By Melisa Schuster

From the first moment you see the two lines on the pregnancy test, a flood of feelings begins. Maybe it’s joy or surprise; maybe it’s fear and overwhelm. Whatever feelings arise, there’s no doubt about it, pregnancy is an emotional journey. Even if it’s a planned pregnancy, it’s normal to feel some ambivalence. Becoming a parent is a big undertaking.

A lot of change is about to happen. Pregnant people experience changes in body image, relationships, lifestyle, sense of identity, fears, and anxieties. All of this will influence your emotions, how you feel about yourself, and how you feel about your life.

This is the time many pregnant people focus on making changes to support a healthy pregnancy: they focus on nutrition, gentle exercise, getting enough sleep, taking prenatal vitamins, quitting smoking or the use of alcohol, and attending all prenatal appointments. All of this is important, but what about mental health?

It’s as important to focus on your mental health as it is your physical health. Pregnancy is a time of emotional change as well as physical change. An influx of hormones may cause one to feel sensitive and weepy. Who among those in their first trimester of pregnancy hasn’t cried at a television commercial? It’s normal to have worries as well—about the health of the baby or whether we will be good enough parents, or a myriad of other issues. Some feel guilty at not being able to do everything they were capable of before becoming pregnant.

During pregnancy, the first thing you lose is control—over your body and its needs. Maybe you have “morning” sickness 24/7. Maybe you can barely keep your eyes open. Remember, your body is working on creating a human being—of course you’re tired and slowing down! Even though you’re excited about having a baby, you might also feel irritated, resentful, or downright angry at the loss of control.

Know that this is normal. Having negative feelings doesn’t make you a bad mom: it makes you a human being! Be gentle with yourself. Accept all your feelings, both “positive” and “negative.” Feelings come and go if we don’t deny, suppress, or dismiss them.

Engaging in activities to support our mental health during pregnancy is critical. Studies show that people with untreated anxiety or depression during pregnancy are at greater risk of preterm birth, low birth weight, intrauterine growth restriction, and possibly even preeclampsia.

As with all things, prevention is key. Incorporating mood enhancers like meditation or yoga into your routine has shown to reduce symptoms of depression or anxiety (be sure your yoga instructor has been trained in prenatal yoga as the pregnant body needs modifications to avoid injury). Mild exercise like walking can also improve mood. Talk about your worries and feelings with trusted others or write about your thoughts and feelings in a journal. Find support with other pregnant people in your phase of the journey—childbirth education or prenatal yoga classes are great venues for meeting new moms. Try to avoid other major stressors like moving or starting a new job.

If you find yourself experiencing depression or anxiety symptoms lasting longer than two weeks, then reach out for help. Anxiety or depression symptoms during pregnancy are the greatest predictor of Postpartum Depression. Let your doctor or midwife know what you are experiencing. Just like any other condition, early intervention provides the best outcome.

Research shows that both counseling and medications are equally effective in treating depression and anxiety. Counseling can provide support and validation as well as stress reduction techniques and coping strategies. Counselors can help set up a postpartum support plan and help you recognize early postpartum depression symptoms so you can respond quickly. People with a history of childhood abuse or sexual assault or a previous traumatic birth will need support for their unique needs during pregnancy and the vulnerable and intimate birthing experience.

Many people who are pregnant are concerned about taking medications during pregnancy. If the symptoms interfere with sleep or your ability to take good care of yourself, then the risk-benefit ratio changes. Untreated depression also can have effects on the growing fetus. Discuss the risks and benefits of medication during pregnancy with your provider. Do your research, then choose the right course of action for you.

If at any time you experience thoughts of suicide, harming yourself, or running away, please seek out help immediately. Don’t keep these thoughts to yourself. Share them with your partner, a parent or friend, and especially your medical provider. You can go to the Psychiatric Emergency Department at your local hospital 24/7 or call at 734-936-5800 or call the Suicide Prevention Lifeline at 800-273-8255.

Partners and fathers can also experience stress, depression, and anxiety in the perinatal period but at lower rates than women. About 10% of men experience depression in the 3–6-month postpartum period, and it is often correlated to their partner’s postpartum depression. Dads benefit from good nutrition, sleep, exercise, talking with supportive others, and seeking help from a medical provider or counselor, too. Having a baby is a family affair, and all family members deserve to feel good and to have adequate support and resources to be the best parent they can be. Another good resource for both mothers and fathers is postpartum.net for online support groups, therapist locator, and loss and grief resources.

Melisa Schuster, LMSW, CAADC, is a clinical social worker and certified alcohol and drug counselor in private practice with over 25 years’ experience specializing in perinatal mood disorders, traumatic birth, childbearing losses, and parent coaching. Her mission is to help people to remove barriers to creating strong, loving, and healthy family relationships. You can find her at melisaschuster.com or call 734-302-0033.