Prenatal and Postpartum Depression: Symptoms and Treatment Options

If you’re a new mom or mom-to-be, the expectation is often to be overjoyed about bringing a baby into the world. However, pregnancy is a huge event that causes major changes to your daily life, relationships, and well-being.

So, in other words, it’s not all roses.

If you’ve had mixed feelings about your ability to cope with pregnancy, birth, and a newborn, it’s okay. It’s common to feel wildly fluctuating emotions as your body nurtures a new life.

However, sometimes it’s more than unbalanced emotions. Some women find themselves struggling with seemingly never-ending anxiety and low mood during pregnancy and after giving birth, and this takes a toll on their mental health.

In the United States, up to 15% of pregnant women develop prenatal depression during pregnancy, and as many as 20% of women develop postpartum depression after giving birth.

If you think you may be struggling with prenatal or postpartum depression, it can help to know what the signs are and what treatment options are available. In this article, we’ll explain:

The signs, symptoms, and risk factors of prenatal and postpartum depression
How prenatal and postpartum depression are diagnosed
The treatment options available for both forms of depression
Effective coping strategies for managing depression before and after birth
When to seek help for prenatal and postpartum depression

Signs and Symptoms of Prenatal and Postpartum Depression

The emotional and physical impact of pregnancy and childbirth is unique to each woman. However, there are a typical set of emotional and physical symptoms of postpartum depression and prenatal depression that many women experience.

The emotional symptoms of prenatal depression and postnatal depression include:

Intense sadness
Loss of interest in formerly enjoyable activities
Anxiety
Irritability
Feeling frustrated or overwhelmed

Feelings of guilt or worthlessness are common, too, and these can lead to low self-esteem, especially about being a good enough mother or partner.

The typical physical symptoms of prenatal and postnatal depression are:

Fatigue (often mixed with trouble sleeping, sleeping too much, and changes in appetite)
Aches
Pains
Digestive problems not related to pregnancy

Other Signs of Prenatal Depression

Many expectant mothers are concerned about their own and their baby’s health during pregnancy, and first-time mothers will be especially likely to worry. This is normal. However, if you have trouble concentrating or experience “brain fog" that affects your decision-making and motivation, these may be signs of prenatal depression.

Prenatal and Postpartum Depression Risk Factors

Like the signs and symptoms of prenatal depression, the causes are unique to each woman. However, there tends to be a mixture of biological and environmental factors at play. Prenatal depression may be partially down to hormonal changes, your genetics, the stress of pregnancy, or how difficult it is to access social, financial, and emotional support.

Having a strong and reliable support network can help you manage the ups and downs of pregnancy. The opposite can be said for social isolation and financial worries—these can be big risk factors for prenatal depression.

The causes of postpartum depression aren’t all that different from prenatal depression. They include the factors above, but they relate more to:

The year after giving birth
Bonding with your baby, and
Coping with the responsibilities of motherhood

If you’ve struggled with mental health problems in the past or you’ve faced difficult life events during and after pregnancy, postpartum depression may be more likely. Difficult life events that could increase your risk of postpartum depression are a marital or relationship breakup, extreme money worries, or an unstable living situation. However, the impact of these situations varies massively, and they may not always lead to postpartum depression.

The best rule of thumb if you think you may be experiencing prenatal or postnatal depression is to reach out to a healthcare provider for support.

How Prenatal and Postpartum Depression Are Diagnosed

Once you seek help from a healthcare professional, you’ll likely be invited to a screening—this will be used to rule out other health problems. Clinicians diagnose prenatal and postpartum depression using a combination of clinical interviews, screening tools, and observational assessments.

An initial psychological evaluation may include answering the Edinburgh Postnatal Depression Scale. This questionnaire will ask a range of questions revolving around:

Your feelings of sadness, guilt, and anxiety
How difficult it has been to cope
Any occurrence of sleep disturbances
If you have experienced any thoughts of self-harm

It only takes 5 to 10 minutes to complete, and once you’re done, you’ll receive a score. Don’t worry—it’s not like a regular test. You can’t pass or fail. If you score above a certain number, your doctor or mental health professional may chat more with you before potentially diagnosing you with prenatal or postpartum depression.

If you do receive a diagnosis, know that you’re not alone. Between 15 and 20% of pregnant and postpartum women are right alongside you. The most important thing is that you receive the support you deserve.

Prenatal and Postpartum Depression Treatment Options

Treatments for prenatal and postpartum depression include talking therapies, medication, lifestyle changes, and self-care strategies tailored to your unique needs.

You can receive support in a traditional outpatient setting or more flexibly using virtual therapy and telehealth services. If you’re a busy mom or mom-to-be, you can combine the two, if you like. Let’s look at both options in more detail:

Therapy for Prenatal and Postpartum Depression

Talking therapy involves meeting regularly with a qualified therapist to talk through and resolve any problems you’re facing. Examples of talking therapy treatments for moms struggling with prenatal and postnatal depressions are:

Cognitive Behavioral Therapy (CBT): This approach focuses on identifying and changing harmful thoughts that contribute to your symptoms of prenatal and postpartum depression.
Interpersonal Therapy (IPT): This form of therapy explores how life transitions are affecting your relationships to improve your social support during pregnancy and after giving birth.
Supportive Therapy: This therapeutic approach encourages new moms to express their emotions and concerns in a safe environment. It’s often combined with other forms of therapy.

If talking through problems isn’t your thing, then Transcranial Magnetic Stimulation (TMS) could be for you. This is a non-invasive, non-talking therapy that uses brain stimulation to lift your mood and reduce your anxiety.

Medication Options for Prenatal and Postpartum Depression

Medications are rarely prescribed during pregnancy because of the potential harms to the developing fetus. Nevertheless, medications can be prescribed to treat postpartum depression, as long as a healthcare provider closely monitors its effects.

Medications your doctor may prescribe are:

Selective Serotonin Reuptake Inhibitors and Serotonin-norepinephrine Reuptake Inhibitors: Commonly known as SSRIs and SNRIs, these are antidepressants that help stabilize your mood and ease postpartum depression symptoms.
Brexanolone: An intravenous neuroactive steroid that was approved by the FDA for treating postpartum depression in 2019. It’s administered in a clinical setting under medical supervision and requires careful monitoring by a healthcare provider, typically in a clinic or office.

Zuranolone: One of the first oral neuroactive steroids approved to treat postpartum depression. It can be given for a period of two weeks if you’re seeking a non-intravenous alternative to antidepressants.

Outpatient Treatment Programs for Prenatal and Postpartum Depression

Outpatient treatment programs allow you, whether you’re an expectant or new mom, to remain at home while visiting a clinic for regular support. When it comes to these programs, you have two options:

Intensive Outpatient Programs (IOP) provide therapy while allowing you to return home daily, supporting your mental health and well-being while offering you flexibility.

Partial Hospitalization Programs (PHP) are more intensive forms of support than traditional outpatient therapy. However, they don’t require you to stay there full-time.

Telehealth and Virtual Therapy Options

If you’re an expectant and new mothers seeking greater flexibility, online video calls give you access to talking therapies at home. You can do so via online therapy or virtual support groups.

Online therapy gives you access to licensed therapists via secure video calls, which is ideal if you’re a new mom who prefers the convenience of home-based therapy.

On the other hand, virtual support groups will help you connect with other moms experiencing similar challenges. These are great if you’re feeling isolated.

Lifestyle and Self-Care Strategies for Managing Depression

Putting several lifestyle changes in place can make a big difference for prenatal and postpartum depression symptoms. Here are some things you can try:

Mindfulness practices such as breathwork and meditation can ease stress and make it easier to cope in stressful situations.
Healthy sleep and rest, along with balanced, nutritious meals, are the foundation of your physical and mental well-being as an expectant or new mother.

Gentle exercise like walking or swimming can help boost your mood and energy levels (which you’ll need as a new mom!).

Coping Strategies for Prenatal and Postpartum Depression

Coping strategies for prenatal and postpartum depression aren’t one-size-fits-all. While setting goals may work for someone else, you may find that speaking to a friend is the best approach for you. That’s okay. It’s important that you form habits that work best for you.

If you’re struggling with prenatal depression, some of the most effective strategies are:

Setting small goals for each day to prevent exhaustion and overwhelm. You could set up a daily to-do list and tick things off as you go to conclude each day with a sense of gentle progress.
Prioritizing self-care by practicing self-compassion. Imagine you are your own best friend; how would you support a loved one facing similar challenges? Taking care of yourself isn’t selfish—it allows you to continue to care for others.
Use breathing exercises to manage your stress and anxiety. Breathing is our constant companion, and simple breathing techniques can help reset your mind and body to a more relaxed state.
Reaching out to friends, family, and other supporters. If things feel overwhelming, then don’t forget about the people that love and support you who would be happy to chat or help out. This can also include support group members and professional supporters.

If you’re managing postpartum depression right now, you can use any of the coping strategies above, too. However, this may look slightly different, as it’ll involve taking care of your baby.

To help you during this time, make sure you have a good support network in place of people who can step in and give you a well-deserved break when you need it. And remember: don’t wait until things reach crisis point to reach out. Ensure you’re plugged into local support services for expectant and new mothers.

When to Seek Help for Prenatal and Postpartum Depression

If you’ve read this far and see some of your own problems described, then don’t hesitate to reach out for confidential support and advice. This is especially important if changes in your mood and behavior are affecting your relationships and other aspects of daily life.

You can get support for prenatal depression from your local healthcare providers and support services. However, given the baby blues are normal after giving birth, you might be wondering when to seek help for postpartum depression. The answer is as soon as possible if your low mood and other symptoms last ten days or more.

The team at Mission Connection Healthcare has a hotline you can call for confidential support and advice. You’ll find a friendly listening ear at the end of the phone and more information about our treatment center, resources, and services.

Remember that you’re not alone. You deserve support, and at Mission Connection Healthcare, we’re here to help.

References

Brain Health Center (2024, May 15). How TMS therapy can help postpartum depression: A comprehensive guide. https://brainhc.com/how-tms-therapy-can-help-postpartum-depression-a-comprehensive-guide/

Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression. The British Journal of Psychiatry, 150(6), 782–786. https://doi.org/10.1192/bjp.150.6.782

Dennis, C., Singla, D. R., Brown, H. K., Savel, K., Clark, C. T., Grigoriadis, S., & Vigod, S. N. (2024). Postpartum Depression: A Clinical review of impact and Current Treatment solutions. Drugs, 84(6), 645–659. https://doi.org/10.1007/s40265-024-02038-z

OASH (2023). Postpartum depression. Office on Women’s Health. https://www.womenshealth.gov/mental-health/mental-health-conditions/postpartum-depression

Van Niel, M. S., & Payne, J. L. (2020). Perinatal depression: A review. Cleveland Clinic Journal of Medicine, 87(5), 273–277. https://doi.org/10.3949/ccjm.87a.19054