Pregnancy week by week

If you're pregnant, chances are you've heard about a type of depression that happens after childbirth called postpartum depression. But did you know that many people have depression while they're pregnant?

Depression is a common mood disorder that can cause persistent feelings of sadness and loss of interest in daily activities. Some people develop this condition for the first time while they're pregnant.

Here's what you need to know about pregnancy and depression.

How common is depression during pregnancy?

Pregnancy can be a time of joy — and stress. Research suggests that about 7% to 9% of pregnant people in high-income countries such as the United States have depression during pregnancy. Rates might be higher in low- and middle-income countries.

What's more, some pregnant people with depression don't learn that they have the mood disorder. Healthcare professionals may spot, also called diagnose, depression less often in pregnant people compared to those who aren't pregnant. They also may diagnose depression during pregnancy less often than postpartum depression.

Why does depression during pregnancy often get overlooked?

It's possible for both pregnant people and their healthcare professionals to overlook depression. Some symptoms of the mood disorder can seem like those of pregnancy. Depression symptoms can include changes in sleep, energy level, appetite, and sex drive. As a result, you or your healthcare professional might think that these symptoms are due to your pregnancy rather than depression.

Some pregnant people also might not be willing to talk with their healthcare professionals about mood changes during pregnancy. In some communities, beliefs about mental health conditions cause people to dismiss depression symptoms or feel ashamed about them. Also, some pregnant people or their healthcare professionals may focus more on physical health during pregnancy, rather than mental health.

What are the risk factors for depression during pregnancy?

Some risk factors for depression during pregnancy include:

• Anxiety.
• Life stress.
• Personal or family history of depression.
• Stopping use of prescribed depression medicine.
• Poor social support.
• Unintended pregnancy.
• Intimate partner violence or past abuse.
• Health conditions during pregnancy.
• Upset stomach and vomiting that lasts, or feeling unwell for an extended time.
• History of premenstrual syndrome (PMS) or a more serious form called premenstrual dysphoric disorder.
• Poor sleep.
• Young age.

What are the symptoms of depression during pregnancy?

The symptoms of depression can seem like the usual ups and downs of pregnancy. But some clues that may point to depression during pregnancy can include:

• A lot of anxiety about your baby.
• Low self-esteem, such as doubt that you'll be a good parent.
• Lack of interest in the pregnancy.
• Little response to support from loved ones or healthcare professionals.
• Not getting prenatal care or following a healthcare professional's instructions.
• Smoking, drinking alcohol or using illicit drugs.
• Poor weight gain due to not eating enough or getting enough nutrition.

Depression in pregnant people also can cause the same symptoms as in people who aren't pregnant. Tell your healthcare professional if you have any of the following symptoms for two weeks or longer:

• Sad mood most of the day, almost every day.
• Loss of interest in activities you used to enjoy or in work.
• Feelings of guilt, hopelessness or worthlessness.
• Trouble sleeping or sleeping more than usual.
• Poor weight gain due to not eating enough or getting enough nutrition, or eating much more than usual and putting on too much weight.
• Tiredness or a lack of energy.
• Trouble staying focused or making choices.
• Restlessness.
• Thoughts of suicide or self-harm — call 911 or your local emergency number right away.

The risk of depression seems to be similar during each of the three trimesters of pregnancy.

Why is treatment for depression during pregnancy important?

If you don't get treatment for depression, you might not seek ideal prenatal care. You also might not eat the healthy foods your baby needs or have the energy to care for yourself. Your risks of postpartum depression and trouble bonding with your baby after delivery rise as well.

Depending on how serious your depression is, treatment options might include talk therapy, antidepressant medicine, or both.

What are the recommendations for screening for depression during pregnancy?

The American College of Obstetricians and Gynecologists recommends that healthcare professionals check for depression and anxiety at least once during pregnancy. It's common to get checked, also called screened, during the first prenatal care visit and again near or in the third trimester.

During screening, your healthcare professional likely will ask you some questions about mood and anxiety. Your answers are scored. Your total score can be used to find out whether you have depression. Or your healthcare professional might simply ask if in the past month you've felt:

• Down.
• Depressed.
• Hopeless.
• Little interest or pleasure in doing things.

Screening to find and treat depression during pregnancy is important. But not every pregnant person who learns they have depression has access to resources and proper treatment. Still, research suggests that screening itself is linked with a lower risk of depression. It may lessen mental health stigmas and provide some self-awareness about your risk of depression and anxiety.

If you think you might have depression during pregnancy, don't wait for a screening. Talk with your healthcare professional about how you're feeling and ask what steps to take next.