What you need to know about anxiety and depression during pregnancy

Many develop anxiety and depression at some point during their pregnancy. Throughout the entire perinatal period, approximately one in five people, or up to 20 percent, will develop a mood disorder such as anxiety or depression. Many doctors suspect that because many mental health conditions go unreported due to stigma, that number may be much higher.

Though there are certainly risk factors that can increase a pregnant person's risk for anxiety or depression, such as family history or traumatic life events, all who are pregnant are at risk for developing mental health issues.

All of the physical and emotional changes people undergo throughout pregnancy can feel challenging and overwhelming and trigger underlying anxiety and depression disorders.

Here's what to know about anxiety and depression during pregnancy:

What causes anxiety and depression during pregnancy?

There are a mix of contributing factors that may cause someone to experience signs and symptoms of anxiety or depression during pregnancy.

Dr. Kathryn Zagrabbe, a psychiatrist with Main Line Health's Women's Emotional Wellness Center, says pregnancy as a whole puts people at risk for anxiety or depression. During pregnancy, the body produces hormones that can contribute to mood fluctuations. For many, it can be hard to adjust to all of these changes that occur in the body. Many people feel nauseous and fatigued at different points in pregnancy and can worry - sometimes excessively - about whether the pregnancy is going well and if they're doing everything right.

Some who are pregnant might feel as though their expectations of what pregnancy is supposed to feel like doesn't line up with what it actually feels like. 'A lot of times we've created this idealistic version of what a pregnant mom looks like and what it is to be a mom after you deliver, and sometimes your expectations don't necessarily fall in line with reality,' says Dr. Preethi Rajendran, an OB/GYN with Main Line Health. Over time, this can cause underlying anxiety and depression.

There are several factors that may put a person at higher risk. Mental health history, family history, and the occurrence of major life stressors or health complications can increase a pregnant person's risk of anxiety or depression, says Zagrabbe. Though these factors increase a person's risk, even those with no history of anxiety or depression can develop a mental health condition during pregnancy. 'It's common that it arises in pregnancy,' Rajendran says.

Signs of depression and anxiety during pregnancy

The symptoms and signs of depression and anxiety during pregnancy are essentially the same as those of anxiety and depression outside of pregnancy.

This includes restlessness and 'excessive worrying that's difficult to control or that has an impact on your life, so it's prohibiting you from doing your day-to-day activities or accomplishing things you want to accomplish,' Rajendran says.

Some people may feel more irritable, restless, or tired. It may become difficult to sleep at night and concentrate during the day. Some of these symptoms are naturally brought on by pregnancy, but the concern is when they begin to feel excessive or intrusive. These symptoms, when uncontrollable, can be a warning sign that you've crossed from normal pregnancy stress to an anxiety disorder, says Zagrabbe.

How can anxiety and depression impact the baby's and mom's health?

Anxiety and depression can influence pregnancy outcomes in a few different ways.

A pregnant parent with anxiety or depression faces a higher risk of pre-term delivery. Their babies also have a higher chance of being smaller for their gestational age and tend to have a lower birth weight. Pregnant people with anxiety or depression are also less likely to exercise, eat well, or engage in prenatal care. They're also more likely to use substances like drugs and alcohol.

Anxiety and depression during pregnancy is one of the biggest risk factors for postpartum depression. 'When a parent struggles with things like postpartum depression, that can have an impact on ability to bond with the baby and also have an impact on the baby's long-term development,' says Zagrabbe.

In general, most postpartum parents and their babies do fine, according to Rajendran. 'Mental health is just as important as your physical health,' she says. The two are intrinsically linked and can significantly affect one another.

How do you cope with feelings of anxiety and depression during pregnancy?

If you've been feeling anxious or depressed during your pregnancy, the most important step is to seek out help as soon as possible. 'For those who are struggling in pregnancy, it's incredibly important to get treatment as soon as possible. If we can make people feel better during pregnancy, that likely means their postpartum outcomes will be better,' says Zagrabbe.

Your OB/GYN is a great first resource. Psychotherapy, which can be conducted in either an individual or group setting with a therapist or psychiatrist, can also help you work through your symptoms. 'Being with others who are also going through a similar experience with being pregnant and what that means can be really, really effective,' says Zagrabbe.

Rajendran recommends keeping a journal in which you can write down how you're feeling each day. This can help you determine whether your feelings of anxiety and depression are impacting your quality of life and preventing you from functioning throughout the day. There are also medication options that are safe and effective for those suffering from anxiety or depression in pregnancy.

Prioritizing self-care by maintaining healthy sleep, diet, and exercise routines and building a strong support system can also combat feelings of anxiety and depression. Your support system doesn't necessarily have to be a professional therapist; it can be friends or family members who you feel comfortable relying on and opening up to.

'Every pregnant person, no matter what, should do their best to take care of themselves, because by taking care of themselves they're going to be taking care of their baby, too,' says Zagrabbe.

Main Line Health serves patients at hospitals and health centers throughout the western suburbs of Philadelphia. To schedule an appointment with a specialist at Main Line Health, call 1.866.CALL.MLH (225.5654) or use our secure online appointment request form.

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