Depression in pregnancy

It’s normal to feel sometimes up and sometimes down when you’re pregnant but if you're feeling low more than you're feeling happy you need to talk to someone.

"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."Abby, mum of one. Read more...

Depression is when you have those feelings of being unhappy and they don’t go away after a few days but last for weeks or months. Antenatal/prenatal depression can vary from mild to severe and can affect women in different ways.

Typical signs of depression include:

  • you feel generally down most of the time
  • you can’t be bothered with things
  • you can’t concentrate or make decisions
  • you don’t enjoy life
  • you’re tired and don’t have any energy
  • you can’t get to sleep and then you wake up early
  • you feel tearful
  • you feel irritable and don’t want to be with other people
  • you feel restless and agitated
  • you lose your self-confidence
  • you feel worthless
  • you feel guilty
  • you lose your appetite or have a much bigger appetite
  • you lose interest in sex
  • you think about suicide.

If you have depression you won’t necessarily experience all of these symptoms. Remember that some of these things can also be a normal part of pregnancy, such as feeling very tired or tearful or going off sex. If your feelings started gradually you may find it hard to tell where the line is between ‘normal’ difficult feelings and being depressed. Or it may be obvious because you suddenly start to feel very low.

Trust yourself – you are the best judge of whether your feelings are normal for you. If you don’t feel right, or if you have some of the signs of depression and they last for more than two weeks, talk to your midwife or GP.

"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." Stephanie, mum of two. Read more...

How common is it?

Depression in pregnancy and afterwards is common. Around one in every ten pregnant women experiences pregnancy depression (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 should I do?

Tell your midwife or doctor how you feel.  You may feel very distressed or guilty at feeling low at a time when everyone expects you to be happy, but pregnancy depression is not your fault. The midwife or doctor won’t criticise you or judge you for having these feelings – they know this happens to many pregnant women, and they will discuss and organise treatments so you can get better.

It can be difficult to talk about your thoughts and feelings.  You may want to 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. 

If you have had depression in the past, it’s important to tell the midwife or doctor, because you may be more likely to get depression in this pregnancy or after birth. If they know what you have experienced previously, they can give you the best support and help you to minimise any relapse.  

"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. Read more...

What makes depression more likely ?

  • An upsetting event (such as a bereavement or divorce)
  • You’ve had depression before
  • Not having friends or family around
  • Life events such as domestic abuse, money worries or unplanned pregnancy
  • Having a long-standing or life-threatening illness
  • Family history of depression
  • Personality traits, such as low self-esteem or being overly self-critical

But you can get pregnancy depression ‘out of the blue’, even if none of the items in the list above sound familiar to you. It affects women from all walks of life, at different ages and stages of their pregnancy. You are not alone.

What is the treatment for depression ?

It depends on how severe your depression is and what services are local to you. The doctor may recommend:

  • talking treatments, such as guided self-help or psychological therapy, such as cognitive behavioural therapy (CBT)
  • medication, such as antidepressants, especially if you have had depression before.

If you are offered medication, your healthcare team should take into account the stage of your pregnancy. You should be offered the type with the least risk for you and your baby, at the lowest amount that will still work.

If you are already on medication the advice will depend on how severe your condition is.

  • If you have mild to moderate depression your doctor should talk to you about stopping the medication gradually and starting a programme of self-help.
  • If you have moderate depression your doctor should discuss changing to CBT and stopping medication or changing to a medication that has a lower risk for your baby.
  • If you have severe depression, your doctor should consider how well medication has worked for you in the past and whether you might have a relapse (become unwell again) without it. They will discuss the risks to your baby against the risks of stopping the medication or changing to a new lower-risk type and having CBT as well.

If you understand the risks to you and your baby and still decide you would like to stop medication, your doctor should talk to you about changing to psychological therapy (CBT).

How can I help myself?

  • Talk to your partner, family or a friend about how you are feeling.
  • Try not to feel guilty or embarrassed. These feelings are not your fault.
  • Look after yourself. It’s hard to do anything for yourself when you’re depressed, but   if you can, try some of our top tips for looking after your emotional wellbeing.
  • Get some exercise every day – keeping active will release some feel-good endorphins.
  • Eat well even if you don’t have much appetite.
  • Avoid alcohol and smoking – they 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, it’s not safe for pregnancy).
  • Read about planning ahead for emotional wellbeing after birth
  • Use the Tommy's Wellbeing Plan to think about how much support you will have.

More information and support

PANDAS: Helpline 0843 2898401. Provides telephone support, online information and local support groups for pregnancy depression and postnatal depression.

MIND: Helpline 0300 123 3393. Mental health charity providing information, support, local groups and an online chatroom

Local support groups may also be available.  Check out what’s on offer at Netmums or ask your GP.

Find out more about treatments

Other resources

Read more

Sources

  1. NICE (2014) Antenatal and postnatal mental health: clinical and service management guidance, clinical guideline 192, National Institute for Health and Care Excellence.  London, P 4: Available at: http://www.nice.org.uk/guidance/cg192
  2. National Institute for Health and Care Excellence. Antenatal and postnatal mental health: clinical and service management guidance, clinical guideline 192. London: NICE, 2014. Available at: http://www.nice.org.uk/guidance/cg192
  3. NHS Choices [accessed 6/5/2015] Clinical depression – symptoms,http://www.nhs.uk/Conditions/Depression/Pages/Symptoms.aspx
  4. Dennis CL, Allen K (2013) Interventions (other than pharmacological, psychosocial or psychological) for treating antenatal depression, Cochrane Database Syst Rev 2013: 7: CD006795
  5. NHS Choices [accessed 6/5/2015] Clinical depression – symptoms,http://www.nhs.uk/Conditions/Depression/Pages/Causes.aspx
  6. Mercier R, Garrett J, Thorp J, Siega-Riz A. Pregnancy intention and postpartum depression: secondary data analysis from a prospective cohort. BJOG 2013;120:1116–1122.
  7. NICE (2014) Information for the public: Mental health in pregnancy and the year after giving birth.http://www.nice.org.uk/guidance/cg192/resources/information-for-the-public-mental-health-in-pregnancy-and-the-year-after-giving-birth-pdf
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Last reviewed on February 1st, 2015. Next review date February 1st, 2018.

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Comments

  • By Anonymous (not verified) on 18 Apr 2017 - 20:45

    I gave up work after being bullied out of my job for being pregnant  (it was verbal so I can't prove anything and it was an independent business so no HR) and then I took over as the main carer for my partners mum (she's an alcoholic and had several falls resulting in 8 months of last year in hospital and surgery and is still in denial and anorexic to boot and now has epilepsy) I find it really hard because she either is chatty and happy and raring to go OR won't get out of bed or talk to anyone. She doesn't empty her dishwasher or clean up her dogs poo from the hallway or clean her bedding or take her medication. She says she doesnt need carers! But today was the last straw for me. I fell while walking the dog (Im monitoring movements and in a bit of discomfort) and then had to bathe her dog because it rolled in fox muck (its a terrier dog) and she just watched and didn't offer to help. I left the dogs collar off while she dried. Partner went over there to put the collar back on but it had a bit of muck on it and her reaction was to demand to know why I didn't do a thorough job and wash the collar! Apparently my partner told her off and said she had to use her initiative and do some things for herself which made her cry and say that she knows we wished her dead! My partner said he was so worried she was going to work herself up in having a seizure he had to appologise and calm her down! I said I'm finding it too hard to care for her anymore and I am so worried about what will happen when the baby comes. I can't rely on her for support and my own mother is distant (and a heavy smoker) with a new husband whose controlling and doesn't like me and my partner very much. I feel really alone and like I'm struggling. My other half tells me Im doing a great job but my friend is so supportive and thinks I should have more help. I don't know if I should say anything to my midwife (I have had so much trouble with my local service losing me in the system and forgetting about me) and I don't know what help my GP will be. I wasn't even sure if i could have this baby and loom after his mum but he convinced me otherwise and I feel like I'm loosing my mind! I do sleep but I always feel so tired! I do take time out for myself (spinning and walking) but I feel like a slave and relied on too much.
    Is it just me over reacting and needing to pull myself together?

  • By Midwife @Tommys on 19 Apr 2017 - 09:53

    Hi Abby. I am ever so sorry to hear how much you have going on in your life at the moment. It really does sound very tough and not at all like you are over-reacting. You most certainly do not need to just "get on with it" or "pull yourself together"!
    I sense that a one- to -one phone call would be the best option for you than a long worded, public message on this page here. Please would you call us on 0800 0147800 for a chat!!!
    We can go through each of your worries step by step then!
    I really look forward to hearing from you! Please take care of yourself!

  • By Anonymous (not verified) on 12 Dec 2016 - 09:06

    I dont know who to turn to im currently 16 weeks pregnant with a man ive adored since i met him five years ago . We were on off for a couple of years then two years ago we decided to make a go off things . Im 33 with three older children from previous relationship .. but my love off my life has been choosing coke binges all weekend which causes me untold amount off distress .. i have packed his stuff up lots since ive been pregnant but always get the same dribble i love u in sorry ive messed up wont do it again .. we had a chat when i found out i was pregnant if he wanted it he was over the moon and said he couldnt wait .. im confused upset and angry he is doing this to me after ive told him i cant do this on my own with three other children and a full time job the stress is unbearable ..i find my self goggling suicide or abortion .. ive lost everyone i cared about as ive cut myself off i just go to work come home sort the kids out and cry im exhausted ...and feel i cant do it anymore i dont know who to turn to

  • By Midwife @Tommys on 12 Dec 2016 - 12:22

    Hi Lisa
    I am so sorry to hear what a difficult time you are going through. I am unsure how best to help you via webpage message! It would probably be best for you to call and speak to one of us on 0800 0147800. There is a team of midwives here and we run the service Mon to Fir 9am to 5pm and we would be more than happy to talk to you about the problems you are having. We aren't trained counselors, but we are happy to have a friendly chat with you and try to suggest some ways that you could seek more help. I really feel for you and it really does sound like you need a friendly ear. So please call us (or Samaritans) for a chat!

    Here is some accurate information on Abortion for you to read too, to ensure that you are reading accurate information.http://www.nhs.uk/conditions/Abortion/Pages/Introduction.aspx
    Samaritans can easily be contacted, to help you with your suicidal thoughts specifically- by phone or email - 116 123/jo@samaritans.org

  • By Midwife @Tommys on 16 Nov 2016 - 12:07

    Hello thank you for posting. I am so sorry that you are feeling so lonely and suicidal as you wait for the arrival of your second baby. It is so hard when a relationship breaks down and for you to experience this in pregnancy makes everything so much worse. I am really concerned that you feel all alone and have no one to support you. Please call the Samaritans today on 116 123 (free from UK) there is always someone there to speak to, to listen and to help 24 hours a day.
    I would also urge you to contact your GP today and confide in your midwife at your next antenatal appointment so that you can move forward from this lowest point. There is help and support out there for you and your family.
    Please know that as midwives we are also available to talk to 9-5 weekdays on 0800 0147 800.
    You are important and there is hope so please make the first call to the Samaritans now.
    Tommy's Midwives

  • By Midwife @Tommys on 15 Nov 2016 - 16:25

    This is the time you need support more than ever! Does your Community Midwife or GP know how you are feeling? You are not on your own & your midwife could be an excellent support at this time. If you are feeling suicidal, you should talk to someone today at PANDAS on 0843 2898401 or the Samaritans on 08457909090 (24 hours). If you feel you would rather talk to one of the Midwives here at Tommy's, there is a Midwife here every weekday from 9am till 5pm on 0800 0147 800. If the medication and Counselling did not work there are other treatments available so -please contact your GP for help too

  • By Anonymous (not verified) on 15 Nov 2016 - 14:41

    I been depressed since I was a teenager after problems at home then when I left school I met someone and we moved to quick moving in with each other and having a baby which I didn't want we had alot of problems after that and after 3 years trying we split then I met someone else and again rushed everything and git pregnant and again he's left me and I feel I'm at my lowest point I hav less than 3 weeks till I have the baby I have no partner no supportive friends and no support from family i took medication which hasn't worked I done counciling which isn't helping and now all I can think of is gettin this baby out and suicide I lost the will to do anythin not eating always cryin don't go out snapping at everyone I lost interest in life I'm not my usual self so everyone has noticed I don't laugh much or smile like I used to take everythin to offense just don't enjoy anything... I don't no what else to do I just want my bf back settle down and be a family but he's gave up and I'm all alone what can I do

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