What Is Prenatal Depression?

What Is Prenatal Depression?

Prenatal depression is depression that occurs during pregnancy. Like postpartum depression, which occurs after childbirth, prenatal depression can range in severity. If untreated, it can negatively harm the pregnant person and baby.

It's helpful to note that the terms prenatal, perinatal, and peripartum are often confused; but all of them refer to a specific time period between pregnancy and up to one year after birth. Depression that occurs around this time may be called different things depending on the time of onset.

Pregnancy can be physically, emotionally, and mentally draining. You are likely to feel a wide range of symptoms, including hormonal shifts, physical ailments, and sleep disruptions, which can directly affect mental health.

Symptoms of Prenatal Depression

Pregnancy can be an exceptionally difficult time. The body is changing, hormones are up and down, sleep is disrupted, and life’s demands often lead to anxiety, stress, and exhaustion, but these symptoms should not be persistent and ongoing. If your symptoms occur on a regular basis, let your doctor know.

Common symptoms of prenatal depression include:

• Feelings of guilt, hopelessness, or worthlessness
• Irritability
• Persistent sadness, anxiousness, or feelings of emptiness 
• Restlessness or trouble sitting still
• Fatigue or severe decrease in energy
• Aches, pains, headaches, cramps
• Loss of interest or pleasure in hobbies and activities 
• Difficulty sleeping 
• Thoughts of death or suicide

Some of these symptoms are naturally experienced during pregnancy, such as difficulty sleeping or irritability, which can make prenatal depression hard to recognize and diagnose. If the symptoms are severe or ongoing and last longer than 10 days, then you should notify your healthcare provider right away.

Causes of Prenatal Depression

Prenatal depression can occur in any pregnant person, regardless of their age, race, socioeconomic status, culture, or education.

Some risk factors for prenatal depression include:

• A personal history of anxiety, depression, or bipolar disorder
• A family history of perinatal disorders or mental illness 
• An unwanted or teenage pregnancy
• A high-risk pregnancy 
• Low socioeconomic status and lack of support
• A diagnosis of a substance use disorder 
• A history of physical or sexual abuse

If you are at high risk of developing prenatal depression, Dr. Basch recommends starting therapy while trying to conceive or early in your pregnancy to maintain your mental health throughout the perinatal period. This can help prevent prenatal depression in some pregnant people. 

Studies have shown that counseling interventions during pregnancy and the postpartum period are associated with a 39% decrease in the likelihood of perinatal depression in women who were at risk for depression, but did not yet develop it.

Diagnosis of Prenatal Depression

It may be diagnosed through different screening measures, including the Edinburgh Postnatal Depression Scale and the Structured Clinical Interview for DSM-5 (SCID-5). It can also be diagnosed through the expert evaluation of a mental health clinician. 

The DSM classifies prenatal depression as major depressive disorder (MDD) and then specifies if the depression is in the peripartum period or not.

So some people may receive a diagnosis of major depressive disorder with "peripartum onset." Based on their symptoms, others may be diagnosed with an adjustment disorder with depressive symptoms.

In some cases, a person might receive a diagnosis of adjustment disorder with anxiety. Many women with prenatal depression also experience symptoms of anxiety. In fact, one study found that nearly two-thirds of women with peripartum depression also had an anxiety disorder.

If you’re experiencing symptoms or if you notice a partner experiencing symptoms, notify your doctor right away. Once you have a diagnosis, you can work with your doctor and a mental health professional to determine the best possible treatment plan.

Prenatal Depression Treatment

Failure to treat prenatal depression can cause serious consequences, including a higher incidence of preterm delivery, preeclampsia (a complication of pregnancy that involves high blood pressure), low birth weight, behavior disturbances, maternal self-harm, or suicidal ideation.

If prenatal depression goes untreated, it can cause serious harm to both mothers and babies. In the postpartum period, suicidal ideation and suicide deaths are a leading cause of maternal mortality.

Treatments will depend on the severity of your depression but may include psychotherapy, such as interpersonal therapy and cognitive-based therapy, and/or antidepressant medications. 

If you’re considering taking an antidepressant, consult with your doctor to discuss the risks. While antidepressants are often deemed safe for pregnancy, you’ll want to make sure you assess potential adverse effects.

When treating prenatal depression, integrated care models are often the most effective, as they involve a combination of psychotherapy and other modalities. Both individual and group therapy sessions, for example, can benefit those who are expecting and need one-on-one attention and social support. Treatment can also be accompanied by exercise, bright light therapy, yoga, and other alternative treatments.

Coping With Prenatal Depression

If you’re experiencing prenatal depression, know you’re not alone, it’s not your fault, and there is support available. While pregnancy will naturally impact your mental health, it should not result in depression. If it does, know that it’s treatable. 

Even if you have a treatment plan in place, you should consider implementing daily coping strategies, which may help improve your mood and maintain your overall mental health. 

According to Dr. Basch, here’s what you can do:

• Engage in your social support network. If you don’t have one or if you’d like to widen it, join pregnancy support groups.
• Regulate your sleep habits as best as you can. It's important to make sure that you're getting as much quality sleep as possible. If you can rely on a friend, partner, or family member to help take on some chores or run a few errands, this may help you get some more resting time in.
• Find ways to lower your stress levels and mood. This could include meditation or trying pregnancy-safe exercises.
• Reach out to a professional. Find a doctor or midwife who is knowledgeable in mental health conditions and can support you throughout your pregnancy journey. 

A Word From Verywell

If you’re missing prenatal visits, uninterested in visiting with family or friends, or turning to unhealthy behaviors to cope with feelings of anxiety or depression, then it’s important to seek care. If your depression goes untreated it can develop into postpartum depression or another more serious perinatal mental health disorder. 

Pregnancy is often boasted as a beautiful experience, but it’s not always that way. It’s completely normal to experience mental health changes throughout the pregnancy, but in order to keep you and the baby healthy, you want to focus on maintaining your mental health and treating any mental health conditions that arise.