About Prenatal Anxiety & Depression

Depression and Anxiety During Pregnancy

Many people are familiar with the terms postpartum depression and anxiety, but prenatal mental health conditions are rarely spoken of. 

Both prenatal depression and prenatal anxiety are types of perinatal mood and anxiety disorders (PMADs). PMADs are a broad category of maternal mental health conditions that occur during pregnancy or shortly after giving birth. 

Prenatal depression and anxiety occur while a mother is pregnant. Approximately 1 in 5 mothers experience these conditions. Anxiety and depression can develop during pregnancy or may be present before a woman becomes pregnant and persist during her pregnancy. Expectant mothers are most vulnerable to these conditions during the first and third trimesters.

Signs of Prenatal Depression and Anxiety

While each woman is different, women with prenatal depression and anxiety will show similar types of symptoms. It’s normal to experience changes in mood or mild worry from time to time, but expectant mothers with a PMAD will experience these symptoms much more often.

Symptoms of Depression:

• Feeling sad or down.
• Diminished interest or lack of pleasure in once enjoyable activities.
• Low energy.
• Moving more slowly and appearing more sluggish than usual.
• Changes in sleep, either sleeping too little or too much.
• Feelings of worthlessness or guilt.
• Difficulty concentrating.
• Suicidal thoughts.

Symptoms of Anxiety:

• Excessive worry that is hard to control.
• Feeling irritable or on edge.
• Restlessness.
• Low energy.
• Muscle tension.
• Difficulty sleeping.
• Difficulty concentrating.

Causes of Pregnancy Anxiety and Depression

Prenatal anxiety and depression are often caused by a combination of biological and environmental factors. Potential causes include:

• Hormonal changes, including increased levels of estrogen and progesterone. These changes can cause a woman to feel more emotionally vulnerable.
• Physical pain and discomfort, such as nausea, vomiting, muscle aches and pains, heartburn, fatigue, headaches, and frequent urination. These symptoms can be uncomfortable and hard to cope with.
• Anxiety and fear related to delivery, the baby’s health, and becoming a parent.

In addition to stress related to pregnancy and parenting, women may be dealing with other issues in their lives, such as family, work, or financial problems. These can all contribute to stress, moodiness, and worry.

Risk Factors

Risk factors are events or experiences that increase the likelihood of a person developing a health condition. Certain experiences put women at higher risk of experiencing depression and anxiety during pregnancy. Risk factors for prenatal depression and anxiety include:

• History of depression, anxiety, or other mental health issues.
• Family history of mental illness. 
• Low self-esteem before pregnancy. 
• Lack of support from family and friends.
• History of abuse or domestic violence. 
• Difficulty getting pregnant and/or utilizing assisted reproductive technology (ART), such as in vitro fertilization (IVF). 
• Unplanned pregnancy. 
• Having a high-risk pregnancy. 
• Expecting multiples, such as twins or triplets. 
• Developing medical conditions during pregnancy like hypertension or gestational diabetes. 
• Experiencing other stressors, like financial problems, conflict with a spouse or partner, or housing instability. 

While certain factors may increase your risk for an emotionally challenging pregnancy, there are tools and resources available to help you cope with these challenges.

How will depression and anxiety affect my baby?

Prenatal depression and anxiety can have an impact on a developing baby. Some research studies suggest that stress during pregnancy is linked to preterm birth, lower birth rate, and developmental delays. However, taking steps to address these issues and making efforts to bond closely with your baby after birth is also associated with positive developmental outcomes for children. Therefore, it’s important to remember that even if you struggle with depression and anxiety during pregnancy, you can recover and develop a close mother-child bond.

Coping with Depression and Anxiety During Pregnancy

Taking steps to reduce mood and anxiety symptoms can help you have a more positive pregnancy experience. There will always be ups and downs, but taking steps to manage your stress can help you recover from the downs more easily. Consider the following to help reduce stress during pregnancy:

• Take it easy. Now is not the time to add more to your plate. Pregnancy requires lots of rest as you grow your baby and prepare for parenthood. If possible, avoid taking on big projects that can add extra stress, like moving, changing jobs, or getting a new pet.
• Phone a friend. Loneliness and isolation are common symptoms of depression, but connecting with others can be a powerful tool for coping. If you already have a good support system of friends or family, make an effort to reach out to someone you trust. If you don’t have anyone you can talk to, consider joining a support group for new parents. 
• Permit yourself to be imperfect. Putting unrealistic expectations on yourself can lead to a constant state of stress and feelings of failure, which are recipes for anxiety and depression. If thoughts of perfection creep up, try to challenge them by reminding yourself that you’re doing your best and that is enough.

Treatment

Therapy is the recommended treatment for prenatal anxiety and depression. One of the primary benefits of therapy during pregnancy is the creation of a safe and non-judgmental space for the expectant mother to explore and express her feelings. Pregnancy can bring about a wide range of emotions, from joy and excitement to worry and fear. A therapist trained in perinatal mental health can help women process these emotions and offer insights and coping strategies. 

Therapy can also assist in identifying and addressing the root causes of prenatal anxiety and depression. These causes can vary widely and may include concerns about the health of the baby, fears related to childbirth, past traumas, relationship issues, or external stressors such as financial difficulties. By delving into these underlying factors, therapy helps expectant mothers gain a deeper understanding of their emotions and develop healthier ways of coping. 

Additionally, therapy provides a supportive environment for learning and practicing relaxation techniques. Techniques such as deep breathing, mindfulness, and guided imagery can help manage anxiety symptoms. These tools not only offer immediate relief but also empower women to cultivate a sense of calm and resilience that can be beneficial during pregnancy and beyond. 

Furthermore, therapy offers a valuable opportunity for expectant mothers to develop a support network. Pregnancy can sometimes feel isolating, and having a therapist as a consistent source of support can be crucial. 

In addition to individual therapy, group therapy sessions specifically for pregnant women can provide a sense of community and shared understanding, which will help reduce feelings of isolation.

What types of therapy are effective for treating prenatal depression and anxiety?

Cognitive-behavioral therapy (CBT) is a commonly used therapeutic approach for managing anxiety and depression during pregnancy. CBT helps people recognize and challenge negative thought patterns, providing practical tools to reframe anxious or depressive thinking. This can be particularly beneficial for expectant mothers dealing with worries about their ability to parent, concerns about the future, or fears related to the birthing process.

For some women, prenatal depression or anxiety may be linked to unresolved issues from their past. Therapists skilled in psychodynamic or interpersonal therapy can help mothers explore these deeper issues, fostering a process of self-discovery and healing. Understanding and addressing past traumas or unresolved conflicts can contribute to improved mental health during pregnancy.

It's important to note that therapy is a collaborative process, and the expectant mother plays an active role in her mental health journey. The therapist serves as a guide, offering expertise, empathy, and validation. Through this collaborative relationship, women can build resilience, enhance coping skills, and develop a stronger foundation for the challenges of motherhood.

When should I get help if I experience an increase in anxiety or depression during pregnancy?

Most pregnancies involve a degree of worry, mood swings, and insomnia, symptoms that are also found in mood and anxiety disorders. Because of the overlap, it can be difficult to know when your symptoms are too much and it’s time to get help. Signs that you should consider seeking professional help include:

• Your symptoms have lasted for over two weeks and are not improving. 
• Your symptoms are interfering with your ability to function and carry out your responsibilities, such as attending your prenatal appointments or caring for other children.
• You feel all alone or like you don’t have anyone to talk to. 
• You have thoughts of harming yourself or suicide. 

Around 20% of women experience anxiety and depression during pregnancy. Taking active steps to reduce your stress and seeking treatment can help you cope with these symptoms and improve your pregnancy experience. 

At Phoenix Health, we support parents at all points of their journey. If you’re experiencing prenatal anxiety or depression, we are here to help. Schedule an appointment with a maternal mental health specialist and start feeling better today.