Anxiety and Depression During Pregnancy: Signs, Symptoms and Getting Help

Anxiety and Depression During Pregnancy: Signs, Symptoms and Getting Help

Pregnancy can bring a wide range of emotions. Alongside excitement and anticipation, it is common to experience uncertainty, worry, tiredness, irritability or periods of low mood as you adjust to physical changes and the prospect of becoming a parent.

For some women, anxiety or low mood becomes more persistent, more intense or begins to interfere with everyday life. When this happens, it may be a sign of antenatal anxiety or depression.

Antenatal means during pregnancy. Antenatal anxiety and depression are part of what health professionals refer to as perinatal mental health, which covers pregnancy and the period after birth.

Anxiety and depression during pregnancy are recognised mental health conditions. They are not a sign of weakness or failure, and experiencing them does not mean you will be a bad parent. Effective support and treatment are available.

What is antenatal depression?

Antenatal depression is depression that occurs during pregnancy. It affects the way you feel, think and function and is more than simply having a difficult day or experiencing the normal emotional ups and downs that can accompany pregnancy.

Depression does not have a single cause. It is usually influenced by a combination of biological, psychological, social and life factors. A personal or family history of depression or other mental health difficulties may increase vulnerability, as can stressful life events, relationship difficulties, limited support or other significant pressures.

Sometimes symptoms of depression can be difficult to recognise during pregnancy because tiredness, changes in sleep and appetite, and reduced energy can also occur as part of pregnancy itself. What matters is the overall pattern of symptoms, how long they have been present and how much they are affecting your wellbeing and daily life.

Symptoms of depression during pregnancy

You may be experiencing antenatal depression if you have had persistent low mood or loss of interest or pleasure for at least two weeks, together with several other symptoms.

Symptoms may include:

  • Ongoing sadness, low mood or feeling emotionally flat
  • Loss of interest or pleasure in activities you would normally enjoy
  • Feelings of worthlessness, hopelessness or excessive guilt
  • Low energy or persistent fatigue that feels greater than expected
  • Difficulty concentrating, thinking clearly or making decisions
  • Changes in appetite that are not simply related to pregnancy
  • Difficulty sleeping or sleeping much more than usual
  • Feeling unusually restless or slowed down
  • Withdrawing from family, friends or activities
  • Recurrent thoughts about death, self-harm or suicide

Depression affects different women in different ways. Symptoms can range from mild to severe, and you do not need to experience every symptom to benefit from seeking support.

What is antenatal anxiety?

Worry is a normal part of pregnancy. You may have concerns about your baby’s health, pregnancy complications, birth, becoming a parent, changes to your relationships or how life will look after your baby arrives.

Antenatal anxiety becomes more concerning when worry or fear is persistent, difficult to control, causes significant distress or begins to interfere with your daily life.

Anxiety during pregnancy can occur for the first time, return after an earlier period of anxiety, or continue from a condition that was present before pregnancy. Anxiety and depression can also occur together.

Symptoms of anxiety during pregnancy

Symptoms of antenatal anxiety may include:

  • Ongoing or excessive worry that is difficult to control
  • Persistent fears about your baby’s health or development
  • Fear about pregnancy, birth or your ability to cope as a parent
  • Feeling constantly on edge or unable to relax
  • Racing or repetitive thoughts
  • Irritability
  • Restlessness
  • Difficulty concentrating
  • Difficulty sleeping because of worry or anxious thoughts
  • Physical symptoms such as trembling, sweating, dizziness, a racing heart or shortness of breath
  • Avoiding situations, appointments or activities because of fear or anxiety

Anxiety can take different forms, and not everyone will experience the same symptoms. If worry is becoming difficult to manage or is affecting your ability to function, it is worth talking with a health professional.

Why can anxiety and depression develop during pregnancy?

There is usually no single reason why someone develops anxiety or depression during pregnancy. A range of factors can contribute, and these will be different for every woman.

Factors associated with increased vulnerability may include:

  • A personal or family history of depression, anxiety or other mental health conditions
  • Previous perinatal mental health difficulties
  • Stressful or traumatic life experiences
  • Relationship or family difficulties
  • Limited social or practical support
  • Financial, housing or employment pressures
  • Pregnancy complications or concerns about the baby’s health
  • Previous pregnancy loss, infertility or a difficult fertility journey
  • Major changes in identity, relationships or expectations about becoming a parent

Having one or more risk factors does not mean you will develop anxiety or depression. Similarly, some women experience these conditions without any obvious risk factors.

How do I know if what I am feeling is more than normal pregnancy worry?

There is no single test you can use on your own to determine whether you have anxiety or depression. A useful starting point is to consider how persistent and intense your symptoms are and how much they are affecting your life.

Consider seeking extra support if:

  • Your low mood or loss of interest has persisted for two weeks or more
  • Your worry or anxiety feels persistent or difficult to control
  • Your symptoms are becoming more severe
  • You are finding it difficult to manage your usual daily activities
  • Your sleep, relationships, work or ability to care for yourself are being significantly affected
  • You are withdrawing from people or activities that would normally support you
  • You feel unable to cope on your own

You do not need to wait until symptoms become severe before asking for help. Getting support early can make it easier to understand what is happening and identify the type of help that may suit you.

Screening for anxiety and depression during pregnancy

Mental health is an important part of antenatal care. Australian perinatal mental health guidelines recommend that women are offered screening for symptoms of depression and anxiety, along with assessment of relevant psychosocial factors, during pregnancy.

Screening questionnaires can help identify women who may benefit from further assessment, but they do not provide a diagnosis on their own. If screening suggests you may be experiencing significant anxiety or depression, your midwife, GP, obstetrician or another health professional can talk with you further about your symptoms and the support available.

Getting help for anxiety or depression during pregnancy

Antenatal anxiety and depression are treatable. The type of support that is appropriate will depend on your symptoms, their severity, your circumstances, your preferences and any previous mental health history.

A good first step can be to speak with your GP, midwife, obstetrician or another health professional involved in your pregnancy care. They can help assess what you are experiencing and discuss suitable treatment and support options.

Psychological treatments, including cognitive behavioural therapy, can be effective for perinatal depression and anxiety. Other forms of treatment may also be appropriate depending on your individual needs. If medication is being considered, or if you already take medication for a mental health condition, discuss this with your doctor rather than stopping or changing medication without medical advice.

Online support during pregnancy

Mum2BMoodBooster is a free, evidence-based online cognitive behavioural therapy program designed specifically for women experiencing depression, anxiety or feeling overwhelmed during pregnancy.

The program includes six structured online sessions, interactive exercises, personalised activities, mood monitoring and practical cognitive and behavioural strategies tailored to pregnancy. It can be accessed privately from home and completed at your own pace.

For women experiencing milder emotional difficulties, the MindMum app provides practical tools for managing emotional ups and downs during pregnancy and early parenthood. It includes strategies for dealing with sadness and worry, tracking your mood, relaxation and planning activities that support emotional wellbeing.

You can also visit MumSpace for evidence-based information, self-assessment tools and mental health programs for pregnancy and early parenthood.

When to seek urgent help

If you are thinking about harming yourself, having thoughts of suicide, feel unable to keep yourself safe, or are experiencing severe distress, seek urgent professional help immediately.

Contact emergency services, attend your nearest emergency department, or use an appropriate crisis or urgent mental health service. Do not stay alone if you feel you may be at immediate risk.

You do not have to manage this alone

Anxiety and depression during pregnancy can be difficult and sometimes frightening, particularly when you expected pregnancy to be a happy time. Experiencing emotional difficulties does not mean you have failed, and it does not define the kind of parent you will be.

Recognising that you are struggling and seeking support are important steps. Whether your symptoms are mild and beginning to affect your wellbeing, or more persistent and difficult to manage, help is available.

With appropriate support and treatment, many women recover from antenatal anxiety and depression and go on to experience improved emotional wellbeing during pregnancy and after their baby is born.