Depression doesn’t always wait until after pregnancy

Postpartum depression (PPD) is a serious and common condition that is finally starting to get more recognition and airtime thanks to clinicians, survivors, and advocates who are working really, really hard to erase stigmas and raise awareness. This is a good thing.

The fact that isn’t discussed nearly as often is that depression doesn’t always wait until after childbirth – it can, and often does, start during pregnancy. “Perinatal” is a term that refers to the time during pregnancy and up to a year after birth, and more accurately covers the time during which hormones and life changes can wreak havoc on a woman’s mental health. Perinatal depression that starts during pregnancy can be even scarier than the postpartum kind, especially because many women don’t know it exists.

The symptoms for postpartum and prenatal depression are mostly the same, including persistent feelings of sadness and loss of interest in things you once enjoyed. And some of the symptoms sound an awful lot like just being pregnant – like changes in sleep, appetite, and energy level – so it may be tempting to dismiss those “off” feelings as just part of the deal.

There are a few less-common symptoms that are unique to prenatal depression. They include excessive anxiety about your baby or upcoming delivery; low self-esteem and strong feelings that you’re not going to be a good mom; smoking, drinking, or using drugs during pregnancy; and avoiding prenatal care. Bottom line: if your mood and energy level are lower than low for days or weeks and you’re experiencing any of these other signs, it may be prenatal depression.

While the American College of Obstetricians and Gynecologists recommends that healthcare professionals screen women for mood disorders like depression and anxiety at least once during their pregnancy, the reality is that most women are not screened. That makes it even more important for expectant moms and their partners to be on the lookout for signs that something isn’t right.

Like postpartum depression, prenatal depression is treatable with professional help. But because childbirth introduces a whole new set of circumstances like sleepless nights and other wacky hormone surges, it’s essential to treat prenatal depression before it turns into postpartum depression, which can have lasting effects on both mom and baby. The biggest risk factor for postpartum depression is depression during pregnancy.

There’s a lot of pressure for pregnancy to be an incredibly happy time in a woman’s life (Decorating the nursery! Gender reveals! Showers!). But if you’re feeling really down most days, those expectations can feel like an overwhelming challenge to just put on a happy face. Instead, tell your OB/GYN how you’re feeling. They can help connect you with a therapist in your area to work through those feelings and help you feel better soon.

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If you feel that you’re in deep depression and you fear that there is immediate danger, such as self-harm or harm to your baby, please call 911 or 1-800-SUICIDE (1-800-784-2433) for help.

To find support and resources outside of Western PA, contact Postpartum Support International at or call 1-800-944-4773.

To find out more information about how AHN Women is innovating the treatment of postpartum depression and anxiety, follow AHN on Instagram, Twitter and Facebook.

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