Low mood in early pregnancy – more than morning sickness

You might be blaming the tiredness

Early pregnancy genuinely wears you down. Many people feel wiped out, queasy/nauseous, foggy or unable to sleep properly, sometimes all at once, sometimes for weeks. So if you've been feeling low, it makes sense that you'd file it under “just another pregnancy complication."

But fatigue and low mood aren't quite the same, even though they can and do overlap. The difference is subtle and important to recognize.

Tiredness tends to lift, at least a little, when you finally rest. After a decent stretch of sleep, or a quiet afternoon, you might still be tired, but you can find moments of interest or even pleasure: a show you like to watch, a meal you look forward to or a message from a friend.

Low mood doesn't lift in the same way. It tends to sit underneath everything. It can dull the things you normally enjoy, so they feel flat or far away. While you may still experience moments of feeling okay, the baseline is dark. And this mood often sticks around even after a good night's sleep — the rest helps your body, but the heaviness is still there in the morning.

What this can look like:

• Feeling low or heavy most of the day, most days, even after resting
• Things you usually enjoy feeling flat, distant or like too much effort
• A sense of going through the motions without really being present
• Feeling little joy or connection to the pregnancy
• Being more irritable or tearful than the situation seems to call for
• Having very critical or hopeless thoughts about yourself/your situation/the world in general

If any of this sounds familiar, it doesn't mean something is wrong. But it might mean what you're feeling is worth a closer look.

Why early pregnancy can affect mood

A lot happens at once in the first trimester. Your hormones shift quickly, your body changes, sleep gets disrupted. And underneath all of that is the quiet psychological weight of a major life change (even a wanted one!).

Mental health is one of the most common things affected during pregnancy and the postpartum period: up to about one in five people in Canada experience a mood or anxiety challenge during this time. In Newfoundland and Labrador, this number is even higher — with some surveys showing 28% experiencing perinatal mental illness symptoms. Many experience it for the first time in pregnancy, with no prior history.

It’s important to remember: depression doesn't only happen after birth. Depression during pregnancy — sometimes called antenatal depression — is real and recognized. It’s common, and it’s not a personal failing. It says nothing about how much you want this pregnancy or whether you are doing this right.

It's not one thing

It can be tempting to look for the single reason you feel this way, to wonder whether you're simply not handling things well enough. But that isn't how this works.

Low mood during pregnancy usually results from several factors interacting at once. Hormonal change is part of it. There may also be a past history of depression or anxiety, broken sleep, strain in a relationship, not having enough support, money worries or other stress in your life. Researchers consistently describe the causes of depression in pregnancy as multifactorial — meaning many factors feed into it together, rather than one cause being to blame.

In fact, a single risk factor on its own rarely causes this. It's usually a combination, and most of those factors are nothing you chose or could have prevented.

When low mood is a signal worth acting on

The clearest signal to pay attention to is feeling low most days for two weeks or more, especially if it's making it harder to do the things you need or want to do. A few other signs should be taken seriously too, like losing interest in nearly everything, a hopelessness that doesn't lift or distressing thoughts that push their way in and upset you.

None of this is cause for alarm. It's simply a signal that support might help, and the earlier you reach for it, the better.

Intrusive thoughts are normal for new parents. But if intrusive thoughts start to feel like reality, or something you have to act upon and might start planning for, that needs urgent attention.

If you or someone you know are having thoughts of harming yourself, you can call or text the Suicide Crisis Helpline at 9-8-8, or call 9-1-1 for immediate help.

Make the next conversation small

You don't have to diagnose yourself or have it all figured out before you say anything.

The next step can be a single sentence at your next appointment. Something as simple as: “I‘ve been really sad almost every day since we last met.”

You're likely already meeting with care providers during pregnancy, so bring this up with any of them, your family doctor, midwife, obstetrician or nurse. They can take it from there, and mood challenges in pregnancy typically get better with support.

If low mood has been with you most days for the last two weeks, mention it at your next appointment. Our [Services Finder] can also connect you with someone who specializes in perinatal mental health.

This article was developed using sourced educational content from Canadian Perinatal Mental Health Trainings (CPMHT), and informed by the collective knowledge and expertise of CPMHT professionals and Karen Clarke, BA, MSW, RSW, Doula (Open Book Doula, Counselling and Consulting Services), as well as the following cited research and clinical practice guidelines: