Depression Types What Is Perinatal Depression? Depression During Pregnancy: Symptoms, Causes, Diagnosis, Treatment, and Coping By Sara Lindberg, M.Ed Sara Lindberg, M.Ed Sara Lindberg, M.Ed., is a freelance writer focusing on mental health, fitness, nutrition, and parenting. Learn about our editorial process Updated on February 09, 2021 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Verywell / Bailey Mariner Table of Contents View All Table of Contents What Is Perinatal Depression? Symptoms Diagnosis Causes Treatment Coping Pregnancy and the weeks immediately following birth are physically, emotionally, and mentally challenging. It’s not uncommon to experience feelings of elation and happiness one moment, only to feel sadness, fatigue, and anxiety the next. While these emotions can reflect normal mood swings during pregnancy and postpartum, there are instances when these changes in mood may be reflective of something more serious. How to Avoid Emotional Stress During Pregnancy What Is Perinatal Depression? Perinatal depression is depression experienced during or after pregnancy. The condition affects one in seven women, making it one of the most common medical complications during pregnancy and the postpartum period. There are several terms used to describe mood disorders that result in depressive feelings during pregnancy or after birth, including postpartum depression, maternal depression, prenatal depression, and postnatal depression. Depression during pregnancy typically covers the period of pregnancy through the first 12 months after delivery. What Is Antepartum Depression? Symptoms It’s natural to experience emotional ups and downs during pregnancy and the postpartum period; mild mood changes during pregnancy are common. However, if feelings of depression or anxiety during or after pregnancy persist for a few weeks or interfere with daily activities, it is time to ask for help. Symptoms of perinatal depression include: Persistent sadnessLoss of interest in activities you once enjoyedFeelings of emptinessFeelings of hopelessnessFrequent cryingReduced ability to think or concentrateTrouble sleepingFatigue or low energyIrritability Increased feelings of anxiety and worryLoss of interest in caring for self and/or childPoor bonding with babyChanges in appetite and weightThoughts of death or suicide If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911. For more mental health resources, see our National Helpline Database. Symptoms of Clinical Depression Diagnosis Diagnosing pregnancy depression follows some of the same guidelines as diagnosing other forms of depression, but your doctor will consider the peripartum onset as an important specifier, often resulting in a diagnosis of major depressive disorder (MDD) with peripartum onset. That said, there are some slight discrepancies in the time frame of perinatal depression between the DSM-5 and other organizations such as the American College of Obstetricians and Gynecologists (ACOG). The DSM-5 cites symptom onset as occurring any time during pregnancy or within four weeks of delivery, yet many professional organizations, including ACOG, acknowledge that symptoms of perinatal depression can occur up to 12 months after delivery. Getting Screened for Pregnancy Depression ACOG recommends: At least one screening for depression and anxiety symptoms during the perinatal periodA follow-up screening during the comprehensive postpartum visit ACOG and the American Academy of Pediatrics (AAP) both recommend: Screening with a validated tool such as the Edinburgh Postpartum Depression Scale (EPDS), which is a simple, 10-question screen that is completed by the motherA referral from a doctor for additional mental health services if further treatment is needed Living With Generalized Anxiety Disorder When You're Pregnant Causes The causes of perinatal depression involve a variety of medical, social, and psychiatric vulnerabilities. That said, depression in general is more common in women than men, with twice as many women being affected. The initial onset of depression symptoms often peaks during the reproductive years, which points to hormonal activity as one of the causes of pregnancy depression. Shifting hormones during pregnancy and in the postpartum period may play a role in symptoms of perinatal depression. Several risk factors exist for perinatal depression, including: Personal or family history of depressionMaternal anxietyLife stressLack of social supportUnintended pregnancySmoking Poor relationship qualityHistory of physical or sexual abusePregnancy complications Women with current depression or anxiety who become pregnant should be closely monitored during pregnancy and the postpartum period. Factors That Could Increase Your Risk of Depression Treatment Even though the daily symptoms can feel overwhelming and permanent at times, depression during and after pregnancy is treatable. Through a combination of different therapies, medications, and self-care, you can begin to feel better. Since perinatal depression is under the umbrella of depressive disorders, adhering to the proven therapeutic options for treating depression should be followed. Therapy and Counseling Psychotherapy is often the first line of defense when treating perinatal depression. During therapy, you can begin to understand your diagnosis and how it impacts your life. A therapist will also work with you to develop strategies that decrease the severity of the symptoms. There are several forms of psychotherapy, but two, in particular, have been studied in treating perinatal depression. Cognitive behavioral therapy (CBT) emphasizes the link between thoughts and feelings. Through CBT counseling sessions, you will work to identify and reframe negative thinking patterns into positive thoughts. This can help you recognize how your thinking influences your emotions. Interpersonal therapy has also been successful in treating perinatal depression. This type of therapy focuses on treating interpersonal issues that may contribute to the development of depression, with the goal of social adjustment and improving your relationships with other people. Get Treatment With the 7 Best Online Help Resources for Depression Antidepressants Your doctor may also talk to you about antidepressants, which are a group of drugs commonly prescribed for treating depression. They work by increasing levels of a group of chemicals in the brain called neurotransmitters (primarily serotonin, norepinephrine, and dopamine) which are involved in regulating mood. There are differing opinions on the use of antidepressants during pregnancy, and special consideration should also be given while breastfeeding. Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants during pregnancy and the postpartum period. Talk with your doctor about the risks associated with taking medication during pregnancy, as well as any risks associated with untreated depression. They can help you decide what’s best for you. Taking Antidepressants During Pregnancy Acupuncture Additionally, preliminary research has shown that alternative therapies like acupuncture and acupressure may be helpful interventions for managing depression symptoms during pregnancy. Understanding Acupuncture for Depression Coping Managing the symptoms of depression while pregnant and caring for a newborn can feel overwhelming at times. In addition to any treatment plan that may involve therapy or medication, there are several self-care and coping tips you can try in order to alleviate some of the symptoms of pregnancy depression. Exercise and physical activity. Staying physically active and engaging in exercises that you enjoy not only benefits your health, but it can also help alleviate some of the symptoms of depression. Try to include some form of exercise most days of the week. Talk with your doctor if you’re unsure of the safety of a particular activity. Adequate rest. Quality sleep and rest during pregnancy and the postpartum period is critical to managing the symptoms of depression and the health of your baby. Insufficient sleep can make coping with the stressors of life more challenging. While waking up during the night is common, try to get seven or more hours of sleep each night, which is the recommended amount for adults. Healthy diet and nutrition. Your body needs additional calories and nutrients when pregnant and breastfeeding. To support overall health, focus on a diet full of fresh fruit, vegetables, healthy fats, complex carbohydrates, and lean protein. What you eat can determine how you feel both physically and mentally. Support groups. One way to help ease some of the stress and feelings of loneliness is to find your community. Whether it’s friends, other women going through the same thing, family members, or a support group run by a therapist, sharing your experience with others can help you feel supported and find new ways to cope. 8 Tips for Living With Depression A Word From Verywell Pregnancy and motherhood can produce a range of feelings from sheer excitement and joyful celebration to sadness, loneliness, and emptiness. For some women, these ups and downs are temporary, but for others, these feelings persist or increase in intensity as time goes on. If you’re experiencing any symptoms of perinatal depression, the most important thing to remember is that you are not alone. There are safe and effective ways to treat and manage the symptoms of depression. That’s why it’s important to talk to your doctor right away. Asking for help is the first step in finding ways to feel better so you can begin to fully enjoy this remarkable time in your life. 16 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. The American College of Obstetricians and Gynecologists. Screening for perinatal depression. Alhusen J, Alvarez C. Perinatal depression. Nurse Pract. 2016;41(5):50–55. doi:10.1097/01.NPR.0000480589.09290.3e National Institute of Mental Health. Perinatal depression. Rollè L, Giordano M, Santoniccolo F, Trombetta T. Prenatal attachment and perinatal depression: a systematic review. Int J Environ Res Public Health. 2020;17(8). doi:10.3390/ijerph17082644 National Alliance on Mental Illness. Major depressive disorder with peripartum onset. Stuart-Parrigon K, Stuart, S. 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Sleep. 2015;38(6):843-844. doi:10.5665/sleep.4716 Additional Reading Centers for Disease Control and Prevention. How much sleep do I need? By Sara Lindberg, M.Ed Sara Lindberg, M.Ed., is a freelance writer focusing on mental health, fitness, nutrition, and parenting. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for Depression Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.