Depression during pregnancy

Pregnancy does not always feel happy, hopeful or exciting. Some people experience depression during pregnancy, also known as antenatal depression, and it can affect people with or without a previous history of depression.

Feeling low occasionally is not necessarily the same as having depression. But if you often feel low or hopeless, have lost interest in things you usually enjoy, or are worried about how you are feeling, speak to your midwife or GP. You do not need to diagnose yourself before asking for help.

What is depression during pregnancy?

Depression during pregnancy is depression that develops while you are pregnant. The NHS refers to it as antenatal depression.

Pregnancy can involve changes in sleep, appetite, energy and emotions, so it is not always easy to know what is related to pregnancy and what might need more attention. This is one reason it can be helpful to talk openly with a healthcare professional about how you have been feeling rather than trying to work it out alone.

Depression can begin during pregnancy even if you have never experienced a mental health problem before. If you have had depression or anxiety previously, symptoms can also return during pregnancy.

Signs of antenatal depression

Depression can feel different from person to person. According to the NHS, possible signs of depression during pregnancy include:

feeling sad, low or tearful much of the time
feeling irritable or becoming angry more easily
losing interest in other people or things around you
eating more or less than usual
having negative thoughts
feeling guilty, hopeless or blaming yourself
finding it difficult to concentrate or make decisions

Some of these experiences can overlap with changes that happen during pregnancy. Tiredness, changes in appetite and disrupted sleep, for example, do not automatically mean that someone has depression.

What matters is how you are feeling overall and how much it is affecting your life. If you are concerned, tell your midwife or GP.

Why depression can be difficult to recognise in pregnancy

There can be an expectation that pregnancy should be a particularly happy time. That can make low mood, numbness, irritability or hopelessness harder to talk about.

You may also wonder whether what you are experiencing is simply part of being pregnant. Physical and emotional changes can make that distinction difficult.

There is no need to wait until your symptoms fit a perfect description. NHS guidance recommends speaking to a maternity unit or GP if you are worried about your mental health during pregnancy.

For some people, previous experiences may also shape how pregnancy feels. Pregnancy after loss, fertility treatment, trauma or a difficult previous pregnancy can bring complicated emotions. Others may be dealing with pressures that have little to do with pregnancy itself, such as work, money, housing, relationships or caring responsibilities.

Whatever the circumstances, your feelings deserve to be taken seriously.

Depression, anxiety and stress can overlap

Low mood is not the only mental health difficulty that can occur during pregnancy. Anxiety and stress can also affect how you feel, and symptoms may overlap.

For example, you might feel low as well as worried, have difficulty concentrating, withdraw from other people or find everyday tasks harder.

You do not need to decide for yourself whether what you are experiencing is depression, anxiety, stress or a combination. A midwife, GP or mental health professional can listen to what has been happening and discuss appropriate support.

What support is available?

Support depends on your symptoms, circumstances, preferences and medical history.

The NHS says depression and anxiety during pregnancy can often be helped with talking therapies such as cognitive behavioural therapy. In England, adults can usually contact an NHS Talking Therapies service directly, without first seeing a GP.

Some people may also be offered medication. Decisions about medicines during pregnancy need individual medical advice because healthcare professionals consider the potential benefits and risks for the pregnant person and the pregnancy.

If you already take prescribed medication for a mental health condition, NHS guidance says not to stop it when you discover you are pregnant without first speaking to your doctor or specialist.

People who need more specialist support may be referred to a community perinatal mental health team. These services specialise in mental health during pregnancy and after birth.

NICE guidance also recommends considering a person’s mental health history, current symptoms, treatment preferences and the possible risks associated with both treatment and leaving a mental health problem untreated.

Small ways to support yourself while getting help

Self-care is not a replacement for professional support if you are experiencing depression. It can, however, sit alongside the care you receive.

NHS pregnancy mental health guidance suggests talking about your feelings with someone you trust, making time for things you enjoy and staying active where appropriate for your pregnancy.

If everything feels difficult, think small. Eating something, having a shower, answering one message or stepping outside for a little while may be enough for that moment. There is no need to turn looking after yourself into another list you feel you have to complete.

It may also help to tell someone close to you what you are experiencing, if that feels safe and comfortable. You can be specific about what would help, such as company at an appointment or practical help with everyday responsibilities.

What if you have experienced depression before?

If you have a history of depression or another mental health condition, tell your midwife and the healthcare professional who usually manages your care.

Pregnancy does not mean you should automatically stop existing mental health treatment. NHS guidance specifically advises people taking prescribed medicines to speak to their doctor or specialist before making changes.

Depending on your history and current needs, your maternity team may involve other professionals or refer you for specialist perinatal mental health support.

If you notice your mental health changing, you can raise it at any point rather than waiting for a routine appointment.

When to get professional advice

Speak to your midwife, maternity unit or GP if you think you may have depression during pregnancy, if low mood is affecting your day-to-day life, or if you are worried about your mental health. NHS guidance encourages people to ask for support rather than waiting for symptoms to become severe.

Contact a GP urgently if you start seeing or hearing things that are not real, or develop strong beliefs that are not shared by other people. If you cannot contact a GP, NHS guidance advises using NHS 111 or going to A&E.

If you think there is an immediate danger that you might harm yourself or someone else, call 999 or go to A&E. Mental health emergencies need urgent care just as physical emergencies do.

If you are unsure where to get urgent mental health help and there is no immediate danger, NHS 111 can direct you to appropriate support.