Tips for Managing Depression and Anxiety Before and During Pregnancy
By Dr. Annie Valente, MD
How common is depression during pregnancy?
Pregnancy can be exciting, but it is also a time of many changes. Though you may feel happy and excited during pregnancy, you may also experience sadness, overwhelm, fear, and anxiety. When these emotions get in the way of normal day to day functioning, depression could be the reason. Around 14-23% of women will experience symptoms of depression at some point during their pregnancy. A recent study done by the Centers for Disease Control and Prevention (CDC) showed that the presence of a depression diagnosis at the time of delivery increased by seven times between 2000 and 2015.
What are the symptoms of depression?
Depression can show up in the following ways:
- Changes in sleep, either sleeping more or less than usual
- Feeling sad and down
- Loss of interest in activities that used to be enjoyable
- Increased feelings of guilt of doubting one’s worth
- Lack of energy
- Difficulty concentrating
- Less appetite than usual, sometimes with weight loss
- Recurring thoughts of death or suicide
- Feeling hopeless
Usually, these symptoms last for two weeks or more.
What should I do if I feel depressed?
Though there are good treatments available, it is estimated that only 50% of women with depression in pregnancy receive treatment. While prioritizing good mental health is always important, pregnancy is a time to make sure to take care of ourselves. If depression goes untreated, it may be more challenging to follow prenatal care advice like eating well, getting enough rest, and avoiding drinking alcohol or smoking. If you are experiencing any of the symptoms above, talk with your prenatal care provider, a mental health professional, or your primary care provider. Help is available.
How can I treat depression symptoms during pregnancy?
Often, lifestyle changes can go a long way in relieving depression symptoms. Some tips include:
- Go to sleep and wake up at the same time every day
- Make sure to get adequate rest
- When possible, reduce stress
- Continue exercise routines you had before pregnancy
- Reach out to existing support networks
- Establish new networks by joining a support or new parents group
Counseling with a private therapist or in a group setting is an effective therapy for depression and can be a great first step in treatment along with lifestyle change. Ask your prenatal care provider for suggestions of therapists or group programs.
There is some evidence that acupuncture can be an effective treatment for depression during pregnancy. Acupuncture involves inserting small needles into specific points on your skin and is a form of Traditional Chinese Medicine (TCM). Massage therapy may also help with symptoms, whether it be a professional masseuse or your partner simply massaging a cooling pregnancy lotion on your swollen feet and ankles to help you de-stress.
Medications like antidepressants are available if needed. Though few medicines are considered completely safe during pregnancy, antidepressants are very effective and can be an essential part of a treatment plan if other therapies aren’t working.
If you or someone you know is in crisis, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) for free and confidential crisis counseling available 24 hours a day, 7 days a week. TTY: 1-800-799-4889.
For more information on depression in pregnancy, the American College of Obstetrics and Gynecology has patient-directed information here. Read more articles about mental health and pregnancy here.
Annie Valente is a primary care doctor practicing family medicine with obstetrics in Portland, OR. She is passionate about helping women have gentle and transformative pregnancy, birth, and postpartum experiences. She has an MD from UCSF.