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Clinical Corner

Pregnancy and Mood

A Q & A with Renee Goldberg, MD, and Cindy Kobelin, MD

Moodiness often accompanies pregnancy. We asked OB/GYN specialists Renee Goldberg, MD, and Cindy Kobelin, MD, about how moods and emotions may swing during each trimester, how you can help keep it in check, and when moodiness may be a sign of something more serious, like depression.

Q. What can cause general moodiness during pregnancy?

Renee Goldberg, MDRenee Goldberg, MD (right): There are many physical and emotional changes during pregnancy that can cause moodiness. Basically, it is hormones, sleep deprivation, and the anxiety of anticipated changes in your life that can all contribute. In the first trimester, there are some physical changes — women do get a little nauseous, some breast tenderness — and there really is some overwhelming tiredness. There are some very wide hormonal changes that are mostly responsible for some of the mood changes that we see.

The second trimester tends to be a time that’s a little bit quieter for women. The mood usually settles: most women tend to sleep better, and tend to feel better in general. In the third trimester, unfortunately, some of the discomforts of pregnancy do come back again — so the sleep quality becomes more difficult, women are just bigger and it’s more difficult to move around.

Hormones tend to swing quite a bit at this time, and these things all contribute to some of the moodiness. But, a lot of the emotional side effects start happening too: women are now trying to finish everything up at work, there’s the anxiety of thinking about a new baby coming home, about labor and delivery, and the effect that this new baby is going to have on your partner or on other children in the household.

Q. What are some ways to keep moodiness in check?

Renee Goldberg, MD: One is to get enough sleep. Sleep is really critical, and it’s hard to get a lot of sleep, especially if you’re working or have other kids at home, but sleep can make the next day feel so much better.

Exercising regularly is also very important. Exercise will stimulate a natural hormone that’s almost like your own body’s anti-depressant. By exercising 20 or 30 minutes a day — even just taking a walk — can make a huge difference in boosting this hormone level up and improving mood.

Q. How do I know if my moodiness is actually depression?

CindyCindy Kobelin, MD (right): Sometimes, the mood swings and anxiety can surpass what’s considered normal, and can become an almost depressive syndrome. That’s something to be aware of and certainly your obstetrician, when they see you at your visits, will be talking to you about how you’re doing. If the anxiety you’re having seems to be taking over your life, it could be a sign of depression.

Other signs to look for include a lack of enjoyment or excitement about your pregnancy and the birth of your baby, and not eating or sleeping well or at all. If you notice these symptoms, that’s when you need to have a conversation with your obstetrician, and you may need to be referred to a psychologist or even a psychiatrist that works specifically with pregnant women.

Q. Can women take anti-depressants when pregnant?

Cindy Kobelin, MD: When having your pre-conception consult, it’s important to talk about a history of anxiety or depression, and if you have ever been or are currently on medications. There are many anti-anxiety and anti-depression medications that are safe and fine during conception and throughout the pregnancy and with breastfeeding.

But, there are also some medications that may not be safe, and those need to be changed prior to conception, so having that discussion in advance and finding a medication that works well prior to conceiving is very important. 

Q. If you’re taking these medications and find out you’re pregnant, what should you do?

Cindy Kobelin, MD: The first, most important thing is not to panic that you did conceive on these medications, because most medications that are prescribed to women of child-bearing ages are chosen specifically because they are actually safe and fine and do not cause birth defects. The worst thing you can do is stop your medication at a time that we know you’re at the highest risk for developing more mood swings and depression.

So, don’t stop your medication, but when you realize you’re pregnant, you should call your obstetrician — they will review with you what medications you’re on, and about 99 percent of the time, those medications are safe.

Learn more about other pregnancy-related topics in our Ask the OB section »

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

Posted March 2014

Contact Information

Department of Obstetrics and Gynecology
Beth Israel Deaconess Medical Center
East Campus
330 Brookline Avenue
Boston, MA 02215