Feeling Alone During Pregnancy: What It May Mean For Mental Health

Expecting a child can be exciting, but some expectant mothers may experience loneliness during this phase of life. Changes in social habits, along with the stress and anxiety that can be associated with this major life change, may contribute to loneliness. Loneliness, particularly when paired with social isolation, may be an early sign of mental health conditions like perinatal depression (which includes postpartum depression as well as depression during pregnancy). It can be important to seek support if you experience these or other mental health concerns while pregnant. Often, working with a licensed therapist can offer relief from challenging symptoms.

Why pregnancy can feel isolating

During pregnancy, loneliness may be a common and recurring experience for expectant parents. Common reasons for loneliness during this life stage can include the following:

• Physical changes: Pregnancy may cause a variety of physical changes to the body that can cause discomfort and fatigue. Some amount of tiredness can be normal during pregnancy, but when this extends beyond normal fatigue, it can lead to a sense of loneliness and may be a sign of depression. 
• Emotional changes: Hormonal shifts can contribute to mood swings, pregnancy blues, and, in some cases, prenatal depression. These emotions can impact how expectant mothers react to stimuli in the world around them. In some cases, this can lead a pregnant woman to withdraw socially during times of high stress, even when she is feeling overwhelmed.
• Limited social support: Women who have a limited social support system may experience an increased sense of loneliness during pregnancy. Having a network of close friends and family members to offer support in daily life may reduce loneliness during pregnancy. 
• Relationship strain: For single mothers, mothers with unsupportive partners, and those who experience frequent relationship conflicts, pregnancy may feel isolating. 
• Comparisons and expectations: Pregnant women who have high expectations of themselves or who compare their pregnancy to others may experience increased isolation and loneliness. In some cases, social media may play a role in a mother’s expectations of what pregnancy should be like, and if reality doesn’t match these expectations, it could lead to a sense of isolation. 
• Pre-existing mental health conditions: Pregnant women who are living with pre-existing mental health conditions, such as depression or anxiety disorders, typically have an increased risk of loneliness while pregnant.  

When loneliness may signal a mental health concern

Mental health concerns, like anxiety and depression, are quite common in pregnancy. One recent study about these conditions in pregnancy found that 47.5% of participants had anxiety, 16.2% were depressed, and 15.6% had both anxiety and depression. While these conditions can have many symptoms beyond loneliness, a sense of isolation can be an early sign that a pregnant woman may need additional support.

Depression and anxiety during pregnancy

According to the American College of Obstetricians and Gynecologists, some women experience depression and anxiety for the first time during pregnancy or after delivery. These conditions can cause various symptoms for the mother, including loneliness, trouble sleeping, loss of interest in activities, and sleep disturbances, and they can also increase the risk of problems for the baby, including:

• Poor fetal growth
• Early labor
• Low birth weight
• Health complications after birth
• Newborns who may be harder to comfort
• Emotional and behavioral problems in childhood

Research also suggests a significant correlation between having a history of previous mental illness and developing depression in perinatal women.

Pregnancy and serious mental health conditions

Serious mental health conditions, including bipolar disorder, can emerge or worsen during pregnancy and in the post-partum period. Recognizing the signs early can be important for the mother's well-being and the health of the baby.

Bipolar disorder during pregnancy

Bipolar disorders are characterized by periodic, intense emotional states affecting a person's mood, energy, and ability to function. These mood episodes can last from days to weeks, and symptoms can include intense sadness, happiness, or irritability.

Research suggests there is a higher incidence of bipolar episodes during the perinatal period, with one meta-analysis finding that 54.9% of women who had a prior bipolar disorder diagnosis had at least one bipolar-spectrum episode during pregnancy. Women who discontinue mood-stabilizing medication during pregnancy may be at particularly high risk of relapse.

When to contact a doctor

If pregnant women experience the following symptoms, it may be important to contact their doctor right away or seek immediate support:

• Severe mood swings
• Prolonged periods of sadness or hopelessness
• Racing thoughts
• Elevated energy
• Reduced need for sleep
• Difficulty functioning in daily life
• Thoughts of self-harm

These can all be signs of serious mental health problems that may require professional evaluation and intervention.

How to seek help and build a support system

It can be important to remember that you do not need to go through pregnancy alone, and seeking support can improve your mental and physical health. Some places to start when building a support network may be with your partner (if applicable), close friends, and loved ones. Talking with your partner about your feelings of loneliness may help them understand your emotions and more effectively support you. Close friends and family members may be able to offer practical and emotional support as well, and other moms may understand or identify with how you’re feeling.  

In addition to developing a strong support system of friends and family, it may be beneficial to seek out support groups made up of other moms or pregnant women. These support groups may be beneficial because they allow pregnant women to discuss concerns, stressors, or emotions in a group with others who are experiencing similar situations. A support group, especially when led by a mental health professional, may offer a more unbiased view of pregnancy and a wider variety of solutions for challenges like loneliness. 

If you are feeling lonely and struggling to find community, it may help to search outside of your current circle to find people who fully understand what you’re going through. Consider joining a local pregnancy group, signing up for a prenatal class, or looking for a hospital-run program that brings expecting parents together to offer support to one another. If you’re unable to attend in person, there are also online groups, forums, and apps where you can connect with others who are going through a similar experience.

Treatment options for loneliness and depression during pregnancy

Several treatment options may be available for women who are experiencing depression and loneliness during pregnancy. Seeking help early can help make a difference in both maternal well-being and pregnancy outcomes. 

Coping strategies you can use right now

Small daily actions can help pregnant women cope while seeking out additional support. For example, taking a warm bath can help ease physical tension and bring a moment of calm, and prioritizing rest can be beneficial for recouping mental and physical energy. That said, if you try these coping strategies and they don’t seem to help, you still feel sad, or you experience depression symptoms for more than two weeks, it may be beneficial to seek professional support.

Talk therapy and emotional support

Cognitive behavioral therapy (CBT) has a strong evidence base for treating prenatal depression, helping women identify and reframe unhelpful thought patterns and change associated behaviors. Research has also found that interpersonal therapy (IPT) can be beneficial for treating depression during pregnancy.

Medication and taking antidepressants during pregnancy

Antidepressants have not been known to cause birth defects, and they may be safe to use during pregnancy. Risks of leaving moderate to severe depression untreated during pregnancy should be weighed carefully against any potential risks associated with medication. Whether to take medications during pregnancy should always be made by consulting a qualified healthcare provider.

Professional support for loneliness

For expecting mothers, seeking professional support from a licensed therapist may be an effective way to navigate difficult emotions and reduce loneliness. A therapist may implement a variety of strategies to identify and restructure negative thought patterns. 

During pregnancy, an expectant mother may have many appointments to attend, and the thought of adding a weekly therapy session may be overwhelming. Online therapy can empower women to attend regular sessions from the comfort of their homes or other preferred locations, and appointments can be scheduled at convenient times, even outside of typical office hours. Research suggests that online therapy can be an effective option for treating perinatal depression, with one study concluding, “Internet-based psychological interventions are considered a convenient and effective alternative treatment for perinatal depression and anxiety.”