinatal mood disorders: prenatal depression vs. postpartum depression

Prenatal and postpartum depression are terms that can often get confused with each other, as they are both mood disorders that surround the perinatal period. However, these conditions all encompass different time frames. 

For clarity, postpartum depression is depression that’s developed after delivery and can extend up to six weeks after, though some mental health professionals extend that time frame to up to a year. On the other hand, perinatal depression is an umbrella term that’s used to describe depression experienced in both the prenatal and postpartum periods. 

When prenatal depression develops, it’s important to seek treatment immediately to prevent it from continuing into postpartum. Prenatal depression can develop anytime during pregnancy, which is why understanding symptoms and monitoring mood fluctuations can bring clarity to a diagnosis. 

Related: What Postpartum Depression Treatment is the Safest?

Prenatal depression vs. hormonal mood swings while pregnant

Pregnant women will often experience mood swings caused by normal pregnancy-related hormonal fluctuations, which are to be expected. Additionally, physical discomfort, anticipatory anxiety, and worry about your baby’s health are all natural responses to this dramatic life transition. 

However, persistent low mood, changes in eating habits, sleep disruptions and deprivation, excessive crying, or disproportionate feelings of worthlessness, guilt, or restlessness raise concern. Furthermore, thoughts of hurting yourself or the baby require immediate professional intervention. If you are having thoughts of suicide or harming others, call the National Suicide Prevention Lifeline at 988 or the Maternal Mental Health Hotline at 1-833-943-5746 immediately.

Understanding paternal prenatal depression

During pregnancy, non-birthing parents and fathers can also struggle with a mood disorder known as paternal prenatal depression — also called sympathetic pregnancy depression or expectant father depression. Individuals might feel guilty or helpless as they watch their partner struggle with physical and mental pregnancy-induced challenges. They may feel the stress of looming caregiving and financial responsibilities, or worry about potential changes in romantic, familial, or social relationship dynamics.

Paternal prenatal depression can not only impact the father, but the pregnant individual and the health of your relationship. Symptoms of men with depression in the prenatal period include lacking energy or motivation to help, persistent negativity, concerningly low mood, and self-isolation from peers. 

Types of Prenatal Depression: Severity, Timing, and Presentation

There are several ways to categorize prenatal depression, including by severity, by trimester of onset, by how the mood disorder presents in the individual, and by specific types. Understanding the nuances of each and detecting symptoms early on can help ensure the health of you and your baby. 

By severity 

Prenatal depression exists on a spectrum, from mild to severe. Here’s what that looks like: 

• Mild prenatal depression: Symptoms impact daily life but don’t completely impair functioning.
• Moderate prenatal depression: More pronounced symptoms that significantly affect daily activities and relationships.
• Severe prenatal depression: Debilitating symptoms that substantially interfere with self-care and daily functioning.

By trimester of onset

Prenatal depression can arise at any point during pregnancy, including: 

• First trimester prenatal depression: Often coincides with physical symptoms like morning sickness and fatigue.
• Second trimester prenatal depression: May develop as the pregnancy becomes more physically evident and reality starts to set in.
• Third trimester prenatal depression: Can emerge as birth approaches, often related to anxiety surrounding labor and parenting.

By presentation and specific types

There are specific types of prenatal depression, each presenting their own concerns, including: 

• Major depression disorder (MDD): Many pregnant women deal with depression, but it becomes MDD when symptoms persist daily with no relief. This can last throughout the pregnancy and can persist even after the pregnancy has ended.
• Prenatal anxious depression: Anxiety and depression can show up as comorbid conditions during pregnancy, triggered by hormonal changes or stress from upcoming life changes. Additionally, preparing to give birth can cause a considerable amount of anxiety, which then paves the way for depression symptoms.
• Bipolar disorder: This can arise due to hormonal imbalances or pausing bipolar medications when pregnant. 

Understanding the different ways mental health professionals categorize prenatal depression can provide clarity on diagnosis and prepare you to seek help when the symptoms arise. 

Causes of Prenatal Depression

Depression is rarely caused by a single trigger. Rather, prenatal depression can typically be attributed to a culmination of risk factors, including:

• Biological factors: Hormonal fluctuations during pregnancy, genetic predispositions or a personal or family history of mood disorders, physical health complications, and changes in brain chemistry experienced during pregnancy are all common triggers for depression during the prenatal period.
• Psychological factors: Individuals with pre-existing mental health conditions tend to be at higher risk of developing prenatal depression and may struggle more due to pregnancy-related symptom exacerbation. Additionally, parental stress, anxiety, changing household dynamics, grief surrounding your previous identity, and a history of trauma or traumatic childhood experiences can make you more susceptible to developing depression.
• Social and environmental factors: If you’re lacking adequate support from your partner, having relationship difficulties, struggling with workplace depression, or experiencing stressful life events related to upcoming parenthood, you may be at a higher risk of developing depression. 

Symptoms and Signs of Prenatal Depression

Signs and symptoms of depression during the prenatal time frame that may require treatment include: 

• Feeling sad, empty, guilty, or worthless that is excessive and persistent, with an emphasis on pregnancy-related struggles.
• Loss of interest in previously enjoyed activities.
• Difficulty making decisions about pregnancy, childbirth, or post-birth plans.
• Thoughts of self-harm, harming others, or not wanting to continue the pregnancy.
• Self-isolating from your partner, friends, or family members.
• Neglecting self-care, or refusing to adhere to prenatal health protocols.
• Appetite fluctuations that differ from typical pregnancy-related appetite changes.
• Shortness of breath or racing heart followed after negative thoughts.
• Concerning sleep patterns or trouble sleeping that are out of the norm of pregnancy-related sleep pattern changes.

If you start experiencing these symptoms, it’s important to reach out to a healthcare provider right away for proper assessment assessment and to discuss treatment options that are safe during pregnancy.

Can prenatal depression harm the baby?

If left untreated, prenatal depression can impact the physical health of your baby. For example, prenatal depression can cause a preterm birth, low birth weight, or birth defects — all which may inhibit your child’s development. That’s why seeking mental health help when pregnant is critical to mitigate any potential risks. 

Related: Stress and Parenting Children with Autism

Challenges With Diagnosing Prenatal Depression

Navigating a depression diagnosis in pregnant women can be challenging due to the various physical and psychological changes experienced when carrying a baby. Sleep changes and disruptions, appetite fluctuations, and fatigue are all a normal part of pregnancy. However, these behavioral changes can be confused with those of clinical depression. It’s important to focus on emotional and cognitive symptoms — like negative thought patterns or anxious thought spirals — to really differentiate typical sadness and moodiness from a depressive disorder. 

It’s important for pregnant people to continuously assess, track, and communicate changes to mental health care professionals to receive the most accurate diagnosis. Long-term tracking and comparing can provide you with a detailed analysis of how your symptoms have changed over time. 

Many people assume pregnancy should be joyful, but for many this is not the case. Pregnancy can be the toughest life transition of someone’s life, and the shame that comes with the negative emotions of depression can prevent individuals from seeking help.

Options for Prenatal Depression Treatment

Proper treatment for prenatal mental health typically involves a comprehensive treatment approach for depression tailored to your specific needs and circumstances. Your healthcare provider will work with you to determine which treatment options are most appropriate based on your symptoms, medical history, and individual preferences.

Here are your options for prenatal depression treatment.

Psychotherapy

Psychotherapy, often called “talk therapy,” provides a safe space to address thoughts, feelings, and behaviors contributing to prenatal depression. Several evidence-based therapeutic approaches have shown effectiveness for treating depression during pregnancy, including:

• Cognitive behavioral therapy (CBT): Can help you identify and change negative thought patterns related to pregnancy, parenthood, and self-image while developing healthier coping strategies for pregnancy stressors.
• Dialectical behavior therapy (DBT): This therapeutic modality can teach emotional regulation and distress tolerance skills, which can be particularly helpful for managing intense emotions and hormonal fluctuations experienced during pregnancy.
• Interpersonal therapy (IT): Focuses on improving relationships and communication, addressing changing roles during the transition to parenthood as well as building stronger support systems.
• Group therapy: Connects you with other expecting parents experiencing similar challenges, reducing isolation and providing peer support during this unique life stage.
• Couples therapy: Can help mothers and fathers navigate the emotional and practical changes of pregnancy together, improving communication and strengthening the relationship before the baby arrives.

In addition — while not an official therapeutic modality — therapy for new parents provides a safe space to process pregnancy-related anxieties, develop coping strategies for stress and hormonal changes, and strengthen family relationships before baby arrives, significantly reducing prenatal depression symptoms.

Medication or antidepressants

For moderate or severe depression, medications for depression may be recommended after a careful risk-benefit assessment. Types of antidepressants include Selective Serotonin Reuptake Inhibitors (SSRIs) — like sertraline (Zoloft) and citalopram (Celexa) — which are often considered first-line options during pregnancy due to their established safety profiles. Antidepressant decisions are highly individualized, considering depression severity, previous treatment response, and pregnancy stage.

Are antidepressants safe for pregnant women?

Research shows many antidepressants pose minimal concerns during pregnancy, with benefits that typically outweigh risks when depression is moderate to severe. While some studies show slight increases in certain risks, these must be compared against the substantial risks of untreated depression. 

Most common side effects of antidepressants in pregnant women include a small risk of respiratory issues in newborns and potential mild withdrawal symptoms, but most babies develop normally without complications. Never stop taking prescribed antidepressants without consulting your healthcare provider, as abrupt discontinuation can cause withdrawal symptoms and depression relapse ².

Related: How To Discuss Antidepressant Sexual Side Effects With Your Psychiatrist

Mindfulness-based and complementary approaches

In addition to conventional treatments, mindfulness-based and complementary approaches can be valuable components of prenatal depression care and include: 

• Mindfulness meditation and pregnancy-specific yoga can help manage stress and promote emotional regulation by encouraging present-moment awareness and acceptance. 
• Acupuncture has shown promise in some studies for alleviating depressive symptoms during pregnancy without medication side effects. 
• Light therapy may benefit those whose depression has seasonal patterns. 
• Transcranial magnetic stimulation (TMS) therapy is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain and represents an emerging option for pregnant women with treatment-resistant depression, as it avoids medication-related concerns about fetal exposure. 

These complementary approaches often work best when integrated into a comprehensive treatment plan developed with healthcare providers who specialize in perinatal mental health. 

Related: TMS and Pregnancy

Providing Support for Prenatal Depression

Several support groups exist for those experiencing prenatal depression. Some notable options include:

• Postpartum Support International (PSI): Despite the name, they provide support for mood disorders during the prenatal as well. They offer online support groups, helplines, and can connect you with local resources.
• Maternal Mental Health NOW: Offers virtual support groups specifically for pregnant and postpartum individuals.
• The Blue Dot Project: Connects mothers with local peer support groups focused on perinatal mood disorders.
• Local chapters of organizations like the National Alliance on Mental Illness (NAMI): These groups often have specific groups for prenatal mental health.
• Hospital-based programs: Many hospitals with maternal mental health services offer support groups.

Many of these groups are led by trained facilitators or mental health professionals who specialize in perinatal mental health. They provide safe spaces to share experiences and coping strategies with others who understand what you’re going through.

How Neuro Wellness Spa Can Support and Treat Prenatal Depression

Understanding and addressing prenatal depression is vital for the well-being of both expectant parents and their developing fetus. Early recognition, practical support, and evidence-based treatment options empower individuals to navigate this challenging aspect of pregnancy. At Neuro Wellness Spa, we offer a comprehensive therapeutic approach including CBT and DBT to help manage symptoms and develop effective coping strategies during this vulnerable time.

If you or a loved one is experiencing prenatal depression, remember that effective support is available. We also provide TMS therapy, which can be particularly valuable during pregnancy. Contact us today for compassionate, personalized care from our dedicated team of specialists who understand the unique challenges of prenatal mental health. Take the first step toward a healthier pregnancy journey by reaching out to Neuro Wellness Spa — because your wellbeing matters.

References

1. Depression during pregnancy. (n.d.). March of Dimes. https://www.marchofdimes.org/find-support/topics/pregnancy/depression-during-pregnancy

2. Antidepressants: Safe during pregnancy? (n.d.). Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/antidepressants/art-20046420