"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.
Some mums expect, or perhaps feel pressured, to feel excited and happy throughout their pregnancy. But unfortunately this isn't always the case.
We all dream of floating serenely through pregnancy, channelling a sense of calm for the growing baby inside us. But, often, the reality is somewhat different. Try our practical tips to help you relax in pregnancy.
Stress in pregnancy is not unusual. Here are some ideas for how you can relax and look after your emotional wellbeing when you’re pregnant.
If you need help and support with your emotional health, there are a number of different options.
Pregnancy and having a baby can be an exciting and demanding time for women. If you have an existing or past mental health condition it brings extra challenges and you are at higher risk of relapse during this time than at others.
Myths and facts about mental health
- 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
- 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
- NHS Choices [accessed 6/5/2015] Clinical depression – symptoms,http://www.nhs.uk/Conditions/Depression/Pages/Symptoms.aspx
- Dennis CL, Allen K (2013) Interventions (other than pharmacological, psychosocial or psychological) for treating antenatal depression, Cochrane Database Syst Rev 2013: 7: CD006795
- NHS Choices [accessed 6/5/2015] Clinical depression – symptoms,http://www.nhs.uk/Conditions/Depression/Pages/Causes.aspx
- 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.
- 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
ℹLast reviewed on February 1st, 2015. Next review date February 1st, 2018.
By Anonymous (not verified) on 6 May 2018 - 12:00
I'm struggling with my self image and it's impacting on every aspect of my life. I am over weight, I hate how I look. Every day I have to get dressed and every day I look in the mirror and hate myself. I also have rosacia so my fat face is also swollen and red all the time, frequently spotty. I am 6 weeks pregnant with a beautiful 2 year old boy who I adore, but I am just feeling so low. And when I feel low I eat rubbish, which makes things worse. This was a planned pregnancy, but now I am feeling rubbish because I can't try to lose weight because of the baby. I am just stuck. I hate myself which makes me not want to do anything, my house is a tip which stresses me out. My husband gets cross with me because I can put on a brave face with friends but then sit at home and cry. I feel pathetic.
By Midwife @Tommys on 10 May 2018 - 11:12
Hi there. Thank you so much for contacting us. I really do think it would be of use to you to call us for a friendly chat on 0800 0147800, or if you feel that a face to face would be better, make an appointment with your GP/midwife to discuss your low mood in this pregnancy. Both your GP and your midwife can help to support you through this difficult time with more appointments and better tailored care for you, and if your BMI is a concern, then you can be referred to a dietitian for consultation and review during pregnancy so that they can support you in having a healthier diet in this pregnancy, which in turn, may help your low mood and self image as the pregnancy progresses.
Well done for reaching out. If email is a better place for you to make further contact with us, you can reach us on [email protected]'s.org
All the best and i hope to hear from you soon
Sophie, Tommy's Midwife
By Anon (not verified) on 2 May 2018 - 22:11
Im 6 months pregnant and had HG and shingles during pregnancy. Im sick and tired and sad and the world feels so heavy. Im afraid to talk to someone as i worry about what the repercussions could be. Once you openly talk to someone about a mental health issue thats all they see and its all you become. I dont want that to happen to me.
By Midwife @Tommys on 3 May 2018 - 14:41
Hi, Thank you for your comment.
We are sorry to hear that you have been feeling this way for a while now, you have made the first step in getting help and you should be congratulated for that as it takes a lot of courage. There is so much support available for women who are feeling low in pregnancy and it is important that you find the courage to ask.
Please try not to worry about any repercussions, in the past there has been a stigma around mental health but now it is recognised as a treatable illness, but you do need to make your GP or midwife aware of how you are feeling. Pregnancy comes with its own worries and anxieties and there are many contributing factors that can increase these and cause low mood and as you say, it makes you feel tired, because is can become exhausting. You are not alone, there are people there to help you if you ask for it. It can be challenging having that initial conversation with a GP or midwife but we know that mental health issues can increase during and after pregnancy so it is important that you receive the right support and guidance so that you can start on your journey to feeling a little better. Please call you GP or midwife as soon as you can because they will listen and will want to help you. You can always contact us on [email protected] if you would like any additional support at this time. Hope that this has helped, Take Care, Tommy's Midwives x
By Zoe (not verified) on 31 Dec 2017 - 11:59
My partner is worried that I have a hint of depression and asked me to speak to the midwife. Problem is I know I'm down sometimes and wanna cry but I just out down to hormones.
I'm 16 weeks pregnant and 6 years ago I got pregnant at same time and I had to have a medical abortions as I miscarried and I didn't expel the babies as I should of....i lost them due to domestic abuse and that abuse carried on through my next pregnancy with my 5 year old. I nearly lost her twice due to him. He left and I met my fiance last year. We lost a baby in May 2017 and all i can think about is ones I lost and I wanna cry.
Im struggling with this pregnancy now as all I can think is "what would they be like? If I had protected them i would of got this far 6 years ago? Is there really a baby in there now?!"
My fiance is trying so hard to support me, work and help raise my 5 year old. He bought me a feral dipole to try put my ,and at rest but I just bring myself to use it because what if nothing is there?
I'm meant to be enjoying this time but I'm struggling too. Please someone help......any advice?
By Midwife @Tommys on 4 Jan 2018 - 13:03
Hi Zoe, Thank you for your comment.
It sounds like this time of year is very difficult for you as well as pregnancy holding a lot of past memories. It would be advisable for you to speak to your GP or Midwife about getting some form of talking therapies so that you can work through these memories and even allow yourself to grieve for those losses.
Your past pregnancy losses were not your fault, it was the circumstances that you were in and sometimes it is very difficult to get out of, if you are with a controlling and abusive partner.
It sounds like you are with a supportive partner now and this must be a great comfort to you. But you do need another form of support so please don't be afraid to ask for it, the help is there and you can start on your journey to feeling a bit better, not to forget, but to learn the tools to manage the memories.
We would advice against using a fetal Doppler as they are only to be used by a trained health professional. At 16 weeks, it may still be a challenge to hear a heart beat as baby is still small, but if you contact your midwife, she may be able to try and listen to the baby's heart beat for you.If you would like to speak to one of the Tommy's Midwives then please call us on 0800 0147 800 or email us on [email protected] Take Care, Tommy's Midwives x
By Stacey C (not verified) on 6 Dec 2017 - 02:57
I'm currently 33+5. This will be my second child (1st one with my partner) He has suffered depression for years. He has been getting help but is still awaiting the treatment he needs (have been told he will go in 1 week after baby arrives). The last few weeks have been hell for me. I keep getting reduced movement and he shrugs it off. He has started to self harm again. I have being getting about two hours sleep if lucky. I am constantly crying over nothing and I feel as though I can not cope. I have always been the one everyone can rely on, friends, family and partner but lately I am not interested in helping anyone or seeing anyone. I have taken maternity leave so I don't even have that to distract me. I don't know if it is depression or if it is just because of my partners depression that I feel like this.
By Midwife @Tommys on 6 Dec 2017 - 09:30
Hi Stacey, I think it would be a really good idea for you to call us and have a chat on 08000147800 so that we can properly talk through your needs and how we can suggest you might get some support and help!
I think it is really important, if you have not already done so, to tell your midwife and GP how you are feeling and to also fill them in on your partners condition in order that they can better support you through this.
I am not at all surprised that you are finding things hard, it really does sound like you've got such a lot on at the moment. And i think its really wonderful that you have recognised that you too are struggling and need some support! So please do call us! I am here all day today between 9-5pm. We only have the one phoneline, so if you cannot get through, please leave a voicemail and contact details and we will call you back as soon as we can. I look forward to our chin wag :) Take good care of yourself.
Sophie, Tommy's Midwife
By Elaine (not verified) on 26 Nov 2017 - 10:28
I talk to my daughter on tonight she nine months and her baby father told her he did not want another baby he just did that cause she want it he wasn't really trying he don't want to be with her no more he want her to bag up off him he ain't ready for no relationship she's crying so hard saying she's so hurt how could he do that to her she put her all an all into him she doesn't have any friends first baby he messing around with many women and I'm hurting because when my child love she love hard and she have lose everything job,car, and now she about to lose her apt she has loss a lot being with him an there relationship was all a lie and it hurt because I don't know what else to do beening her mother and her presure goes up the doctor all ready told her if her presure keep going up there going to have to do a c section and I don't want to see my child go through these changes I'm scare for even dou I pray for my child who can I turn to for help
By Midwife @Tommys on 28 Nov 2017 - 09:50
Thank you for your comment
I'm so sorry to hear what has happened to your daughter. It sounds like you are giving her lots of emotional support at this stage. Hopefully there are other family members and friends who can also help.
I would advise that she contacts her midwife for extra support-there may be a specialist midwife team she can be referred to help with housing and other practical support if she needs this. She will be feeling very vulnerable ; it's also important to look after her psychological and emotional needs. I have attached a link that you both may find helpful-
Please also make sure that you look after yourself as well. Also, please do not hesitate to contact us on Tommy's PregnancyLine 0800 0147 800 for further advice
By Anonymous (not verified) on 1 Oct 2017 - 20:40
I was so depressed through my pregnancy, i really hate it,first sick and tired then enormous and in pain, nothing to enjoy at all, effected my going to the gym (lifting weights) then not being able to turn in bed or sleep, miserable but as soon as I had my son it was instant happiness, it lifted straight away. My partner couldn't believe the change in me and we both joke I don't get post natal depression I get prenatal not realising this is actually a thing! Until now. So just wanted to say your not alone if you hate pregnancy but once baby is here it will all be worth it ❤
By Midwife @Tommys on 2 Oct 2017 - 12:18
Thank you for your comment. So glad you are enjoying motherhood x
By Abby (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 lisa (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
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/[email protected]
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.
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