Antenatal depression is depression a person may experience during pregnancy. It may be due to hormonal changes, genetics, and environmental factors. Treatment may help reduce symptoms and prevent pregnancy complications.

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It is normal to experience a wide range of emotions during pregnancy, but if a person is feeling consistently low during pregnancy, they may have antenatal depression. This condition may occur at any point in a pregnancy.

The authors of a 2020 review note that the condition is reasonably common and may occur in 7–20% of cases in each trimester of pregnancy. The authors found that antenatal depression may affect 15–65% of people around the world.

Getting treatment as soon as possible is important to help a person feel better and maintain a healthy pregnancy.

This article looks at signs and symptoms of antenatal depression, how to get help, and treatment options.

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According to Tommy’s, a pregnancy charity based in the United Kingdom, symptoms of antenatal depression may come on slowly over time or occur suddenly.

A person may have antenatal depression if they are feeling consistently low or sad for weeks or months at a time during their pregnancy.

Symptoms of antenatal depression can range from mild to severe and affect people in different ways.

Signs and symptoms of antenatal depression may include:

  • lack of energy
  • disturbed sleep
  • loss of interest in self, pregnancy, or activities that are usually enjoyable
  • excessive worry about childbirth and parenthood
  • consistent tearfulness or feelings of anger, irritability, or emotional detachment
  • a desire to isolate from other people
  • chronic anxiety
  • loss of interest in sex
  • poor concentration and difficulty making decisions
  • hopelessness about the future
  • lack of enjoyment in life
  • restlessness and agitation
  • lack of self-confidence
  • feelings of worthlessness or guilt
  • thoughts of self-harm or suicide

People may not experience all of these symptoms.

It is also important to note that some symptoms, such as reduced sex drive and feeling more emotional than usual, can be normal parts of pregnancy.

If a person feels that they may have antenatal depression, it is important that they speak with a healthcare professional as soon as possible. Prompt treatment may help a person recover and prevent potential health complications for both the pregnant person and their baby.

A healthcare professional can provide support and discuss the best treatment options. A doctor or midwife may refer someone to a mental health professional who specializes in antenatal depression and can monitor them throughout their pregnancy.

Treatment for antenatal depression may depend on:

  • the severity of symptoms
  • a person’s personal choice
  • the stage of pregnancy
  • any risks that may come from either taking medication or not taking it
  • whether people have had depression previously and whether previous treatments have been effective

Treatments may include:

  • counseling and talking therapies
  • cognitive behavioral therapy, in which people learn more helpful methods of thinking and responding to situations in order to relieve depression and anxiety
  • interpersonal therapy, which helps people improve communication skills in relationships, develop social support networks, and manage expectations in order to deal with issues that may be a factor in their depression
  • antidepressants such as selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, or tricyclic anti-depressants, all of which affect how the brain uses chemicals to regulate mood and are low risk to use during pregnancy

Some people may find that a combination of therapy and medications works well for them.

According to the National Institute of Mental Health, the risk of harm to a fetus, including fetal development irregularities, if a person takes antidepressants in pregnancy is very low.

Antidepressants can take 6–8 weeks to have an effect, so it is important that a person continue taking them as their doctor prescribes. Symptoms related to concentration, appetite, and sleep may improve before mood-related symptoms.

It is important to speak with a doctor before taking any medications to treat depression, including herbal remedies such as St John’s wort, as these may not be safe to take during pregnancy.

They can also be dangerous if a person combines them with prescription medications.

If a person have a partner with antenatal depression, ways to support them include:

  • asking them how to best help and support them
  • attending antenatal classes and appointments with them
  • suggesting activities to do together, similar to those they did before becoming pregnant
  • remaining patient and giving them any space they need
  • learning about antenatal mental health
  • listening to them about how they feel without judgment and recognizing that it may be hard for them to talk about
  • offering practical support, such as taking care of daily household tasks or arranging medical appointments
  • helping them research support options, such as finding a support group

Antenatal depression may result from a combination of genetic and environmental factors, including:

  • hormonal changes that occur during pregnancy
  • life stressors such as work, relationships, and previous trauma
  • the physical and emotional demands of pregnancy

According to a 2020 review, fluctuations of peptide and steroid hormones during pregnancy may contribute to antenatal depression. The research also suggests that antenatal depression may reoccur in repeat pregnancies.

Risk factors for depression during pregnancy include:

  • personal or family history of depression, anxiety, or bipolar disorder
  • a history of depression in pregnancy
  • unplanned pregnancy
  • financial or relationship problems
  • lack of social support during pregnancy

Antenatal depression is a medical condition and is not the result of anything a person does or does not do during pregnancy.

Doctors diagnose antenatal depression by asking people what symptoms they have been experiencing and for how long. They may also take a medical history to check for any personal or family history of mental health conditions.

Doctors may use certain criteria and questionnaires to assess symptoms and diagnose antenatal depression.

Without treatment, antenatal depression may contribute to a higher risk of:

  • low birth weight
  • intrauterine growth restriction, in which a fetus does not grow to the expected size during pregnancy
  • preterm birth
  • pregnancy complications
  • developmental, emotional, and attachment concerns in infants
  • potentially harmful behaviors during pregnancy, such as misusing substances or not following health or medical care guidelines

In most cases, proper treatment can help reduce depression symptoms and help people feel better.

Treating antenatal depression as soon as possible is important to help prevent any health complications for the pregnant person or the fetus.

Experts are not sure how to prevent antenatal depression, but being aware of the symptoms may help people seek help quickly and get prompt treatment.

People who are pregnant or plan to become pregnant may find the following strategies helpful:

  • being aware of any risk factors that may increase the likelihood of developing antenatal depression
  • speaking with a healthcare professional about symptoms to look out for and possible treatment options
  • learning about pregnancy and what to expect and speaking with a healthcare professional about any worries or concerns
  • setting realistic expectations for themselves and their family
  • planning ahead and seeking social support from family, friends, antenatal classes, or a support group
  • planning ways to help themselves feel better, such as making time for themselves, doing activities they enjoy, and taking time to relax

Antenatal depression is depression that occurs during pregnancy. It is important to seek treatment for antenatal depression as soon as possible. People will need to seek help right away if they have any thoughts of self-harm or suicide.

Treatment can help people feel better and reduce depression symptoms. Treatment may involve therapy, antidepressant medications, or a combination of the two.