The Pregnant Blues: Antepartum Depression Unmasked

Baby blues, postpartum depression, pregnancy fears—some of these you may be familiar with.

But what about the pregnancy blues?

Depression during pregnancy is real and we don’t talk about it nearly enough.

That we’re only slightly better at discussing depression after childbirth makes it too easy to sweep antenatal depression under that very large rug where we hide the other taboo pregnancy topics.

And it’s that deafening silence that only makes things worse.

Yes, pregnancy is a time of change and joy, but it can also be overwhelming, exhausting, and scary.

Financial concerns, family dynamics, existing mood disorders—there’s a lot of factors that can drag the pregnancy feels down.

It’s really time we normalized the conversation.

So, join us as we unpack signs, risks, and how to help depression during pregnancy.

In this article: 📝

What are the pregnant blues?

Pregnancy can be, to use the old cliché, an emotional rollercoaster.

Your body is changing in all sorts of ways, your hormones are everywhere, and you’re about to go through a major life change.

The pregnancy hormone cocktail of hCG, estrogen, and progesterone may be leaving you feeling blissfully happy in one moment, and teary and frustrated the next.

In other words, it’s totally, utterly normal to be feeling out of sorts.

Just like feeling overwhelmed during pregnancy is almost a right of passage.

But it’s when feeling lonely while pregnant comes with endless crying spells, sadness that won’t shift, lack of energy, and a heavy sense of dread that pregnancy blues may be to blame.

Or what experts call antenatal depression.

Listen up, mama: you’re not doing anything wrong.

This is hard.

Let’s talk it through together.

What is antepartum depression

In the simplest terms, antepartum depression (or antenatal depression) is a non-psychotic clinical mood disorder experienced during pregnancy.

It can also be referred to as perinatal depression—although this is more a collective term that covers depression during and after pregnancy.

Feeling moody during pregnancy or even having moments of loneliness, sadness, and sheer tiredness is a common experience felt by many mamas-to-be.

But antepartum depression stands out for its similarity to major depressive disorder.

Simply put, when it’s been more than two weeks, and your low mood shows no end in sight, and you’re just not coping with pregnancy, it’s a solid sign intervention is needed.

What are the triggers of antenatal depression?

Antenatal depression (or antepartum depression) can just happen. To anyone. For no reason at all.

This is not a failing on your part, nor is it a reflection on your abilities as a new mom.

There’s no clear-cut answer as to why—income level, race, age, and culture mean little—our minds are complicated.

But there are certain conditions or risk factors that may increase someone’s chances:

• Experiencing other mood disorders: Recent research found a metabolomic similarity between antepartum depression and anxiety and non-pregnant depression.
  
• No emotional support during pregnancy: Studies have pointed to a link between low social support and increased risk of third-trimester depression.
  
• Hormonal imbalance: Growing research is revealing the impact of hormonal dysregulation on the HPA axis (hypothalamic-pituitary-adrenal axis—the neuroendocrine system that controls our responses to stress.
  
• An unintended pregnancy: Several cohort studies found a link between unplanned pregnancy and higher levels of depressive symptoms.
  
• Having had a miscarriage before: It may come as little surprise that women who have experienced pregnancy loss consistently report anxiety and prenatal depression during their second pregnancy.
  
• Experiencing any sort of violence: Intimate Partner Violence (IPV)—including emotional, physical, and sexual violence—can increase the risk of depression and anxiety in pregnancy.
  
• Chronic stress: Going through other stressful situations while pregnant—financial, relationship, work, etc.—may increase odds of experiencing antepartum depression.
  
• Struggling with substance abuse: One 2009 study found a connection between opioid use during pregnancy and depressive disorders.
  
• Trouble sleeping: Medical research has found a jarring link between poor sleep quality and feeling suicidal during pregnancy.
  
• Poor nutrition: A wealth of studies connected perinatal depression with low levels of vitamin D, folate, zinc, iron, and fatty acids.

Symptoms of depression during pregnancy

Let’s be clear: Depression is more than feeling emotional, moody, or not excited about pregnancy.

It’s a mood disorder that requires treatment.

Symptoms of antenatal depression can look very similar to postpartum depression (PPD).

These include:

• Unshakable emotional, irritable feelings or mood swings
  
• Struggling to find enjoyment in things you love
  
• Serious brain fog or difficulty concentrating
  
• Major fatigue or inexplicably low energy
  
• Feeling guilt, shame, or that you’re not enough
  
• Trouble sleeping
  
• Stark changes in appetite
  
• Low libido and lack of interest in intimacy
  
• Losing weight during pregnancy
  
• Isolating yourself from the people you love
  
• Suicidal thoughts while pregnant

Is it normal to feel depressed while pregnant?

Research stats give every indication that an unhappy pregnancy is as much a reality as a glowing, joyful one.

And the pressure on women to feel positive throughout their pregnancy is failing them.

According to this 2021 study of 343 pregnant mamas observed, antenatal depression showed up in about one in four pregnancies.

So, by no means a rare phenomenon.

In fact, the same paper indicates that roughly 25-35% of pregnant women experience depression during pregnancy and of those, 20% meet the criteria for major depression.

Is it normal to feel alone during pregnancy?

It’s not ideal, but it’s a valid feeling experienced by many moms on Peanut.

Whether it’s because you’re the first of your circle to have a baby (or even the last), or you lack family support, feeling lonely in pregnancy is unfortunately common.

But just because an experience is shared doesn’t mean it’s the norm. And it certainly does not mean it has to stay that way.

When you’re feeling intense emotions like sadness or uncontrollable anger during pregnancy, it’s only too easy to create distance from triggers—which includes people.

But support comes in many forms, including support groups (like the many mini-communities on Peanut), online forums, or even a therapist.

The point is, there are steps you can take to navigate loneliness during pregnancy.

And if you feel utterly unable to take even the first small one, it’s worth checking the symptoms list again to explore if depression is what’s holding you back.

Is it bad to cry a lot during pregnancy?

No. It’s normal.

Just like it’s normal to feel sad, confused, and anxious.

And sometimes weirdly aroused (but that’s a conversation for a different day).

There can be a lot to cry about when you’re pregnant.

Those hormonal changes, for one, especially in the first trimester when estrogen and progesterone levels are on the upswing.

(So, if you’re experiencing early pregnancy crying spells, that’s probably why.)

And then there’s the fact that your body is hurting and swelling in all sorts of places.

Not to mention the healthy grieving of an old life (and the unknown of a new one).

So yes, randomly crying during pregnancy is totally normal.

It’s when the crying spells stay persistent that red flags appear.

Does crying during pregnancy affect the baby?

There’s no indication that a random crying session causes any harm to your baby or that they even feel it.

So, feel free to release those tears.

But uncontrollably crying every day during pregnancy may be a different story.

This is more down to the factors and emotions fueling those feelings than the actual crying itself.

For example, a 2007 study found that stress and emotional issues during pregnancy could increase your chances of having an excessively crying baby.

Antepartum depression, on the other hand, can impact your pregnancy and the health of your baby—possibly contributing to low birth weight and preterm delivery.

And then there’s the potential emotional connection between mom and fetus.

More on this just below.

Do negative thoughts during pregnancy affect baby?

You’re so intensely super connected to that little being growing inside you.

To the point that they can quite literally sense what you sense—and, yes, feel what you feel.

And it may be down to the placenta.

Research seems to show that chemical signals can be passed from mom to baby through the placenta, directly altering their environment in your womb.

It also shows that consistency in your psychological state before and after pregnancy has an impact on baby’s development after they’re born.

And if that state is one of high stress and dysregulation, especially early in pregnancy, there’s an increased risk of delayed fetal maturation, disrupted emotional regulation, and poor cognitive performance during infancy.

Now, this doesn’t mean that you have to be cheery all the time.

But it does mean that self-care matters (it always does and always will).

Prioritizing your mental health is not a luxury, it’s essential to you and your baby’s well-being.

So when those first trimester blues look set to become third trimester blues, reach out.

There’s a hand waiting for you.

Connection is everything.

How to treat depression during pregnancy

Chatting with your healthcare provider is the most crucial step you can take in treating depression during pregnancy—and that can be as soon as you feel you’re at higher risk of experiencing it.

It’s worth noting that your antepartum depression symptoms will be entirely unique to you.

So, it’s possible to feel disconnected, unmotivated, and depressed without crying spells or low appetite.

You don’t need to hit the perfect mix of symptoms to secure a diagnosis.

But how your antenatal depression shows up will influence your treatment plan.

Some possible avenues include:

• Taking antidepressants: Your doctor will have a list of safe antidepressants during pregnancy that you can take. The most common ones are selective serotonin reuptake inhibitors (SSRIs) like Celexa (citalopram) and Zoloft (sertraline).
  
• Therapy for pregnancy: You may be advised to avail of counselors or therapists who specialize in talk therapy/psychotherapy specific to pregnancy and mental health. Cognitive behavioral therapy is another empowering option that gives you more control over negative thoughts.
  
• Support groups: It takes a village to raise a child and a community to keep mama lifted. Your healthcare provider can provide a list of local pregnancy support and advocacy groups.

Your healthcare provider might even use a combination of options depending on your situation.

Anterpartum depression is often best tackled through a holistic approach that treats your mind and body.

So alongside therapy and medication, you may also be encouraged to include natural ways to help depression while pregnant, like improving nutrition or increasing daily movement.

What happens if you don’t treat depression (during pregnancy)

We’ll say it again: antepartum depression impacts so much more than your mental state.

And it’s definitely not a bout of pregnancy blues that clears up on its own.

Severe depression tends to stick around if left untreated and, when you’re pregnant, can lead to serious health risks even after childbirth.

Studies show the most common effects of untreated depression during pregnancy include:

• Postpartum depression
  
• Developing chronic anxiety disorders
  
• Paternal depression
  
• Lower gestational age
  
• Increased risk of c-section
  
• Low birth weight
  
• Pregnancy complications

And that includes long-term effects on baby too:

• Impaired neurodevelopment
  
• Learning difficulties
  
• Behavioral issues
  
• Difficulty managing emotions
  
• Increased risk of mood disorders like antisocial or borderline personality

Can depression cause miscarriage?

Some studies do suggest a link between depressive disorder and pregnancy loss.

For example, one 2022 study found that out of the 16.6% miscarriages studied, 1.25% were due to depression.

Other research found that depression or anxiety alone can increase the risk of recurrent pregnancy loss.

There’s much more research still needed to be done, but experts are pointing toward the importance of antepartum depression intervention.

At the very least, it gives you the validation that your emotions deserve to be heeded and supported.

There’s no other way to slice it; antepartum depression is serious.

But help is out there.

It’s a lot to take in.

The most important takeaway as you make those first steps toward relief is this:

You matter.

You’re not alone.

You will get through this.

We’ve got you. 🫶