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Pregnancy
For many women pregnancy is an exciting and nerve-wracking time of life; it can also be a source of anxiety and even depression, especially when concerns are fueled by hormones or by societal expectations. In addition to physical symptoms of early pregnancy such as a missed period, sensitivity to smells and certain foods, and fatigue, women may experience mood swings and the onset of depression. Expectant mothers, in general, should take steps to protect and enhance their emotional well-being as well as their physical health during this important time.
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Pregnancy and its attendant hormonal changes can have a significant impact on moms-to-be and their mental health. It’s normal for pregnant women to experience a wide range of emotions, from joy and excitement to bouts of anxiety and mood swings.
Paying attention to any emotional and psychological changes during and after pregnancy can help keep mother and baby safe and healthy. For instance, some women experience peripartum or postpartum depression or other well-recognized conditions for which treatments are available. New or soon-to-be mothers and their families should be alert for feelings of anxiety, persistent sadness, or other symptoms that may reflect more than sleep deprivation.
It’s normal to experience ups and downs while pregnant. However, some symptoms may be an indication of mental health issues that may need to be addressed if they persist. The most common of these include sleeping either too much or too little, focusing problems, anxiety, lingering sadness, loss of interest in activities that were once enjoyable, and feelings of guilt, shame, and worthlessness. Taking care of mental health during pregnancy involves being aware of these warning signs when they appear. Some pregnant women may benefit from seeking out professional help if their symptoms persist beyond two weeks.
The pregnancy blues are common but not often talked about, making many women reluctant to reach out for the support they need. It doesn’t help when friends and family dismiss a woman’s feelings as just pregnancy hormones run amok. Paying attention to unusual sadness or depression is critical because the pregnancy blues can be dangerous for both mom and baby and may lead to postpartum depression. If you experience sadness you can’t shake or similar feelings, try talking to someone you can trust, whether that’s your partner, a friend, a family member, or mental health professional.
Women tend to pay greater attention to babies in general during pregnancy. However, pregnant women who are struggling with depression may actually show decreased interest in babies, especially when they are in distress. Fortunately, treating depression can improve pregnant women’s attentiveness and potentially strengthen their bond with their own children.
The heartbreaking phenomenon of false pregnancy, or pseudocyesis, occurs when a woman experiences the physical symptoms of pregnancy without actually being pregnant. These symptoms can include a stopped menstrual cycle, abdominal and breast enlargement, nausea and vomiting, weight gain, and even feeling phantom fetal movement. The woman’s desire to be pregnant is so overwhelming that she can’t accept she is not with child, even when her tests come back negative.
False pregnancy is more likely to occur in the wake of loss, such as fertility problems or miscarriage. The partner's desire to get pregnant can also play a role in prompting and/or perpetuating a false pregnancy. When the woman and her partner ultimately realize they are not pregnant, they might require the support of family, friends, and potentially a mental health professional to deal with the subsequent complicated feelings.
Pregnant women may experience social and internal pressures that they neither want nor need. Expectant mothers are bombarded with information about what to eat, how to cope with morning sickness, the best way to give birth, and more. Women may receive unwelcome or disconcerting feedback about their behavior or their appearance during pregnancy.
Gaining a better understanding of the kinds of pressure that pregnant women face could help women—and those around them—beware of and avoid these stressors during pregnancy. Some of these may originate partly from within: Pregnancy may bring new desires to act a certain way, look a certain way, or make preparations for birth with impossibly high standards.
Those who are close to pregnant women should also be conscious of the potential negative impact of the pressure they put on women themselves—including, for example, passing remarks on a pregnant woman’s size. Researchers have found associations between experiences of weight stigma during pregnancy and reported stress and depression.
Some women might not experience any cognitive changes during pregnancy. Other expectant moms may get pregnancy brain, a colloquial term for common symptoms like forgetfulness and inability to concentrate. Studies have found that the gray matter in women’s brains, which is responsible for processing and responding to social cues, may temporarily shrink during pregnancy. At the same time, a pregnant woman’s brain becomes more efficient, allowing her to attune to her baby and form a strong attachment bond.
Perfectionism and the pregnant woman can be a dangerous combination. Pregnancy is rife with triggers for a perfectionist, who may worry how her appearance, relationship, and overall pregnancy experience stack up against other women. Pregnant women also receive no shortage of advice and lectures on what they should be doing, which can take a toll on their mental health. Women who are perfectionistic are more likely to become anxious and depressed during pregnancy and are at greater risk of developing postpartum depression. That’s why it’s so important for pregnant women to be kind with themselves and embrace flexibility.
Pregnant women may be expecting a baby and body dissatisfaction. In a culture that prioritizes thinness as a standard for beauty, any weight gain is experienced with dread, even if it has a healthy purpose, such as providing nourishment for a developing fetus. Instead of measuring themselves against impossible beauty standards, pregnant women would be better served by growing positive feelings about their body based on what it can do (give birth to new life) rather than what it looks like.
No matter what the intention, remarks about a pregnant woman’s weight are harmful and stigmatizing. They can cause great distress and mental health problems. The damaging effects of commenting on pregnant women’s bodies include increased stress, depression, and maladaptive eating behaviors. Weight shaming can also lead to the development of postpartum depression.
A mother’s mental health during pregnancy can have a profound impact on both her and her baby’s physical health. Negative emotions, particularly stress, anxiety, and depression, can dampen a woman’s motivation to eat healthily, sleep well, exercise, and take the right nutritional supplements. Pregnant women may suffer in silence instead of reaching out for the support they need and deserve. The more a woman knows about the relationship between pregnancy and mental health, the more ready she will be to face the psychological challenges of being pregnant.
For those who are wondering how to cope with pregnancy stress, it helps to be alert for early signs of mental health problems. Be proactive and address symptoms (e.g., anxiety, catastrophizing, depression, etc.) as soon as they arise instead of minimizing them. Pregnant women also benefit from time for reflection, as it helps them manage their emotions better. Being aware of stressors and setting healthy limits can improve the pregnancy experience. It’s also important to develop effective coping strategies, such as meditation, breathing exercises, visualization, and gratitude practices.
Pregnancy can be a stressful time, and staying mentally healthy is key. Mindfulness and meditation can boost pregnant women’s well-being. Planning regular date nights can help keep partners feeling connected and intimate even while their relationship undergoes significant changes. Additionally, pregnant women need to carve out alone time; just a short amount each day can help reduce stress. Most importantly, women will find they are better able to shoulder the burdens of pregnancy if they are able and willing to ask for what they need.
Listen to her. Ask her what she is thinking and feeling. Be honest about your own experience if she has a specific question, but don’t overload her with details. Avoid being condescending (i.e., don’t say things like, “You think you’re tired now? Just wait till the baby’s born!”). You can also help in practical ways by making lists of things she will need leading up to, during, and after childbirth, especially items that she might not think of herself. Encourage her to take time to care for herself—and time with her partner. Most importantly, just be there for her.
Certain medications may have an increased risk of birth defects and other complications. However, there is no conclusive evidence that psychotropic medication causes autism or gestational diabetes, which is a common concern for parents-to-be. Ultimately, taking medications while pregnant is a personal choice that should be made in consultation with a trusted doctor who can help the patient weigh the risks and benefits.
