Perinatal anxiety and depression

Pregnancy is often pictured as a joyful time, but for many women it also brings anxiety, low mood or overwhelming worry. These feelings are common, and support is available.

What it is

Perinatal anxiety and depression refer to mental health difficulties that occur during pregnancy or in the year after birth. They are among the most common complications of pregnancy, yet they are frequently missed because symptoms can be mistaken for normal pregnancy tiredness or hormonal change. These conditions are not a reflection of how much you love your baby or how capable a parent you'll be, and a professional can assess what's happening and help.

Signs to notice

• Persistent worry that feels hard to switch off, including fears about the baby's health or your ability to cope
• Low mood, tearfulness or a sense of hopelessness lasting most days
• Difficulty sleeping, even when tired, or sleeping far more than usual
• Loss of interest in things you'd usually enjoy
• Feeling disconnected from the pregnancy or, after birth, from your baby
• Racing thoughts, panic attacks or physical symptoms like a racing heart
• Intrusive, frightening thoughts that feel distressing and out of character
• Thoughts of harming yourself or feeling life isn't worth living

What helps

• Speak up early. Tell your midwife, doctor or clinic nurse how you're really feeling at antenatal visits - they can screen for and support perinatal mental health.
• Stay connected to a support person, whether a partner, friend or family member, and let them know what you're going through.
• Keep basic routines around sleep, movement and nutrition as steady as possible, recognising this can be hard in pregnancy.
• Consider talking therapy, which is safe and effective during pregnancy and can be adapted to your needs.
• If medication is recommended, discuss the risks and benefits with your doctor - many options are considered safe in pregnancy and breastfeeding.
• Join a support group for pregnant women or new mothers, where you can hear that you are not alone in these feelings.

When to reach out for help

Reach out promptly if worry or low mood is persistent, if it's affecting your ability to function, sleep or care for yourself, or if you have any thoughts of harming yourself or your baby. These thoughts, while frightening, are a sign you need support urgently, not a reflection of who you are as a parent.

Getting help in South Africa

Cleared Mind's EAP counsellors can support you through pregnancy-related anxiety and depression. Your antenatal clinic, midwife or doctor can also refer you to appropriate mental health support. SADAG's Mental Health Line (011 234 4837) provides guidance and referrals for perinatal mental health concerns.

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If you or someone else is in immediate danger, reach out now. SADAG Suicide Crisis Helpline (24h): 0800 567 567 or SMS 31393. SAPS 10111, ambulance 10177, GBV Command Centre 0800 428 428.