Persistent sad or empty mood
Sustained low mood that lasts most of the day, more days than not, beyond the first trimester.
Prenatal (Antenatal) Depression
Depression during pregnancy is real — and treatable.
Prenatal depression — also called antenatal depression — affects an estimated 1 in 7 pregnant women, yet it is frequently overlooked because pregnancy is culturally framed as a uniformly happy time. At Pasadena Clinical Group, we treat prenatal depression with the same clinical seriousness as postpartum depression, providing perinatal therapy across Los Angeles County.
What it is
Prenatal Depression, in plain language
Prenatal depression is a clinical mood condition that develops during pregnancy. Unlike pregnancy fatigue or hormonal mood shifts that resolve in days, prenatal depression is sustained — present most of the day, more days than not — and it interferes with eating, sleep, prenatal care, and the ability to feel any anticipation about the baby.
Many pregnant women in Los Angeles describe feeling a confusing combination of guilt and grief during prenatal depression. They expected to feel "glowing" and instead feel flat, hopeless, or disconnected from the pregnancy. The cultural messaging that pregnancy is "the happiest time of your life" can make the gap between expectation and lived reality particularly painful.
Prenatal depression is the strongest predictor of postpartum depression — yet it is treatable in pregnancy with evidence-informed therapy and, when indicated, medication. Treating depression during pregnancy reduces postpartum risk and supports the developing infant.
Common Symptoms
How prenatal depression actually shows up
This list helps you recognize your own experience. It is not a diagnostic tool — a perinatal-trained clinician can help clarify what is happening for you.
Sleep disturbance
Difficulty sleeping, sleeping much more than usual, or sleep that doesn't restore — beyond expected pregnancy fatigue.
Appetite changes
Significant loss of appetite, eating much more than usual, or unintentional weight changes.
Loss of interest
Loss of enjoyment in activities, relationships, and pregnancy itself.
Tearfulness and hopelessness
Frequent crying, feelings of hopelessness, sense that things won't improve.
Guilt about pregnancy
Persistent feelings of inadequacy, guilt, or that you're not bonding with the pregnancy.
Difficulty with prenatal care
Skipping appointments, avoiding the OB office, or losing motivation for self-care.
Thoughts of harm
Thoughts of harming yourself require immediate care. Call or text 988 or 911 right away.
When & Who
When prenatal depression appears, and who is most affected
Prenatal depression can develop at any point during pregnancy. It commonly emerges in the first trimester, deepens during the second, or appears late in the third trimester. Without treatment, it often continues into the postpartum period as postpartum depression.
Risk factors for prenatal depression include:
- A personal or family history of depression or anxiety.
- Previous miscarriage, stillbirth, or pregnancy loss.
- Infertility or assisted reproductive technology stress.
- An unintended or ambivalent pregnancy.
- Limited social or partner support.
- Significant life stressors during pregnancy (housing, finances, immigration, family conflict).
- A history of trauma, particularly relating to medical settings or pregnancy.
- Pre-existing depression discontinued at conception.
How We Help
Treatment that fits the perinatal year
Prenatal depression responds well to perinatal-informed therapy. Treatment focuses on stabilizing mood during pregnancy, supporting the woman's relationship with the pregnancy, and reducing postpartum risk. We coordinate with OB providers and perinatal psychiatrists when medication is part of the plan, including discussions of medication safety in pregnancy.
- Evidence-informed individual therapy (CBT, IPT, ACT).
- Therapist-led groups with other pregnant women.
- Coordinated care with OB providers and perinatal psychiatry.
- Postpartum planning that begins during pregnancy.
Frequently Asked
Questions women ask about prenatal depression
Is it normal to feel low during pregnancy?
Some emotional shifts are expected during pregnancy. Sustained low mood, hopelessness, or loss of interest that lasts more than two weeks is not the normal course of pregnancy and warrants evaluation.
Will I be judged for not being happy during pregnancy?
Not in our practice. Perinatal-trained clinicians understand that pregnancy can be emotionally complicated, and that judgment makes things worse, not better.
Is therapy safe during pregnancy?
Therapy carries no risk to the pregnancy and is the first-line treatment for mild to moderate prenatal depression. For more severe cases, treatment may include medication options reviewed with your OB and a perinatal psychiatrist.
Can medication be safely used during pregnancy?
Some antidepressant medications have a long safety record in pregnancy and may be appropriate when depression is moderate to severe. The risks of untreated depression to both mother and baby are also significant. A perinatal psychiatrist can help weigh the tradeoffs for your specific situation.
If I treat prenatal depression, will it prevent postpartum depression?
Treatment doesn't guarantee prevention, but it significantly lowers postpartum risk. Treating prenatal depression is one of the most effective postpartum prevention strategies we have.
Is depression during pregnancy harmful to the baby?
Untreated prenatal depression has been associated with adverse outcomes for both mother and baby, including increased risk of postpartum depression, preterm birth, and infant attachment difficulties. Treated prenatal depression dramatically reduces these risks. This is why early treatment of depression during pregnancy is one of the most evidence-supported interventions in perinatal mental health.
What helps depression during pregnancy?
Evidence-based treatments include perinatal-informed cognitive behavioral therapy (CBT), interpersonal therapy (IPT), acceptance and commitment therapy (ACT), and — for moderate to severe presentations — medication options reviewed with your OB and a perinatal psychiatrist. Sleep, support, and structured therapeutic care during pregnancy substantially improve outcomes.
Can I take antidepressants during pregnancy?
Some antidepressant medications have a long safety record in pregnancy and may be appropriate, particularly for moderate to severe prenatal depression. The decision is individualized and weighs the well-documented risks of untreated depression against the much smaller risks associated with specific medications. A perinatal-aware psychiatrist works with you and your OB to make the safest choice for your situation.
Related Conditions
You may also want to read
Prenatal Depression often coexists with other perinatal conditions. These pages cover the most relevant overlaps.