Beyond Morning Sickness: Addressing Depression in Early Pregnancy

Either way, any feelings of anxiety, fear, sadness, not liking changes in your body and navigating changes in identity are real for so many. It is important to discuss your mental health during pregnancy to get the support you need to work through all the emotions, thoughts and changes during this time – and boy, are there a lot of changes!

For women, pregnancy involves change on many levels – hormonal changes, body changes and psychological changes in preparing for birth, leave from work, identity shifts, and the responsibility of caring for a baby looming ever closer on the horizon. Partners of pregnant women also experience changes as they prepare for the birth of a baby.

Treating signs and symptoms of antenatal anxiety and depression when you spot them can prevent things from getting worse. It will help you be your best self by the time your baby arrives.

So what are the early signs to look for?

Recognising the Signs of Early Pregnancy Depression

Antenatal depression often flies under the radar, overshadowed by the physical aspects of pregnancy. Yet, understanding and acknowledging its presence is crucial for the well-being of expectant mothers. 

Early detection and intervention can significantly alter the course of a woman’s pregnancy experience, paving the way for a healthier mindset before the arrival of the baby. Let’s dive deeper into the signs that signal the need for attention and care.

Physical Signs

It’s important to recognise that the physical signs of antenatal depression are more than just pregnancy discomforts; they are signals from your body that something deeper may be affecting your well-being. These signs include:

• Feeling tired or an unusual decrease in energy
• Changes in sleep – not being able to sleep even when you have the chance or wanting to sleep all the time
• Not feeling hungry or overeating
• Feeling restless or having trouble sitting still
• No interest or pleasure in hobbies and activities
• A worsening of existing anxiety – racing heart, gastrointestinal symptoms, restlessness, hot flushes or chills, sweating, lightheadedness, nausea.

Emotional and Psychological Signs

Navigating the emotional and psychological terrain of early pregnancy can often feel like walking through a fog – uncertain, disorienting and isolating. 

The psychological effects of pregnancy can be complex, marked by profound shifts that extend beyond the physical changes of pregnancy. These emotional and psychological signs are key indicators of antenatal depression, a condition that requires understanding, compassion and care:

• Feeling sad, anxious, or having feelings of numbness or detachment
• Feeling increasingly angry, irritable, or resentful of others
• Feelings of guilt, worthlessness, hopelessness, or helplessness
• Difficulties concentrating, thinking clearly, or making decisions (which can also result from lack of sleep)
• Isolating yourself, feeling alone and disconnected from others
• Having scary thoughts of harming yourself, your unborn baby and/or others
• Finding it difficult to cope and get through the day
• Constant negative thoughts or being anxious about lots of things or “what ifs,” like bad things happening to you, your pregnancy, your new baby or your partner.

The physical symptoms listed are often considered normal adjustments to pregnancy.

However, when paired with emotional distress and psychological turmoil, they signal a need for support. Recognising these signs is the first step towards seeking help and managing antenatal depression effectively. 

It’s essential to remember that help is available, and reaching out can lead to significant improvements in parental health.

Factors Impacting Mental Health in Early Pregnancy

Often, we can’t predict who will experience antenatal depression or anxiety. However, a combination of anxiety and depression is frequently found. There are some common risk factors that may increase the chance of it, but sometimes people still experience changes in their mental health without any of these risk factors.

Lifestyle & Environmental Factors

There are lots of lifestyle and environmental factors that may affect your mental health. Not all these factors affect people the same way. Take a look at this list and see what may be relevant for you:

• Unplanned or unexpected pregnancy
• History of mental illness
• Being a survivor of abuse or trauma
• Previous conception/pregnancy/birth complications
• Lack of support (including partners, families and social networks)
• Isolation or have recently moved (interstate or overseas)
• Pre-existing health conditions
• Stressful life events (death, relationship issues or breakdown)
• Absence of own or parental figure/s
• Stressful financial situation (or lack of income)
• Housing issues or moving house
• Grief and loss

Pre-existing Mental Health Conditions

If you’ve had a mental health condition before becoming pregnant, it could increase the likelihood of developing anxiety and depression in pregnancy. 

A history of mental health challenges or depression can make people more likely to experience these symptoms again when they go through a big life event, like becoming a parent. A family history of perinatal depression can also increase the chances of developing anxiety and depression during pregnancy or after the birth of your baby.

Hormones, hormones, hormones

Hormones are changing so much during pregnancy, assisting your body to grow and nurture your baby. Changes in hormones can affect how you are feeling causing ‘mood swings’ especially in the early stages of pregnancy when lots of change is happening. 

You may be trying to manage physical changes, morning sickness or nausea and your emotional health all at the same time which can all impact your mood. These pregnancy emotions and mood swings may look like you have suddenly become sad and teary or irritable, or angry at something you wouldn’t normally be.

It can be quite confronting when mood swings include feelings of sadness, worry, anger, fear or feeling low. Especially when you really wanted to be pregnant. Sometimes it might be hard to communicate these feelings to your partner or family as they may be experiencing things differently. 

However, it is important to talk about these thoughts and feelings with someone, especially if they are constant and seem to be happening every day. It’s true today, so much focus is often put on all the wonderful things that expecting parents should feel, that the common feelings of fear, sadness, anger and grief are not acknowledged. Pregnancy, birth, and parenting is such a time of change and adjustment. Fathers and non-birthing parents also experience this as a challenging time also.

Now what? If you’ve been reading and notice some of these signs and factors in yourself or a loved one, what can you do?

Helpful tips during early pregnancy

Look at Lifestyle

Think about your lifestyle. Your diet (eating healthy foods), amount of exercise, and the quality of sleep can all play a role in your mental health. The use of alcohol can also impact mood and sleep and could be masking untreated depression. It’s worth mentioning ceasing all alcohol is recommended when trying to become pregnant, during pregnancy and while breastfeeding.  

Look at Self Care and Wellness

Looking after yourself is another very important factor. Developing these daily habits can assist in keeping our mood stable such as exercise, healthy eating and getting enough sleep. We do know that regular exercise may help ease the symptoms of depression by releasing ‘feel good’ endorphins. Making healthy food choices a priority and taking the time to connect with a supportive friend or your partner.

Mindfulness, meditation, and relaxation techniques can also be really helpful, whether you join a class or use a phone app. This doesn’t have to be a long session, short quick moments in time are helpful for grounding us, like the reset button for clearing our busy mind. Even just spending 5 minutes outside taking in what is around you – the trees, birds, and blue sky!

Look at Who’s Around You

Developing a village of supportive people around you is a must when it comes to managing depression or anxiety during pregnancy. You may have older children, other caring responsibilities or have other struggles on top of preparing for a baby.

Building the support of family and friends is really important – to be your cheer squad, remind you of who you are and be there for you. Your family and friends can be of listening support and practical support (please ask them to help!).  

Your health care professionals can give you guidance, strategies to cope and treatment options. Your GP is a good person to keep track of how you are and can step up care when you need more support. 

Antenatal classes are great for learning about what’s to come and also for starting friendships with others going through the same thing as you at the same time. Relationships started here can support you well beyond your pregnancy if you continue meeting up socially.

Support groups of peer networks available online and in your local area can really help in talking about common issues. You can contact your local council to see what’s in your local area.

The Role of Partners & Family

The role of partner and family is a very important one. Providing a space for you to express your feelings to a family member can make a huge impact on your mental state. They can lower the impact of some of the risk factors we mentioned earlier. If you’re a partner or family member, you could:

• Attend doctor, psychology or midwife appointments
• Take on more chores or emotional load for the family in daily life
• Listen to the thoughts and feelings of your loved one
• Share what you learn from your own research about having a baby
• Be understanding of your partner’s mood swings during pregnancy
• Give your partner or loved one support, love and care
• Get the support you need to support your partner such as counselling
• Educate yourself on pregnancy, the birth process and options as well as the postnatal period, breastfeeding and care of the baby

Why Talking About It Matters

Whether it’s to family, friends or health professionals, talking about how you are feeling is so important – it may seem daunting, but taking that first step of sharing with someone can make a huge difference. 

Figuring out a plan for support throughout your pregnancy, birth, and the postnatal period, and starting to process some of these feelings and thoughts can have a significant and positive impact on your transition to parenthood.

Discussing your feelings can be challenging especially if you feel shame or don’t understand that many expectant mothers and fathers experience negative thoughts and feelings during pregnancy. Sharing your feelings may make you feel ‘lighter’ and feel less alone. A shared struggle is a struggle half shared!

Getting Professional Help

Talking with a counsellor or psychologist can often help during this time. 

There are some professionals who specialise in using psychological therapy int his area. Most often CBT (Cognitive Behaviour Therapy), IPT (Interpersonal Therapy) and ACT (Acceptance & Commitment Therapy) are used in these sessions allowing you to express your feelings and explore strategies to manage your mood and how you are feeling at the moment.

Medications: A Considered Approach

In some cases, talking therapies may need to be complemented with medication to manage more severe symptoms of depression or anxiety. Selective Serotonin Reuptake Inhibitors (SSRIs) are among the medications that can be used during pregnancy. SSRIs, for example, are commonly prescribed due to their safety profile and effectiveness in treating depression.

It’s imperative to have an open and honest discussion with your healthcare provider about the benefits and risks associated with medication during pregnancy. They may recommend a consultation with a psychiatrist who specialises in perinatal mental health to tailor a treatment plan that best suits your needs and ensures the safety of both you and your baby.

Navigating the Path to Support

We understand that getting help can be daunting. Being honest with how you are feeling is important to get the right care, treatment and support for you and your baby. It may be useful to have a partner or family member go along with you to see your GP to start this conversation.

ForWhen can point you in the direction of useful resources and professionals that would best meet your needs. Our clinicians will listen to what’s going on for you and work with your GP to get you on the right path.  You or a concerned partner or family member can give us a call on 1300 24 23 22 to start the conversation today.

Preparing for the Rest of Your Pregnancy

Planning and preparing for the rest of your pregnancy and the early months after the birth of your baby is good to start early. Thoughts about caring for your new baby can trigger new symptoms such as thoughts and worries about your infant and if your bond with your baby will develop.

Setting realistic goals can help manage your expectations of yourself. These goals could be a daily goal such as prioritising self-care, which could then help your overall journey to support and improve your mental health.

Often those who are experiencing mental health issues and specifically antenatal depression, focus on the ‘when will I get better?’ question or ‘how long will it take until I am myself again?’. This focus can create expectations of yourself. Working with your family, partner, and treatment team to set realistic goals, a care plan and a support plan can help manage expectations you have of yourself and also others.

Even though it may feel like your life is about to be tossed out of your control, you are the one in charge of you. You can decide what help you will accept. A process of checking in with yourself on where you are at with your mental health symptoms is just as important.

This could look like documenting in your phone with an app tracker, notepad, or just taking a moment to self-monitor with your thoughts. Another way is to set up a time specific with a person of support like your partner each day or each week and have a chat about your mental health.