It seems like everyone and their mother has heard of postpartum depression. Even if we haven’t actually had or seen it, most of us are glancingly familiar with the idea of a mother whose mental health is thrown completely off kilter following the birth of a new child. It isn’t surprising that conditions like postpartum anxiety and postpartum OCD are also prevalent. But what isn’t focused on nearly as much as it should be is the anxiety and depression that affects people prenatally - during their pregnancy, long before the condition would count as “postpartum.”

In this article, we’ll take a closer look at the mental health issues faced by a startlingly high number of pregnant people, and why you may only now be hearing about this. We will discuss:

• Prenatal mental health issues and statistics
• Why conditions may not be diagnosed
• Symptoms of anxiety and depression
• How you can help

Prenatal Mental Health

Also known as Perinatal Mood Disorders

Technically, the issues we’re talking about here are usually referred to as “perinatal mood and anxiety disorders,” but for the purposes of this article, it is important to recognize that these issues are liable to come up at any point during pregnancy. While “perinatal” refers to the period immediately surrounding birth, “prenatal” simply means “before birth,” meaning that it may be more of an apt description.

Although many women know to look out for postpartum disorders, they may be unfamiliar with the fact that anxiety, anger, and irritability experienced during pregnancy may also be indicative of mental health. In many cases, had these symptoms been addressed, the depression that developed postpartum might have been addressed sooner; somewhere between 50 and 80 percent of people with postpartum depression also experienced depression during their pregnancy. In fact, people are about twice as likely to experience prenatal depression and anxiety than they are to experience postpartum depression and anxiety.

Why It Doesn’t Get Diagnosed

Uncertainty, Ignorance, and Assurances

If Perinatal Mood and Anxiety Disorders are so common, then why don’t more people know about them and report their symptoms? The answer effectively comes down to two different categories: either people don’t really know what’s going on, or they don’t really think it’s a problem. In the first case, a pregnant person may not recognize themselves in a list or symptoms or may not be aware to look out for prenatal conditions. In the second, the person themselves or those around them may have convinced them that what they are experiencing can be chalked up to gloominess and hormones, and that they’ll start feeling better if they just wait it out.

According to Psychology Today’s research, 53 percent of women report that, when it comes to their mental health, they aren’t sure what is and isn’t normal during pregnancy. They may be experiencing symptoms of anxiety and depression, but because they aren’t sure whether or not that’s to be expected, they don’t seek help. Much of the time, people will convince themselves that their experiences are nothing more than the fault of hormones. There’s also a big problem of people not knowing what symptoms of perinatal mood disorders look like, and if they don’t understand the symptoms and warning signs, they’re less likely to go to a doctor.

Symptoms

What does it look like?

In order to understand the issue of prenatal depression and anxiety, it’s important to recognize what depression and anxiety look like. While it might look like the classic media representations - moodiness, pervasive melancholy, excessive fretting, even suicidal feelings - actual mood disorders are more likely to look a little different than what one might expect.

Depression

If you have any combination of the following symptoms, it is possible you may be suffering from Depression. If you need immediate help, contact SAMHSA’s National Helpline at 1-800-662-HELP (4357).

• Feelings of sadness, emptiness, or hopelessness
• Angry outbursts, frustration, and irritability, often over seemingly small matters
• Loss of interest or pleasure in normal hobbies and activities
• Sleeping too much and/or insomnia
• Agitation and restlessness, often paired with anxiety
• Sluggish moving, thinking, and/or speaking
• Fixation on lack of self-worth and past failures
• Memory and focus issues
• Suicidal thinking, passive or active suicidal ideation, or fixation on death
• Back pain and headaches

Anxiety

There are several different common anxiety disorders. What follows is a list of potential symptoms for generalized anxiety. Again, if you need immediate help, you can always contact the Substance Abuse and Mental Health Services Administration (SAMHSA).

Generalized Anxiety Disorder (GAD)

• Restlessness, being wound up or “on edge”
• Focus issues
• Becoming easily fatigued
• Irritability
• Muscle tension
• Sleep issues such as insomnia and restless or unsatisfying sleep
• Shaking or trembling

How to Help

Spread the Word

Despite being a pervasive problem, prenatal mental health issues are reported far less often than postpartum disorders. You can help by spreading the word. Help by getting yourself and your loved ones educated about postpartum and perinatal/prenatal mental health issues, and making that information more widespread so that it is accessible to the people who need it. And remember: never be afraid to seek help, even if you don’t think your problems are the end of the world.