Depression in pregnancy
What is antenatal depression?
Antenatal depression is when you feel sad all the time for weeks or months during your pregnancy. The condition can vary from mild to severe and can affect women in different ways.
Some women have depression after having a baby. This is called postnatal depression.
Pregnancy can be a very emotional experience and it can sometimes be difficult to know whether your feelings are manageable or a sign of something more serious. Pregnancy hormones can affect your emotions, you may also have difficulty sleeping and you may be feeling sick. This can all make you feel low.
Trust yourself. You are the best judge of whether your feelings are normal for you. Talk to your midwife or GP if you think you have any symptoms of depression and they last for more than two weeks.
Depression is a mental health condition and not a sign of weakness, something that will go away on its own or that you should just ‘snap out of. Depression can be treated with the right care and support.
What are the symptoms of antenatal depression?
"Pregnancy is meant to be such a happy time but because we don’t talk about mental health in pregnancy women don’t know that it can be a very different story."
Typical signs of depression include if you:
- feel generally down most of the time
- can’t be bothered with things
- can’t concentrate or make decisions
- don’t enjoy life
- feel tearful
- feel irritable and don’t want to be with other people
- feel restless and agitated
- lose your self-confidence
- feel worthless
- feel guilty
- think about harming yourself or suicide.
You may not have all these symptoms and they may come on gradually or you may suddenly start to feel very low.
If you feel like you want to harm yourself or feel like you want to die, it’s important to tell someone. This could be a family member, friend, your GP or midwife. Help is available now if you need it. You can call the Samaritans on 116 123.
"I wasn’t sleeping well and I’d wake up with that horrible feeling of doom starting every day. I’d cry at the drop of a hat about things that wouldn’t normally make me cry."
How common is it?
Depression in pregnancy is very common. Around one in every ten pregnant women has antenatal depression.
“I just started feeling snappy, not my usual self at all – I shrugged it off at first and thought it was just my hormones playing up. However, it started to get worse. I knew I really wanted the baby, but I didn’t feel like I wanted it."
Clare, mum of one
What causes depression?
You may be more likely to get antenatal depression if you:
- have had depression before
- have anxiety
- are going through a very difficult life event, such as a bereavement or divorce
- don’t have support from family or friends
- are having an unplanned pregnancy
- have experienced domestic abuse or violence.
But anyone can get depression in pregnancy, even if they have no experience of anything in this list. It can happen out of the blue and affects women from all walks of life. You are not alone.
What should I do?
Tell your midwife or doctor how you feel. Some women feel very distressed or guilty at feeling low at a time when everyone expects them to be happy. Remember that healthcare professionals won’t judge you. They understand that depression is a mental health condition. It is not your fault, or something that you just need to ‘get over’ or move on from. They will focus on helping you find the right treatment and support so you can take care of yourself and your baby.
If you find it difficult to talk about your thoughts and feelings, you could write down what you want to say first, or you may want to have someone with you. The important thing is to let someone know so that you can get the right help as soon as possible.
It’s important to tell the midwife or doctor if you have had depression in the past because you may be more likely to get depression in this pregnancy or after you give birth. They can then give you the best support to reduce the chances of you getting depression again.
"I felt very tired, every time I sat down I’d just doze off to sleep. I never seemed to feel that glowing period that everybody talks about."
Emily, mum of three.
What is the treatment for depression?
Treatment for depression usually involves a combination of self-help, talking therapies (such as counselling or cognitive behavioural therapy and medicines.
Everyone is different, so treatments that may work for some people may not work for others. Your doctor will help you decide what’s best for you. You will probably also be referred to a perinatal mental health specialist and will be monitored more closely during and after your pregnancy.
The treatment you have will be your decision. Your healthcare professional can help you by talking to you about what you’d like to do and explaining the risks and benefits of all options.
They will also talk to you about:
- what’s best for your stage of pregnancy
- any risks medication may pose to your baby
- the risk that you might become unwell again without medication
- how bad your symptoms are
- whether you have had the condition before
- how well the medication has worked for you so far, if you are already taking it.
If the recommended treatment is antidepressants, your doctor will discuss the risks of the treatment to your baby, including:
- what is known about their safety during pregnancy
- whether the baby may have some mild symptoms when born and whether breastfeeding may reduce the possibility of these occurring.
If you would like to stop medication when you are pregnant, but medication is the best treatment for your depression, your doctor should talk to you about your reasons for wanting to stop medication and about the risks, if any, to you and your baby.
If you understand the risks to you and your baby and still decide to stop medication, your doctor should talk to you about other ways to manage your symptoms. For example, they may suggest talking therapies.
How can I help myself?
Depression can make you want to hide away from the world and you may feel like you don’t want to do anything. But it is important to make sure you take care of yourself. Start with little activities, take things at your own pace and most importantly, ask for help if you need it. Here are a few ideas for what you can do.
- Talk to someone you trust about your feelings, such as your partner, family or a friend.
- Try not to feel guilty, ashamed or embarrassed. These feelings are not your fault.
- Try some of our top tips for looking after your emotional wellbeing.
- Exercise as much as you can. Keeping active will release some feel-good endorphins.
- Eat well even if you don’t have much appetite.
- Avoid alcohol and smoking. This can harm your baby and make you feel worse.
- Don’t take St John’s Wort (although it can help with depression when you aren’t pregnant, we do not know if it is safe for pregnancy).
- Read about planning for emotional changes after birth.
Clinical Knowledge Summaries (2015) Depression antenatal and postnatal https://cks.nice.org.uk/depression-antenatal-and-postnatal#!topicsummary
NHS Choices Clinical Depression https://www.nhs.uk/conditions/clinical-depression/treatment/ (Page last reviewed: 05/10/2016. Next review due: 05/10/2019)
This content is currently being reviewed by our team. Updated information will be coming soon.