Depression in pregnancy: signs, getting help and knowing you are not alone

Pregnancy is often described as a “happy time”. That is why feeling sad or empty can leave you feeling alone or guilty. Yet depression in pregnancy affects many people. It is not a character weakness and it is not your fault.

What is depression in pregnancy?

Depression is a long-lasting state of low mood and loss of interest. In pregnancy, many things can play a part: hormonal changes, sleep, past experiences, relationships, money worries and lack of support. It is often not possible to point to a single cause.

Depression differs from a passing low mood: it lasts for weeks and affects daily life.

Which signs should you watch for?

If several of the following last most days for at least two weeks, it is a good idea to note them down and talk about them:

• Feeling constantly sad, empty or hopeless
• Losing interest in things you used to enjoy
• Extreme tiredness or lack of energy
• Trouble sleeping, or sleeping far too much
• A marked drop or rise in appetite
• Difficulty concentrating, trouble making decisions
• Feelings of worthlessness or guilt
• Difficulty bonding with the baby
• Thoughts of death or of harming yourself

Some signs can resemble the normal effects of pregnancy, such as tiredness. That is why it is safer to sort this out together with your doctor.

Why is asking for help important?

Untreated depression can affect your quality of life and the time after birth. The good news: there are effective forms of support. They include talking therapy, support groups and, when needed, treatment under medical supervision. Only your doctor can decide with you whether medication is needed; do not start or stop anything on your own.

Who can support you?

• Your midwife or obstetrician: often the easiest first step
• Your family doctor
• A psychiatrist or psychologist
• Someone you trust: a partner, family member or friend
• Local health services and hospital mental health units: check your health authority's website for current information

What may help alongside care?

These do not replace treatment, but they can be supportive:

• Set one small goal a day, such as a ten-minute walk if your doctor agrees
• Keep regular meal and sleep times
• Get some daylight
• Keep some contact with people, even if brief
• Tell someone close to you how you feel
• Tell yourself that you are good enough; you do not have to be perfect

For partners and loved ones

Listening instead of trying to fix things, asking “what can I do?” and going along to appointments is very valuable. Sentences like “pull yourself together” usually do not help.

When to contact your doctor

• If sadness or lack of interest lasts longer than two weeks
• If you struggle with daily tasks
• If sleep and appetite have changed markedly
• If you think about dying or harming yourself, call 112 (or your local emergency number) without waiting or go to the nearest emergency department, and keep someone with you

This article is for information only and does not replace a diagnosis; your doctor's advice for your personal situation comes first.