Depression And Pregnancy: Perinatal Depression Signs And Treatment

Depression during and after pregnancy is not uncommon. Though many new parents associate joy and excitement with pregnancy, it is estimated that 10% to 20% of gestational parents experience symptoms of perinatal depression, a form of depression that develops during pregnancy and can form into postpartum depression after birth.

After a miscarriage, approximately 10% of people experience a major depressive disorder. 

Awareness of the signs of depression can help you identify when you might benefit from reaching out for support. Perinatal depression is real and can have severe impacts. Psychotherapy or pharmaceutical treatment has been proven to effectively reduce symptoms of prenatal and postpartum depression in many individuals.  

What is perinatal depression? 

Several factors can increase one’s risk of experiencing perinatal depression, including the following: 

• Life stressors
• The physical toll of pregnancy and childbirth
• A lack of sleep
• Fluctuations in hormone levels
• Young age at the time of pregnancy
• An unwanted pregnancy 
• Low socioeconomic status or education level
• Domestic violence
• Substance use during pregnancy
• A history of trauma
• A personal or family history of mental illness
• Premature birth
• Difficulty breastfeeding or pressure to breastfeed
• A lack of adequate social support from a partner, family, or friends

Women and gestational parents are not the only individuals who face perinatal depression. Studies show that over 10% of fathers experience symptoms of anxiety and depression during the perinatal period, which may be underreported due to stigma and lack of awareness. Same-sex partners may also experience perinatal depression if their partner is pregnant. However, more studies on same-sex couples are needed in mental health. 

If you are facing or witnessing abuse of any kind, the National Domestic Violence Hotline is available 24/7 for support. Call 1-800-799-SAFE (7233) or text “START” to 88788. You can also use the online chat. 

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources.

Signs of perinatal depression

Depression can look different for different people. The duration, intensity, and frequency of symptoms may vary, and the treatments that work for each person can also vary. However, it is common for people with perinatal depression to experience some or all the following symptoms:

• Intense mood swings and irritability
• Frequent crying 
• Prolonged sadness or a sense of emptiness
• Feelings of worthlessness, hopelessness, or guilt
• Difficulty bonding or connecting with your new baby
• Social withdrawal from friends and family
• Weight or appetite changes
• Unexplained physical pains, like headaches or digestive issues
• Worries that you are not enough as a parent 
• A lack of interest or joy in previously enjoyable activities
• Insomnia or hypersomnia 
• Intense fatigue and a lack of energy
• Restlessness
• Difficulty concentrating or making decisions
• Anxiety or frequent worrying 
• Thoughts of self-harm, harming someone else, or suicide

If you are experiencing suicidal thoughts or urges, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text 988 to talk to someone over SMS. Support is available 24/7. If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.

Experiencing perinatal or postpartum depression is common and not an indicator that you are or will be a “bad parent.” Perinatal depression can be serious and sometimes develops months or years after childbirth. However, you’re not alone, and effective treatment is available. If you are thinking of harming your child, reach out for professional support immediately. 

How to receive a diagnosis and support 

Doctors often utilize routine screening to assess whether clients are experiencing symptoms of depression. If they believe you might be experiencing perinatal depression, they can conduct a more thorough evaluation and connect you with the appropriate resources.

You can also contact your OB-GYN, primary care physician, psychiatrist, or an in-person mental health professional if you are concerned that you might be depressed. If you’ve been recording your symptoms in a journal, bringing it with you for your reference during the evaluation may be helpful. They may determine that you have one of the following:

• Perinatal depression: Perinatal depression is a term to describe depression before, during, and after birth. This diagnosable psychiatric disorder is often addressed with medication, psychotherapy, or a combination of the two.
• Postpartum psychosis: Postpartum psychosis is a serious but rare short-term psychotic disorder. People with postpartum psychosis are often treated in an inpatient hospital with medications, therapy, and supervision. 

A physician may not divulge a diagnosis; instead, they may determine that you or your partner are experiencing normal responses to transitioning to parenthood. Many parents experience stress, physical and emotional exhaustion, and sleep deprivation that can cause feelings like sadness and anger. These feelings are often resolved within a few days or weeks of childbirth.

Counseling options 

Some people experience a reduction in perinatal depression symptoms when they attend psychotherapy sessions with a licensed professional. Cognitive-behavioral therapy (CBT) is a type of psychotherapy that focuses on re-evaluating thoughts, emotions, and behaviors to address the symptoms of depression. CBT for perinatal depression has been proven effective at reducing symptoms. 

For people who find that commuting to therapy is a barrier to receiving appropriate care, online CBT through a platform like BetterHelp may be valuable. A study from 2018 found that online CBT could effectively address depression and common mental health conditions. 

Online therapy platforms can enable you to use in-app messaging to connect with your therapist anytime if you experience distressing symptoms outside of sessions. In addition, you can choose between phone, video, or chat sessions and connect with a therapist on your own schedule, which can be beneficial for busy new parents or pregnant individuals.