People sometimes assume that pregnant women are always joyous and enthusiastic, but this isn't true. We also experience ambivalence, fear, sadness, and sometimes anxiety or depression that may require special help. According to some estimates, about one in every ten pregnant women experiences some depression, which is about the same rate as for women who are not pregnant. Yet pregnancy can make depression more difficult to diagnose. For example, sleep disturbances and lack of energy could be related solely to pregnancy, but they could also be related to depression. You may be depressed if you experience significant changes, including total loss of pleasure in activities that you used to enjoy; persistent feelings of worthlessness, sadness, or hopelessness; stark changes in appetite; prolonged periods of fatigue; uncharacteristic tearfulness; and suicidal thoughts. About half of all episodes of postpartum depression begin during pregnancy and may also be accompanied by persistent, intense anxiety that does not respond to reassurance or the usual support needed by women during this period.
Women may feel depressed during pregnancy because of hormonal changes; the circumstances of the pregnancy (for example, an unplanned pregnancy or a hostile or unsupportive partner and/or family); severe and extended nausea; earlier experiences with infertility and/or pregnancy loss that may give rise to anxiety about the current pregnancy; obstetric complications; or a long period of bed rest.