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Having a baby is a big change for most people, but if you also have problems with depression, it can be even more stressful. It's important to get the right support. Here we explain what depression during pregnancy is and how you can get help.

What is depression during pregnancy?

Pregnant depression, or prenatal depression, refers to depression that occurs during pregnancy. It is a form of clinical depression that can affect expectant mothers at any time during pregnancy.

Like other types of depression, it is characterized by feelings of sadness, anxiety, emptiness, and a loss of interest in previously enjoyable activities. Depression in pregnancy can have a major impact on the pregnant woman, the development of the fetus and later attachment, making it important to identify and treat the condition.

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What causes depression in pregnancy?

Depression in pregnancy can be caused by a mixture of hormonal changes, genetic factors, personal stressors and health problems. Hormonal shifts that occur during pregnancy can affect mood, and women with a history of depression or a family history of mental health conditions are particularly vulnerable.

Stress related to pregnancy, financial worries, relationship problems, as well as health complications for both the mother and the fetus, can also play a role. Lack of social support, previous experiences of abuse or trauma, and negative feelings about body changes and self-image can increase the risk.

Early detection and treatment, which may include psychotherapy and, in some cases, medication, is important to support the wellbeing of both mother and baby.

Symptoms of depression during pregnancy

The symptoms of depression in pregnancy can be similar to those of clinical depression, but they occur specifically during the pregnancy period. It can be particularly difficult to identify depression in pregnancy because some symptoms, such as fatigue or changes in sleep and eating patterns, can resemble normal symptoms in pregnancy. However, here are some specific signs and symptoms that may indicate depression during pregnancy:

  • Persistent sadness, anxiety or “emptiness”: Feelings of hopelessness and helplessness that don’t go away and affect daily activities.
  • Loss of interest or pleasure: A noticeable decrease in interest or pleasure in activities that are normally satisfying, including lack of interest in the pregnancy.
  • Changes in appetite and weight: Significant weight loss or gain not directly related to pregnancy, or changes in eating behavior.
  • Sleep problems: Difficulty falling asleep, sleeping through the night, or excessive sleepiness.
  • Increased irritability or frustration: even over small or insignificant things.
  • Feelings of worthlessness, guilt or self-criticism: especially guilt about pregnancy or being a good parent.
  • Loss of energy and fatigue: Feelings of exhaustion and lack of energy for daily tasks, beyond what can be expected from pregnancy.
  • Difficulty concentrating, remembering details or making decisions: Cognitive changes that affect work and daily activities.
  • Recurrent thoughts of death, suicidal thoughts or suicide attempts: thoughts of harming oneself or the baby.

It is important to distinguish between common pregnancy symptoms and signs of depression. If a pregnant woman experiences any of the above symptoms to a degree that affects her quality of life, it is important to seek professional help. Treatment for depression during pregnancy can include psychotherapy, support groups and in some cases medication, all under the close supervision of a health care provider.


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PTSD

Pregnancy can trigger or worsen post-traumatic stress disorder (PTSD) in women with a history of trauma, such as sexual or physical violence. Hormonal changes, increased stress, and fear of childbirth can intensify PTSD symptoms such as flashbacks, avoidance behaviours, negative thoughts, and increased irritability. Interactions with health care providers can also trigger traumatic memories. Treatment is important for the health of both mother and child and may include psychotherapy, such as cognitive behavioral therapy or EMDR, and possibly medication after risk assessment. Early intervention with healthcare providers is crucial for a safer pregnancy and delivery.

Postpartum psychosis

Postpartum psychosis is a rare but serious mental illness that occurs in women shortly after childbirth, usually within the first two weeks. This condition is characterized by extreme mood swings, confusion, hallucinations, delusions, anxiety and difficulty sleeping. The risk of postpartum psychosis increases with factors such as genetic predisposition, hormonal changes after childbirth, lack of sleep and a history of mental illness. Treatment, which usually requires hospitalization, may include antipsychotic and mood-stabilizing medications, as well as supportive psychotherapy and family support. Early treatment is critical to recovery, and most women recover fully with the right care. If you have symptoms of psychosis, you should contact 112 or the nearest emergency room.


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Treatment of depression during pregnancy

Treatment of depression during pregnancy includes psychotherapy, such as cognitive behavioral therapy and interpersonal therapy, while drug treatment with antidepressants, especially SSRIs, may be carefully considered by the treating physician. Lifestyle changes such as exercise, good sleep, a nutritious diet and stress management are also important. Early intervention and collaboration between the pregnant woman, her family and health care providers are essential to ensure effective treatment and protect the health of both the mother and the baby.

Depression in family members during pregnancy

Expectant fathers and other family members can also become depressed during pregnancy. It can be triggered by emotional stress, financial worries, concerns and fears about the future and parenting, and lack of support. The symptoms are similar to typical depression symptoms and treating this form of depression often involves therapy and sometimes medication, with an emphasis on the importance of communication and lifestyle factors. Recognizing and managing paternal prenatal depression is crucial to giving both expectant mothers and fathers the support they need during pregnancy.


12 frequently asked questions about depression in pregnancy

What is depression in pregnancy?

Pregnant depression, or prenatal depression, refers to depression that occurs during pregnancy. It is a form of clinical depression that can affect expectant mothers at any time during pregnancy.

What are the symptoms of depression in pregnancy?

The most common symptoms include persistent sadness, lack of energy, sleep problems, anxiety, a reduced appetite, and feelings of guilt and inadequacy. Consultation with a psychologist or therapist can help make a diagnosis.

How is depression during pregnancy diagnosed?

Diagnosing depression is usually done through interviews and questionnaires that assess your well-being. If you have symptoms, go to your health center or BVC.

How is depression in pregnancy treated?

Treatment options often include a combination of medication, therapy and lifestyle changes. Cognitive behavioral therapy (CBT) is a common form of psychological treatment.

Can lifestyle factors help?

Yes, lifestyle factors such as exercise, keeping a routine, eating well, trying to sleep, asking for help and spending time with people you trust can be helpful.

How long is a treatment for depression?

The length of treatment depends on the severity of the depression and is tailored to the individual.

Can depression affect my relationship with my child?

Yes, depression can affect both how you feel during pregnancy and your relationship with your child, so it is important to seek help if you experience symptoms.

What to do if you have experienced trauma and are pregnant?

If you have experienced trauma and have symptoms of PTSD, it is important to talk to your healthcare provider about it so that it can be taken into account in your treatment plan.

What other problems can occur during childbirth?

You may also experience anxiety or the very serious condition of postpartum psychosis. If there are symptoms of psychosis, you should contact an emergency room or call 112.

What can I do if I feel uncomfortable after coming out of depression?

If you experience symptoms of depression, it is important to seek professional help. Our psychologists and therapists are available for online or face-to-face consultations and can help you make the difficult things easier.

Can I be depressed as a family member?

Family members can also experience depression as a result of having a child and the changes that come with it. In this case, it is also important to seek help.

Where can I get help?

If you experience symptoms of depression, it is important to seek professional help. Turn to your health center or BVC in the first instance. If you experience acute symptoms, contact 112 or emergency psychiatry.

Tips for managing depression during pregnancy

Treatment of depression during pregnancy is mainly done through a health center or a BVC clinic, but here is an overview of the steps that can be included in therapy.

Step 1: An initial assessment session

The first meeting with your psychologist or therapist is usually a diagnostic evaluation to review your mental and physical health. You may be asked questions about your life situation, feelings, thoughts and behaviors. You may also be asked to complete assessment forms specific to depression in pregnancy.

Step 2: Goal setting

This is where you and your therapist set concrete goals for the therapy, both short and long term.

Step 4: Treatment

This is the start of the actual treatment phase, which may include treatment such as Cognitive Behavioral Therapy (CBT) but also medication if necessary. The therapy may include exercises and homework assignments aimed at giving you tools to change the way you feel.

Step 5: Monitoring and evaluation

Treatment is monitored regularly to see how well the therapy is working. If necessary, the treatment plan can be adjusted or renewed.

Step 6: Ending and looking ahead

As the therapy comes to an end, it is time to reflect on the progress made. You will also receive a plan on how to use the tools and strategies you have learned in the future.

If you or someone close to you is seeking professional help for depression, do not hesitate to seek help as it can prevent future problems. If you feel very bad and have thoughts of harming yourself, contact emergency psychiatric services or call 112.

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Written by Ellen Lindgren

Licensed psychologist

Ellen is a licensed psychologist and has experience mainly in clinical psychology where she has worked with various conditions such as stress, anxiety, depression, insomnia, crises and trauma in primary care and psychiatry. She has also worked with research while studying in the US and with affective disorders and insomnia at Karolinska Institutet, Sweden.