It's more common than many realize. 

By Samantha Lauriello
November 08, 2019

Welcoming a little one into the world can be one of the happiest times in a woman's life—but it can also be one of the most stressful. Women are often aware of the risk of postpartum depression, but what many don't realize is there's also a risk of depression during pregnancy. 

About 14 to 23% of pregnant women experience depression while pregnant, according to the American College of Obstetricians and Gynecologists. "It is something that we should be closely monitoring in all pregnant women because the tendency to underreport or underrecognize symptoms is also well known," Natalie Dattilo, PhD, director of psychology services at Brigham and Women's Hospital in Boston, Massachusetts, tells Health

Here, everything women need to know about depression during pregnancy.

RELATED: How to Know If Your Bad Mood Is Actually Depression

Why depression during pregnancy often goes unrecognized 

Some symptoms of depression, like changes in sleep, appetite, and energy levels, can also be symptoms of pregnancy. "It's hard to tell what exactly is going on sometimes when you're pregnant because so many things are happening," says Dattilo, "especially if it's a first-time pregnancy."

Doctors may also mistakenly attribute symptoms to pregnancy rather than depression. Dattilo says though it should be standard practice for doctors to monitor pregnant women's mental health, many still focus more on women's physical health instead. Women may also find it difficult to talk to their doctor about depression because of the stigma attached to it.

Risk factors

The number one risk factor for becoming depressed during pregnancy is having a prior history of depression, Helen L. Coons, PhD, psychiatry professor at University of Colorado School of Medicine in Aurora, tells Health. There's an even greater risk if a woman has experienced depression during a previous pregnancy. Other risk factors include:

  • Family history of depression
  • Personal history of anxiety
  • Complicated pregnancy
  • Poor social support
  • Life stress
  • Past trauma
  • Unintended pregnancy

RELATED: 12 Types of Depression, and What You Need to Know About Each

Signs and symptoms

According to the Centers for Disease Control and Prevention, symptoms of depression during pregnancy include:

  • A lasting sad, anxious, or "empty" mood
  • Feelings of hopelessness or worthlessness
  • Feelings of irritability or restlessness
  • Loss of energy 
  • Problems concentrating, recalling details, and making decisions 
  • Difficulty falling asleep or sleeping too much
  • Overeating or loss of appetite
  • Aches or pains that do not get better with treatment
  • Suicidal thoughts or suicide attempts

When to seek treatment

Though symptoms of depression can be similar to those of pregnancy, Dattilo says, "if your symptoms are worrisome to you or if they're affecting your ability to live the way you'd like to," be sure to consult your doctor.

Think about how your mood has changed since becoming pregnant, she adds. Do things you used to enjoy not sound interesting anymore? Are you withdrawing from relationships or hobbies? Are you questioning if the pregnancy, or life in general, is even worth it? If you answer yes to any of these questions, it's important you seek help. 

Laura Honos-Webb, PhD, author of Listening to Depression, tells Health that regardless of whether a woman's symptoms meet the criteria for depression, therapy can help ease the transition into motherhood. It can also help prevent symptoms from getting worse. Being pregnant is such a stressful time, "why not seek out some help?" she says. 

RELATED: 10 Foods to Help Fight Depression

Why treatment is important

In some cases, depression during pregnancy can affect the baby's development. This is because "when women are significantly depressed, they tend to take less good care of themselves," says Dattilo. "Not because they're doing it intentionally, but because they don't have the energy, interest, or motivation, so they might not make healthy choices in the way they would otherwise." 

Women who become depressed during pregnancy may not feel as excited about being pregnant. They may not keep up with optimal prenatal care (such as regular doctor visits), they may not eat the healthy foods the baby needs, they may not be sleeping as well, and they may turn to alcohol or smoking to cope. 

Untreated depression also puts a woman at an increased risk of experiencing postpartum depression and having difficulty bonding with the baby.

Treatment options

In general, cognitive behavioral therapy (CBT) is often the treatment of choice for depression, says Dattilo. CBT is a type of talk therapy that helps people learn how to identify and change destructive thought patterns that negatively influence their behavior and emotions.

For pregnant women specifically, however, some research suggests that interpersonal therapy (IPT) can be beneficial, Dattilo says. IPT focuses on your relationships with others and how they influence your life. It’s based on the idea that personal relationships are at the center of psychological issues. "This can help in examining your relationships and how they may change with this role transition," she says. IPT can also help you examine your relationship with yourself and how becoming a mother will affect your sense of identity. 

Other research suggests that certain antidepressants may be safe to take during pregnancy. If you're interested in taking antidepressants in addition to therapy, talk to your doctor and a psychiatrist about your options. They can help you decide what's right for you. 

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