Is pregnancy actually making you crazy?

Like any hopeful mom, I wanted to provide a natural and safe environment for my baby’s development. I had heard that some medications could cross the placenta and affect the baby, so I figured a complete detox would be a risk-free approach. Months before I conceived, I tossed all prescription medications, including the antidepressant I’d taken since high school. I wanted to do everything just right to give my baby every advantage for a healthy life. I didn’t realize that my early efforts at becoming supermom were setting me up for a painful ride through pregnancy.

What’s happening to me?
As thrilled as I was to conceive and anticipate the birth of my first baby, my mental state took a turn for the worse, and I struggled. Big time. I not only had stereotypical mood swings and crying spells, but I also encountered loneliness, anxiety, doubts about everything and everyone, and worry to the point of paranoia. I was sure my baby would be deformed because I ate the wrong type of mushroom or accidentally downed a sushi roll containing raw fish. I had to avoid reading articles or watching shows that upped my anxiety. (Honestly, I could watch cartoons and not much else.) I relied upon frequent phone calls with my practical mom. I cried to my bewildered husband. And I prayed.

I’m sure my friends and coworkers couldn’t see what I was dealing with at that time. I was the young wife expecting my first baby, and everyone was jealous of how thin I stayed throughout my pregnancy. (Morning sickness coupled with anxiety has a way of suppressing appetite.) In reality, while I possessed the elements of a good life, it was hard for me to see the sun through the mental cloud cover.

After a few long months of feeling like I was losing my mind, I finally confided in my OB. When I admitted how awful I’d been feeling—mentally, emotionally, spiritually, he suggested putting me back on an antidepressant. So that’s what we did.

Within weeks, I was feeling much more stable. The invisible vipers in my mind had been subdued, but the hormone readjustment resulted in another round of morning sickness in my second tri-mester. I realized that, for me, physical discomfort was far preferable to emotional anguish. By the time I was ready to deliver my baby girl, I was calmer and more confident in my ability to (a) function as a human being and (b) care for a child.

While my case was more intense than the emotional issues faced by some moms-to-be, there are plenty of women out there who have endured worse. I also know now that I could have done more to manage my emotions before I turned back to meds. So whether you’re feeling just a little frazzled or completely off your rocker, know that you can be OK again in time. Start by being honest with yourself about your emotional health and the severity of your issues. Many women, even those without a history of depression, experience similar symptoms during pregnancy. But there are ways to tame the anxiety.

Why do I feel this way?
Increased anxiety is very normal during pregnancy. “We are all programmed from the caveman days to have some level of anxiety. This trait is what helped us to be vigilant and alert in order to survive,” says My Hanh (Theresa) Nguyen, psychiatric mental health nurse practitioner at University of California at San Diego’s Maternal Mental Health Clinic. “When the cavewomen got pregnant, they probably had to be more careful [because] they were more vulnerable.” Although today’s mamas aren’t in danger of being eaten alive, maternal anxiety still has moms-to-be worrying: What if I’m a terrible mother? What if my baby is born with a disability? What if I can’t balance my life at work with my life at home?

Of course, entering parenthood is a major life change, so you will, naturally, have concerns. You might worry about maintaining your relationship and career. You may feel as though you’re losing control over your life—or at least over your body. You are going to reassess your identity, grow and evolve as a person. Motherhood will stretch you—mentally as well as physically, and you may feel overwhelmed, anxious, depressed or worried at times.

Mood swings are also par for the course. The hormonal increases of pregnancy are likely involved, but science has yet to prove exactly how hormones influence emotions. Reactions to hormone fluctuations also vary by individual. Some women are more emotionally afflicted during pregnancy than others, just as some are more emotional during their menstrual cycles. Be prepared to encounter some degree of moodiness, crying and increased sensitivity throughout your 40 weeks.

Are my feelings normal?
“Be aware of the myth that pregnancy is protective to your mental and emotional health, that it is always a time of joy and happiness,” warns Nguyen. “It’s also this myth that makes women feel guilty when they aren’t over the moon about being a new mom.” There are some women who feel calmer during pregnancy than at other times of their lives, but they’re the lucky ones. The rest of us will feel a mix of emotions, and it’s OK to be upset, angry, worried … as long as it’s not all the time.

If you begin to feel that negative emotions are taking over your life and outweighing the positive ones, it’s time to seek help. If your negative feelings are impacting your daily functioning or harming your relationships, it’s also time to find help. These problems go beyond the “normal” everyday mood swings and shouldn’t be ignored.

What can I do?
For many pregnant women, emotional management can be as simple as fitting in exercise, going out for fresh air, eating well, getting a massage, practicing yoga or communicating with loved ones. For others, psychotherapy is a necessary next line of defense. Especially for those who have benefitted from therapy in the past, pregnancy is a good time to go back and check in with a therapist.

Medication should not be the first solution to emotional problems, during pregnancy or any time, but sometimes it is necessary. If you’re experiencing anxiety or depression that you can’t manage through lifestyle adjustments and therapy, talk to your doctor about medicinal options. Antidepressants and antianxiety meds are subject to constant study; at this time, some are considered safer to use prenatally than others. Your doctor can help you identify what will work for you.