The Pregnancy Symptoms We Don’t Talk About: Prenatal Depression and Anxiety

If you’ve been following this blog in real time, you’ll have noticed that it’s been a few weeks (okay… a few months) since I’ve last put my metaphorical pen to paper.

I started this blog with BIG PLANS to write consistently. To show up once a week, connect with you all, and share birth research and evidence. 

But there’s a big reason why that hasn’t happened. My life rapidly changed between when I first dreamed up Expecting Evidence and when I started writing weekly posts.

No, I don’t mean finding out that I am pregnant.

Pregnancy wasn’t the most unexpected change in my life. It’s something that is infrequently discussed. That many pregnant and birthing people do not know about. And that surprises many pregnant and birthing people, their partners, families, and friends.

It’s prenatal anxiety.

The Missing Conversation Around Mental Health in Pregnancy

In my personal experience as a doula and birth researcher,  people are increasingly aware that mental health and having a baby are connected. Over the past few years, I’ve seen more social media posts and educational outreach about postpartum depression and anxiety than in the rest of my career combined. More people are finally talking about postpartum mental health, and that’s an incredible step forward.

What seems to get lost in these conversations, however, is that mental health isn’t just a concern after the baby arrives. Postpartum depression and anxiety are real, and they deserve attention. But so does prenatal depression and anxiety.

Prenatal depression and anxiety refer to mood and anxiety disorders that occur during pregnancy. Just like postpartum mental health disorders, these conditions can be severe and life-altering, affecting not only the pregnant person but also their ability to engage in daily life, maintain relationships, and prepare for birth and parenting (Biaggi et al., 2016).

What Causes Prenatal Depression and Anxiety?

Prenatal depression and anxiety can stem from a variety of sources. Some of these are external: financial stress, relationship dynamics, uncertainty about the future, or fear of birth and parenthood (Bayrampour et al., 2018). Pregnancy is a time of massive life changes, and the pressure to feel joyful or excited can make it even harder to admit when you’re struggling.

But it’s not just external stressors. There are biological factors at play, too. Pregnancy hormones shift rapidly, affecting neurotransmitters in the brain that regulate mood and stress responses (Glover, 2014). For some, this hormonal shift creates a sense of well-being. For others—especially those with a history of anxiety or depression—these changes can trigger or worsen mental health struggles (Ross & McLean, 2006).

In fact, research shows that people who have previously experienced mental health conditions are at higher risk for prenatal depression and anxiety (Dennis et al., 2017). This risk increases if they have experienced significant stress or trauma in the past. Yet, despite this, many people are caught off guard when these feelings arise during pregnancy.

What Helped Me Manage My Mental Health During Pregnancy

As someone who has struggled with mental health before, I had a feeling that pregnancy might be a challenge in this area. The first thing I did when I found out I was pregnant was reach out to a therapist who specializes in perinatal mental health.

Talking to a professional early on helped me recognize what was happening and put strategies in place before my anxiety became overwhelming. If you’re pregnant or planning to be and have a history of mental health struggles, I highly recommend seeking out a perinatal therapist before you’re in crisis. They can help you navigate these emotions, validate your experiences, and provide concrete coping mechanisms (Howard et al., 2014).

I also realized that one of my biggest triggers was social media.

Pregnancy content on social media can be overwhelming. There are endless opinions, misinformation, and fear-based narratives that can fuel anxiety instead of calming it. For me, stepping away from Instagram and pregnancy forums was one of the best things I did for my mental health.

I took a break from social media because I needed space to experience my pregnancy without constantly comparing it to someone else’s. The pressure to do everything “right” or have the “perfect” pregnancy is real—and for me, scrolling through curated snapshots of other people’s journeys only made my anxiety worse.

Why We Need to Talk More About Prenatal Anxiety and Depression

This blog post isn’t just about me—it’s about the millions of pregnant people who are struggling with their mental health and don’t realize they’re not alone.

We need to normalize conversations about prenatal anxiety and depression. We need to acknowledge that mental health challenges don’t start at birth and that struggling during pregnancy doesn’t mean you’re failing or that you won’t love your baby.

If you’re feeling overwhelmed, anxious, or depressed during pregnancy, you are not alone. You deserve support, and help is available. Talking about it—whether with a friend, a partner, a therapist, or even in a blog post like this—is the first step toward change.

TL;DR

• We talk a lot about postpartum depression and anxiety, but prenatal mental health struggles are often overlooked.

• Prenatal depression and anxiety can be caused by a mix of external stressors (finances, relationships, fear of birth/parenting) and biological factors (hormonal changes, brain chemistry shifts).

• People with a history of mental health challenges are at higher risk for prenatal depression and anxiety.

• Working with a perinatal therapist before you’re in crisis can help.

• If you’re struggling, you are not alone. We need more awareness and conversation around prenatal mental health.

References

Bayrampour, H., Ali, E., McNeil, D. A., Benzies, K., MacQueen, G., & Tough, S. (2018). Prenatal anxiety and depression and their impact on children’s early cognitive development: A meta-analysis. Depression and Anxiety, 35(6), 597-606.

Biaggi, A., Conroy, S., Pawlby, S., & Pariante, C. M. (2016). Identifying the women at risk of antenatal anxiety and depression: A systematic review. Journal of Affective Disorders, 191, 62-77.

Dennis, C.-L., Falah-Hassani, K., & Shiri, R. (2017). Prevalence of antenatal and postnatal anxiety: Systematic review and meta-analysis. The British Journal of Psychiatry, 210(5), 315-323.

Glover, V. (2014). Maternal depression, anxiety, and stress during pregnancy and child outcome: What needs to be done. Best Practice & Research Clinical Obstetrics & Gynaecology, 28(1), 25-35.

Howard, L. M., Ryan, E. G., Trevillion, K., Anderson, F., Bick, D., Bye, A., ... & Khalifeh, H. (2014). Accuracy of the Whooley questions and the Edinburgh Postnatal Depression Scale in identifying depression and other mental disorders in early pregnancy. The British Journal of Psychiatry, 206(1), 72-78.

Ross, L. E., & McLean, L. M. (2006). Anxiety disorders during pregnancy and the postpartum period: A systematic review. The Journal of Clinical Psychiatry, 67(8), 1285-1298.