It’s Not a Mood Swing: Depression During Pregnancy

Hi Amy,

I have been reading your Pregnancy Week by Week  and it’s been a big help. Your humor really helps me feel less alone.

My question is this: How can you tell what are normal mood swings?

I want to preface this by saying that I would never ever harm myself or my little girl (I am 20 weeks 3 days along). Ever. I am not worried about doing anything crazy, I am just so sick of having these awful thoughts. I’ve never been depressed before, but ever since I got pregnant, whenever I feel down I don’t just feel a little sad- I feel the all out “what’s the point of anything nothing matters, I’m just going to stay in bed and hope I disappear” sort of despair.

I’ve tried talking to my husband, but I’ve just made him so worried for me, and it ends up turning into me reassuring him and pretending I feel better because I don’t want to make things harder for him. He doesn’t try to make me feel worse, but when he tries to cheer me up he tells me how proud of me he is for everything I’m doing, and I just feel this overwhelming guilt on top of the hopelessness that I already feel.

I also haven’t mentioned anything to my doctor, but that’s mostly just because I know I’m not suicidal, and I don’t feel comfortable talking to him about it anyway.

Is there anything I can do to help myself from feeling so awful? I don’t feel like that all the time; I’m usually happy, excited to meet our little girl, and very active. My diet is great, weight gain is healthy, and I work out. I have a lot of good days. But the bad days are horrible, and sometimes they really get in the way.

Any advice would be greatly appreciated.

Thanks,
A

Ack ack call a doctor call a doctor.

I am not a doctor, so while I obviously am not qualified to make any sort of diagnosis via email and the Internet Tubes, I am going to be blunt and brutal here and say that no, these mood swings do not sound “normal” to me. They sound like prenatal/antenatal depression. Which is a thing that absolutely exists, and sadly does not get talked about enough. One in 10 pregnant women will suffer from some form of anxiety or depression during pregnancy. ONE IN TEN.

What you’re describing — good days mixed with overwhelming feelings of sadness, hopelessness and guilt — are all telltale symptoms of a clinical depression, very likely linked to your pregnancy hormones. It’s not something you can control, it’s not something you caused in any way…but it’s not something you can just sort of…mash down and ignore and hope for the best. YOU NEED TO CALL A DOCTOR.

If you don’t feel comfortable talking to your OB about this, get a new OB, or call your primary care physician or a mental health professional. Stop downplaying your feelings because you’re not suicidal or having thoughts of harming yourself. Your mental health is just as important as your physical health. Not to mention that untreated depression can very much escalate and go on to affect you physically.

It can also lead to pregnancy complications and preterm labor. Yes. Fact.

Which is why you need to TELL SOMEONE (other than your husband) exactly what you wrote here: You’re not just feeling a little down from time to time, you’re veering into “nothing matters” pits of despair, overwhelming guilt, pretending to feel better so you aren’t a burden, unpredictable mood swings despite staying active and working out and having — by all other measures — a healthy, happy, wanted pregnancy.

Again: This isn’t your fault. This is a very common pregnancy symptom that has nothing to do with you or your ability to mother and love your baby. It’s like morning sickness or gestational diabetes, but in your brain chemistry. And while it’s “common” it’s NOT something you can ignore and not talk your doctor about because you feel guilty, silly or embarrassed. You can’t just will yourself out of this, or go on pretending that you’re fine, just fine, I swear I’m fine.

You asked what you can do to help yourself from feeling so awful. You can do that by asking for help from someone qualified to help.

Here is  a list of other resources on prenatal/antenatal depression and anxiety. Read them, use them, then please please please talk to someone in real life about how you’re feeling.

Depression in Pregnancy (American Pregnancy Association)

Depression During Pregnancy (postpartum.net)

Depression During Pregnancy (Baby Center)

Pre/Antenatal Depression (PANDAS)

Depression During Pregnancy (Postpartum Progress)

The Truth About Prenatal Depression (SheKnows)