Understanding prenatal depression

Pregnancy is often portrayed as a joyous time, but in reality, not all women like being pregnant, even if the pregnancy was planned or they’re looking forward to having a child.

Depression during pregnancy, also known as prenatal depression, is more common than most people realise. And if you're noticing a heavy mood, anxiety, or a lack of interest in things you used to enjoy, these are flags worth noticing.

We’ll explore prenatal depression in this article, plus management and treatment options for those who have been diagnosed with this condition.

What is prenatal depression?

Prenatal depression is a type of clinical depression that happens during pregnancy. It can begin in early, mid, or late pregnancy and affects your thoughts, emotions, and ability to cope day to day.

It’s part of a broader category known as perinatal depression, which includes both antenatal (before birth) and postnatal (after birth) depression.

You might be experiencing prenatal depression if you notice:

• Ongoing sadness, crying,  or feeling emotionally numb

• Losing interest in things you used to enjoy

• Difficulty concentrating or making decisions

• Feeling hopeless, worthless, or overwhelmed by guilt

• Difficulty sleeping or sleeping too much

• Eating more or less than usual

• Feeling tired or drained most of the day

• Anxiety, irritability, or restlessness

• Difficulty connecting with your pregnancy or baby

• Thoughts of harming yourself or feeling like your baby or family would be better off without you

Some of these might sound familiar because they can overlap with normal pregnancy symptoms. But the key difference is that depression lasts longer, feels heavier, and gets in the way of daily life.

Is it depression or just the stress of pregnancy?

Many women feel emotional, tired, or even overwhelmed at times during pregnancy. Your body is changing, hormones are shifting, and life might already be stressful. These ups and downs are common.

But when you’ve been feeling low or disconnected from your life for more than two weeks, and those feelings are interfering with your sleep, relationships, or daily functioning, it could be more than just stress.

If any of this feels familiar, it’s worth speaking to your GP, midwife, or therapist as soon as possible.

Who is more at risk?

Any pregnant woman can experience depression, but some people are more vulnerable than others. You might be at higher risk if you:

• Have experienced depression, anxiety, or other mental health issues in the past

• Feel unsupported in your relationship or don’t have people around you to talk to

• Are dealing with financial stress, housing issues, or other big life challenges

• Have experienced trauma or violence from an intimate partner

• Are pregnant unexpectedly or feeling unsure about the pregnancy

• Have health problems or complications with your pregnancy

• Belong to a marginalised or under-supported community

• Are younger or a first-time parent, especially without strong support

• Are already caring for young children or facing high pressure at work or home

Around 1 in 10 women experience depression during pregnancy. In some groups, such as those facing relationship violence, the rate is much higher. 

How is prenatal depression diagnosed?

You might be offered a mental health screening during your antenatal appointments. This usually includes a few questions about how you’ve been feeling recently. One common tool used in Australia is the Edinburgh Postnatal Depression Scale (EPDS), which helps flag symptoms that might need a closer look.

If your answers suggest you may be experiencing depression, your GP, midwife, psychologist, or obstetrician may suggest a more detailed conversation. They’ll ask about how long you’ve felt this way, how it’s affecting your daily life, your past mental health history and any support you have around you.

A diagnosis of depression is made when certain symptoms like persistent low mood or loss of interest have lasted at least two weeks and are getting in the way of your ability to function. 

If you're not sure what you're experiencing, that's okay. A healthcare provider can help you make sense of it. Ideally, you bring a support person to the appointment if you feel it might make it easier to talk openly, especially if you're feeling anxious or unsure.

How to manage and treat prenatal depression?

There’s no single way to manage prenatal depression, but with the right support, it can be treated effectively. Most women benefit from a combination of self-care and professional help, depending on how they’re feeling and what they’re comfortable with.

1. Taking care of yourself

Small daily actions can gently support your mental health. Prioritise rest, eat balanced meals, and move your body when you can. If you're finding it hard to stay connected, reach out to someone you trust or join a pregnancy support group.

Mindfulness or journaling can also help ease anxious thoughts. If tasks feel overwhelming, break them down and take them one step at a time. Remember, looking after yourself is a priority.

2. Talking to a professional

Therapies like Cognitive Behavioural Therapy (CBT) or Interpersonal Therapy (IPT) are safe and effective during pregnancy. A trained counsellor or psychologist can help you explore your thoughts, manage stress, and strengthen your emotional resilience. You can ask your GP for a Mental Health Treatment Plan to access subsidised sessions under Medicare.

3. Considering medication

In some cases, medication might be recommended, especially if symptoms are more severe or long-lasting.

Some antidepressants are considered safe in pregnancy, and your doctor will work with you to make an informed choice. Physical health issues like low iron or thyroid problems can also affect your mood, so it’s worth checking in with your GP.

4. Working with your care team

Sharing how you're feeling with your GP, midwife, or obstetrician allows them to better support you. They can connect you with mental health services and help you plan for after your baby arrives, especially if you’ve had depression before.

Depression can feel isolating, but it only gets worse the more you try carrying everything alone.

A few words for partners and family members

If your partner or someone you care about is pregnant and showing signs of depression, your support is very important. The most important thing you can do is listen with patience and empathy. Avoid trying to “fix” how they feel. Instead, reassure them of your love or support, that you take their feelings seriously, and that they don’t have to go through this alone.

Encourage them to speak with a healthcare professional, and offer to help make the appointment or go with them if they’d like. Be mindful of how much they’re trying to manage and offer practical help, whether that’s with chores, childcare, or simply checking in regularly.

Try not to take mood changes personally, and look after your own wellbeing too. Supporting someone through prenatal depression can be challenging, but showing up with kindness and understanding can provide much-needed reassurance during an emotionally complex time.