Prenatal or antenatal depression and anxiety: signs, symptoms and treatment
Kate Langrish
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Prenatal or antenatal depression and prenatal anxiety affect around one in 10 women. Not to be confused with the rollercoaster of emotions that kick in during pregnancy, here's what they are – as well as how to spot the signs, symptoms and how depression and anxiety in pregnancy can be treated.
Urgent help: If you're feeling extremely low or having thoughts of suicide or self-harm, call the Samaritans free now on 116 123, or find your local emergency NHS helpline here.
What is prenatal – or antenatal – depression?
Prenatal depression (also called antenatal depression) is experienced during pregnancy.
Most of us have heard about postnatal depression, which can occur after giving birth, but depression during pregnancy is much less talked about.
This is despite prenatal depression affecting an estimated 10% of mums-to-be, according to the World Health Organization.
What are the signs you may have prenatal depression?
According to the NHS, the following symptoms may help you to recognise if you have prenatal depression:
- feeling sad and hopeless
- having negative thoughts about yourself
- not sleeping well or sleeping too much
- a lack of interest or pleasure in doing things or being with people
- changes in appetite
Of course, many of these symptoms are part and parcel of the emotional rollercoaster of pregnancy, so how do you know when you might need help?
‘Pregnancy can be a time of emotional challenge and flux,' explains Netmums' official midwife Leah Hazard.
‘It’s completely normal to have days when your mood is low, you question your ability to be a good parent and/or partner, and nothing seems certain anymore.
‘These feelings can all be a normal part of the adjustment to parenthood, and positive change can come from this kind of self-exploration.
‘However, it might be worth seeking help if your low days outnumber your good days, or if your mood is making it difficult for you to function within your job and/or daily life and relationships. Absolutely do seek help straight away if you are having thoughts about harming yourself.’
What causes prenatal depression?
A number of factors can trigger feelings of depression in pregnancy including:
- The physical changes to your body – like swollen boobs and the constant need to wee
- An imbalance of hormones
- Nausea or ‘morning sickness’
- A previous miscarriage or baby loss, or traumatic birth experience
- Dealing with the changes to your life that pregnancy – and motherhood – bring can feel overwhelming
- Thinking about how having a baby will change your life
- Your relationship with your partner
- Fears about how you will get by financially when you’ve had your baby
- Worries about the coronavirus pandemic and how that is affecting your life, work, family and birth plans may also play a part
More likely, it will be a combination of several factors.
‘As with any kind of mood change in pregnancy or at any time, a number of complex factors might be at play: from your hormones and your genetic predisposition to your environment and your relationships,’ explains Leah.
‘Many women find the hormonal and lifestyle changes in pregnancy and early parenthood challenging.’
What's the treatment for prenatal depression?
If you’re struggling with feelings of anxiety and depression, it’s important to let others know, so they can help.
Feeling depressed in pregnancy is quite common and not something to be embarrassed or ashamed about.
Treatment for prenatal depression may include talking therapy and, in some cases, medication.
‘It’s good to talk,' says Leah.
'Discuss your feelings with your GP and/or midwife, who can listen to your concerns and work with you to decide whether further support and treatment are needed.
‘Your local authority may have a dedicated Perinatal Mental Health Team that can provide specialist support, such as counselling or cognitive behavioural therapy.
'And if you require medication, any specialist will be familiar with drugs that are safe to take in pregnancy.’
What is prenatal anxiety or antenatal anxiety during pregnancy?
Prenatal anxiety (also known as antenatal anxiety) is anxiety that occurs during pregnancy.
According to mental health charity Mind, it's common to experience prenatal anxiety and depression together.
What are the signs you may have prenatal anxiety?
According to Mind, prenatal anxiety can cause physical and emotional symptoms including:
- a churning feeling in your stomach or nausea
- feeling light-headed or dizzy
- pins and needles
- feeling restless or unable to sit still
- faster breathing
- a fast, thumping or irregular heartbeat
- sweating or hot flushes
- panic attacks
- trouble sleeping
- feeling tense or nervous
- worrying constantly
What causes prenatal anxiety?
Although anyone can develop prenatal anxiety, PANDAS Foundation says it's may be more likely if you:
- have depression
- have had anxiety or panic attacks before, or have a family history of either of these
- have been through a traumatic event
- have used illegal drugs
- are stressed, perhaps because of financial or relationship issues
What's the treatment for prenatal anxiety?
Treatment for prenatal anxiety is similar to treatment for depression. It can involve talking therapies such as counselling or cognitive behavioural therapy and self-help therapies like breathing techniques. In some cases it may also involve medication.
If you're feeling anxious, talk to your GP or midwife so they can help find the best treatment for you.
If I have, or have had, mental health issues, am I more likely to get prenatal depression or anxiety?
Not necessarily. Everyone is different and some women with a history of mental illness are perfectly well during pregnancy.
However, the NHS says if you have mental health issues now, or have had severe mental health issues in the past, you are more likely to become ill again when you are pregnant or just after giving birth, than at other times in your life.
If you're on medication for your mental health the advice is not to stop taking it until you've spoken to your doctor. The NHS says:
'Consult your doctor or psychiatrist as soon as you decide to start trying for a baby, or as soon as you learn you're pregnant, to discuss any risks associated with taking or stopping your medicine during pregnancy and breastfeeding.
'Don't alter your drug treatment or stop taking treatment without specialist advice, especially during pregnancy.'
What are my chances of getting postnatal depression if I've had prenatal depression or prenatal anxiety?
According to PANDAs Foundation, a support group for families suffering with perinatal mental illness, many cases of prenatal depression disappear after birth. However, it says one third of women do go on to suffer postnatal depression.
‘If you have been diagnosed with depression, it’s good to be aware of your mood and put a good support network in place postnatally and in any future pregnancy,’ advises Leah.
‘It takes a strong woman to recognise and understand her needs – don’t be afraid to seek help at an early stage if you have concerns in pregnancy or about postnatal depression after you’ve had the baby.’
Will I get prenatal depression or anxiety again in my next pregnancy?
Not necessarily but there is a chance. If you're planning on getting pregnant, or once you're pregnant, be sure to remind your GP and midwife about your history with depression.
They will then monitor you closely and give you the best support to avoid getting it again.
Getting support for prenatal depression and anxiety
Antenatal depression and anxiety often go undiagnosed because of the pregnant woman's fears that it's wrong to experience negative feelings during pregnancy.
However, sharing how you're feeling may help you overcome these feelings.
As well as talking to your GP and midwife, be open with family and friends. It can be good to sign up to antenatal classes to meet other mums-to-be, and you may find the following helplines and forums useful, too:
PANDAs Foundation
PANDAS – a support group for families affected by perinatal mental illness – offers a free helpline. Manned by trained volunteers who are there to listen or offer support it's open daily between 11am and 10pm. 0808 1961 776
Netmums Parents' Support Service
In our forum we have a board dedicated to maternal mental health where you can chat to other mums-to-be and families going through similar things.
In our maternal mental health forum you can also get support and advice from a trained Parent Supporter. Our network of Parent Supporters are online between 9am and 12 noon, and 7pm and 10pm every day.
Samaritans
In an emergency, the Samaritans are always on hand 24/7.
How to protect your mental health in pregnancy
While you should seek help from your GP or midwife if you are experiencing issues with your mental health during pregnancy, the NHS says there are steps you can take to look after your wellbeing. These include:
- Eating well
- Reducing the amount of caffeine your drink as it can stop you sleeping. Too much caffeine in pregnancy has also been linked to miscarriage and low birth weight
- Not trying to do too much – it's ok to say 'no' to social engagements or ask for help doing chores like housework and shopping
- Avoiding stressful situations
- Making time to rest and relax
- Organising small treats each day such as a workout or meeting a friend to give you something to look forward to
- Involving your partner or a friend or family member in your pregnancy
Exercise is known as a time-honoured way to boost your mood. Just don't overdo it while you're pregnant; you should be able to hold a conversation while you work out.
You might not feel up to much exercise if you're suffering from pregnancy fatigue. But even a short walk can help to get your endorphins going and make you feel better.
Feeling anxious about your pregnancy? Get help and support in our chat forum, below ...
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