Depression During Pregnancy: Symptoms and Treatment

When it comes to depression and pregnancy, there’s a silent stigma still lurking in the shadows.

Being pregnant is often raised to an almost-holy status. After all, you’re bringing new life into the world. You’re told you just have this glow about you. People--sometimes even total strangers--congratulate you, ask you when you’re due, or even ask to rub your belly. They’re happy for you. But what happens when you don’t feel the same way?

Whether you’ve been pregnant before or not, chances are you’ve still heard of the term postpartum depression. However, there's another kind of depression that's just as insidious, but hardly as well known. Antepartum depression occurs during pregnancy--as opposed to postpartum depression, which women experience after birth. A Northwestern Medicine study claims antepartum depression is even more dangerous because it often goes unnoticed and can last much longer than postpartum depression1.

​In fact, according to the American College of Obstetricians and Gynecologists, 14%-23% of pregnant women experience depression during pregnancy2. However, due to a lack of education about this mood disorder, women often don’t even know to seek treatment.

And it’s easy to understand why: with pregnancy comes the silent stigma that pregnant women should always be happy.

Combine this unrealistic expectation with insufficient screening for antepartum depression, and women who experience symptoms of depression during pregnancy may also feel shame, guilt, or embarrassment in trying to talk about their feelings. If you’ve ever felt this way, the good news is that you’re not alone. Depression during pregnancy is more common than you think and there is no shame in talking about it.

What are the symptoms of antepartum depression?

Between the emotional and hormonal changes (as well as other symptoms that occur during pregnancy), diagnosing antepartum depression can be hard to separate from what some may label as the usual stress and symptoms expectant mothers can experience.

However, consistent feelings of anxiety and depression are clear differentiators, signaling that something more is going on. What matters most is how long the feelings last. Symptoms that continue with little respite for two weeks or more indicate true depression during pregnancy.

Symptoms of antepartum depression lasting two weeks or more include:

Constant, overarching feelings of sadness. Mood swings are to be expected when you factor in the huge hormonal changes happening--especially during the first trimester. But if you’re noticing long-lasting feelings of deep sadness that you can’t seem to shake that are interfering with your daily life (changes in eating, sleeping, and/or personal grooming habits), then it’s time to talk to someone.

Increased anxiety. What’s not to be anxious about when you’re pregnant, right? The difference is when the anxiety starts feeling invasive and even debilitating. There are distinct physical symptoms that accompany extreme anxiety such as trembling, sweating, increased heart rate, shortness of breath, and even chest pain.

Feelings of hopelessness. Pregnancy is often described as an exciting time to look forward and envision what the future will look like with your child, but what if you’re feeling hopeless, aimless, and overwhelmed instead?

If you’re feeling as though the challenges in your life are insurmountable and that the future is bleak, know that others have felt what you do and that there’s help and support for you.

Loss of interest in things you used to enjoy. Have you stopped doing things you used to enjoy? Do you find yourself withdrawing from friends and family? If you’re finding it more difficult to feel driven or motivated to do things, and if activities you used to enjoy now seem pointless, you could be experiencing one of the symptoms of depression.

Trouble concentrating. “Pregnancy Brain” is definitely a thing, but if you’re finding it increasingly difficult to focus or concentrate and are even experiencing memory loss, then those are signs that something more is going on.

Depression can decrease the speed in which you process information, so even though it can be tempting to write it off as just being forgetful, having consistent trouble concentrating can be a red flag.

Feelings of worthlessness. Pregnancy is hard, and between the physical, emotional, and hormonal changes happening, it’s not surprising that many women may feel insecure or not up to the task at times. However, instead of still feeling an overall sense of purpose, many women may feel worthless, unneeded, or invisible, and those feelings may become pervasive.

Low energy levels. Low energy levels can be mistaken for the extreme fatigue often felt during pregnancy. You may feel drained and like you’re losing motivation for daily tasks such as self-care. Low energy by itself may not feel concerning, but when accompanied by other depression symptoms or noticeable changes in eating, sleeping, or self-care habits, it’s time to take a better look.

Thoughts of suicide or self-harm. Whether you are experiencing thoughts of suicide or self-harm alone or in addition to other antepartum depression symptoms, this symptom is one of the clearest indicators that it’s time to talk to someone.

If you’re feeling like you might hurt yourself or your baby, please know that you’re not alone. Depression during pregnancy can increase in intensity the longer it goes undiagnosed, possibly resulting in suicidal ideation or turning into postpartum depression once the baby is born.

How else can antepartum depression affect a pregnancy?

Depression during pregnancy can cause health risks to both you and your baby. Gone untreated, antepartum depression can put pregnant women at greater risk for both a low-birthweight baby as well as premature birth3. Several other risk factors include:

  • Suicide
  • Low APGAR score (newborn health rating)
  • Respiratory distress in newborns
  • Postpartum depression
  • Pregnancy termination
  • Preeclampsia
  • Difficulty attaching to the baby

What are the treatments?

Timing is essential to diagnosing antepartum depression; the longer it goes unchecked, the greater the impact it can have on your pregnancy. Successful treatment options of antepartum depression include:

  • Counseling
  • Cognitive behavioral therapy
  • Interpersonal psychotherapy
  • Support groups
  • Medications

If you realize you're experiencing antepartum depression, it's time to talk with your doctor. Many women have found success in support groups and interpersonal psychotherapy. Some, in fact, started taking antidepressants and engaged in CBT, which coaches people with depression to catch and change negative thinking patterns and behaviors.

Of course, you should always check with your doctor before taking new medication. And if medications aren't for you, there are other treatment options. Many women report that having an emotional support counselor is highly effective in treating their pregnancy depression. The truth is that you know your mind and body better than anyone else.

Trust your instincts and go with what feels right. You’re not alone in how you feel and there is treatment and support, as well as countless other women who can relate to your experience.