Pregnancy, motherhood, and your mood

Pregnancy can be a thrilling time. Every day brings changes. And suddenly there are many things on your to-do list: buying baby clothes, going to checkups, thinking about baby names. 

But along with all that excitement, there are a lot of unknowns. Especially if you’re pregnant for the first time, says OB-GYN Iris E. Dori, MD. Add in pregnancy hormones, and you may have big changes in your mood. 

The biggest mood changes usually happen during the first and third trimesters. You might feel happy one minute, then find yourself sad the next. Or maybe you’re short with your partner or coworker. It can feel like you’re not always in control of your own emotions. 

Here’s what can be behind those ups and downs. Plus, which symptoms are normal, and when you should reach out for extra support. 

Your body is changing — a lot 

Pregnancy hormones are a big reason your emotions will change. “Estrogen levels are going up. Your progesterone levels are going up. And any change in your hormone levels can affect your moods,” explains Dr. Dori. Estrogen and progesterone are important hormones during pregnancy. They rise to support a developing fetus. 

Your body may also feel uncomfortable. Pregnancy brings symptoms like tender breasts, nausea, backaches, and heartburn. Those symptoms are usually normal. But they may be new to you. 

Combine those symptoms with hormone shifts, and it’s no surprise that mood swings are common in pregnancy. 

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How to deal with everyday mood swings 

To tame the ups and downs, be kinder and gentler to yourself. Try to get good-quality sleep, even though it’s tough. Take naps when you can. Spend time with people you love, either on the phone or in person. And stay active. 

Sometimes that’s not enough, though. You might find yourself sad, tired, or unable to get to your tasks most of the day. Or you might not feel like doing your favorite hobbies and activities. 

When low mood or worries take over your life, you could be suffering from pregnancy depression or anxiety. 

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Depression and anxiety during pregnancy 

Prenatal depression is a mood disorder. It affects 1 in 10 pregnant women, according to the American College of Obstetricians and Gynecologists (ACOG). And it is treatable. 

Some signs of prenatal depression include: 

• Your mood is low most of the day, almost every day. 
• Your eating habits change. Maybe you don’t feel hungry. Or you eat too little or too much. 
• You’re tired all the time beyond normal pregnancy fatigue. 
• You’ve lost interest in doing things. 

Patients who have a really hard time getting out of bed or taking care of themselves or their family may have prenatal depression.  

Anxiety may be more common. Some experts think it affects 20% of pregnant women, either during pregnancy or afterward. This is more than the pre-baby jitters. Some signs include: 

• You feel worried or tense most of the time. 
• You have trouble sleeping. 
• You have chest pains. 
• Your heart beats rapidly. 
• Your stomach feels queasy. 
• You're afraid of leaving the house. Or you feel like you or your pregnancy is in danger all the time. 

Everybody is a little anxious when they’re pregnant. That’s OK. They want the best outcome. But you should not be so consumed by fear and worry that you can’t do your daily activities. 

What to do if you feel depressed or anxious 

OB-GYNs usually screen pregnant women for depression and anxiety at least once. And they screen them again after they give birth. Depression and anxiety can also develop in the days or weeks after childbirth, according to ACOG. That’s called postpartum depression. 

Call your OB-GYN right away if your behavior or moods change after a prenatal screening. And tell them if you've had thoughts of hurting yourself at any time during or after your pregnancy. Don’t wait until your next visit to bring it up. The sooner you tell your doctor what’s going on, the sooner you can get the help you need. Untreated depression can be harmful to you and your baby. 

Be sure to let your provider know if you’ve been diagnosed with depression or anxiety in the past. People who have had previous mental health issues are at a higher risk for them during pregnancy, according to the March of Dimes. A family history can also raise your risk. 

Your doctor might recommend that you take an antidepressant. These are medications that treat depression and anxiety. Taking these medications can be temporary to help you through this phase of your life. The risk of birth defects in mothers who take antidepressants is very low, according to the National Institute of Mental Health. Your doctor will talk to you about the risks and benefits, and which type may be best for you. 

And you may also speak to a mental health expert. Cognitive behavioral therapy, a type of talk therapy, can be very helpful. Support groups of other people going through similar journeys can also help. 

The bottom line: It’s important to let your OB-GYN know if you’re feeling down at any point during your pregnancy. They can either reassure you that your thoughts and feelings are normal, or they can help you get the support you need. 

Article sources: 
Prenatal depression statistic: The American College of Obstetricians and Gynecologists 
Anxiety statistic: The American College of Obstetricians and Gynecologists 
Mental health history: March of Dimes 
Screening: The American College of Obsetricians and Gynecologists 
Antidepressants: National Institute of Mental Health