Navigating the Ups and Downs of Pregnancy Emotions

While pregnant, you might experience a wide range of emotions, new emotions, or just much more intense emotions than you have in the past. What's to blame? Well, for one thing, pregnancy is a major life change and it's normal to have strong and even conflicting feelings about everything you're going through and the changes that are still coming.

And for another, your body and brain are going through major physical adjustments, including a huge change in the levels and types of hormones that are flooding your body as it grows another human. (Or for some people, more than one human!)

"Hormonal changes play a huge role in your moods during and after pregnancy," explains Lucy Puryear, M.D., a clinical assistant professor of psychiatry at Baylor College of Medicine in Houston and author of Understanding Your Moods and Emotions When You're Expecting. "All [pregnant people] are different, but in some, the emotional changes can be extreme."

The good news is, there is no such thing as a "bad" emotion—emotions are part of life and definitely a part of pregnancy! You're allowed to feel all the feels as you go through your pregnancy journey. And if you're looking for a little more insight into exactly why you might be feeling all those feels so intensely, here's a guide to pregnancy emotions, why and when each happens, and how to cope when the going gets rough.

The Link Between Pregnancy Emotions and Hormones

Once a fertilized egg implants in your uterus, the developing placenta begins to secrete hormones that are essential to your baby's growth. Ironically, soaring hormones are a pregnant person's best friend—and the baby's lease on life.

That's because human chorionic gonadotropin (hCG), which rises sharply in the first trimester, then dips and levels off around four months, keeps the embryo firmly implanted in the uterine lining. Progesterone and estrogen, which increase throughout the nine months, also rise to help sustain the pregnancy and cause the buildup of nourishing blood vessels.

"This hormonal bath, which is so beneficial to the baby, is sometimes very hard for you to take," says Dr. Puryear. HCG, for example, may cause morning sickness. And estrogen can produce a sense of well-being, intense emotions, and extreme mood swings, including high highs and low lows. Estrogen is also linked to anxiety, depression, and irritability, while progesterone plays a role in anxiety levels and may cause feelings of sadness as well.

You might feel emotions similar to those you felt before pregnancy, but just at an elevated level. A commercial that might have made you take pause before now could leave you sobbing; a mistake at work that normally would have been a blip in your day could instead throw off your entire day.

All of the ups and downs are normal and can be part of the pregnancy journey for some pregnant people; feeling intense emotions doesn't mean anything is "wrong" with you or your pregnancy. That being said, it's also important to stay in touch with how you're feeling and talk to a health care professional you can trust along the way, because in some cases, mood disorders can develop during pregnancy and left unaddressed, may develop into postpartum depression or postpartum anxiety after your baby is born.

Common Pregnancy Emotions (and How to Deal)

Every pregnancy is different and every pregnant person will feel different things throughout the course of their pregnancy. Remember, there's no "wrong" way to feel, and how you feel might change day to day or even hour to hour during your pregnancy. Life has its ups and downs and so does pregnancy.

But here are some of the most common emotions pregnant people report experiencing, along with some suggestions for navigating through those big emotions. And if you feel you need some extra support, don't hesitate to reach out to a health care provider about your mental health.

Blissfully happy

Why you may feel this way: "Estrogen can produce a sense of well-being," explains Dr. Puryear. "Then again, a lot of [people] are just really excited and happy about being pregnant." She adds that some pregnant people who may have been trying to conceive for a while may feel especially strong emotions of happiness, although again, that's not always the case.

How to cope: Just try to enjoy it, and remember these moments when you're feeling less than stellar. And if you are feeling the opposite of happy, remember that's also very normal! Pregnancy is a major life change, so it's normal to have mixed emotions. Try being honest about your feelings, journaling, talking to other pregnant people who might feel the same way, or seeking out therapy.

Teary and irritable

Why you may feel this way: "Hormones appear to play a significant role in the precipitation of emotional issues during pregnancy," explains Geetha Shivakumar, M.D., an assistant professor in the department of psychiatry at the UT Southwestern Medical Center at Dallas, who conducts clinical research in perinatal mood disorders.

"Common symptoms are irritability, sadness, or anxiety, and they may be [more] prominent in certain months of pregnancy," Shivakumar adds. For example, the fluctuating levels of estrogen and progesterone in your bloodstream can make you especially moody during the first trimester.

How to cope: First, explain to your support system that you're experiencing some pretty heavy emotions. By making sure the people around you understand that your feelings aren't necessarily centered around them, you may be able to nip any potential relationship tension in the bud.

Second, take care of yourself: Regular exercise and a healthy diet can help abate the negative feelings and support the positive ones. "Good physical well-being is important for emotional well-being," says Dr. Shivakumar. "Preliminary data also suggest that eating omega-3 fatty acids may improve mood symptoms."

Finally, if you have a history of depression, be sure to tell a health care provider, since depression can not only recur during pregnancy but it can also linger and become more severe after you give birth.

Surprisingly sexual

Why you may feel this way: They don't call the second trimester the "honeymoon phase" for nothing. During this stage of pregnancy, your abdomen size is most likely still manageable and you may find certain changes to your body alluring.

Additionally, the increase in blood volume during pregnancy leads to more blood flow everywhere, which can make sexual sensations more pleasurable and intense. "Your nipples and genitals are more sensitive, so you may feel more sexual," says Dr. Puryear. "Plus, the uterine contractions during orgasm feel more intense when you're pregnant."

How to cope: As long as you're cleared for sexual activity by a prenatal health care provider, go ahead and lean into your sexy feelings. Whether partnered or solo, sex and orgasm can be extra satisfying.

Fatigued and foggy

Why you may feel this way: In tandem with progesterone, hCG levels may be behind the crushing exhaustion and morning sickness many people experience in the first trimester. The fatigue, while normal, may also make you feel a little more foggy than usual; you might notice you're misplacing your phone more often or forgetting details you normally don't.

How to cope: You might find it helpful to write down your thoughts and to-dos. Having a list can not just help you feel organized but will it can also prevent you from forgetting them entirely.

Most important, move your body even if you don't feel like it. "To give your energy and mood a boost, exercise," urges John Hobbs, M.D., an OB-GYN at Northwestern Memorial Hospital and a clinical instructor at Northwestern University in Chicago. "I tell my pregnant patients that taking a swim will make them feel a whole lot better."

If you're extremely exhausted and mentally sluggish, share that with a health care provider. They may want to perform tests to rule out conditions such as anemia (caused by having too few red blood cells) or hypothyroidism (a low-functioning thyroid gland).

Depression During Pregnancy

Another emotional challenge you might experience during pregnancy is feelings of depression or anxiety. "For decades, pregnancy was thought to be a period of emotional well-being," says Dr. Shivakumar. "However, studies have suggested that pregnancy poses a risk for recurrence of depression in women with prior histories of major depression."

While an estimated 10% to 20% of pregnant people show symptoms of major depression during pregnancy, some pregnant people mistakenly believe their feelings are the result of normal hormonal changes and do not consult a health care provider. But when left untreated, mental health disorders during pregnancy can be dangerous to both the pregnant person and the baby.

For instance, untreated perinatal depression is linked to substance use disorders in the pregnant person, lowered nutrition levels, premature birth, low birth weight, and even later cognitive, emotional, and developmental problems for the child.

If you have any of the following symptoms for two weeks or more, discuss them with a health care provider immediately:

• Intense sadness or anxiety
• Difficulty concentrating
• Sleeping too little or too much
• Change in eating habits
• Loss of interest in favorite activities
• Recurring thoughts of death, suicide, or hopelessness
• Feelings of guilt or worthlessness

Treatment options include support groups, cognitive behavioral therapy, light therapy, and pregnancy-safe antidepressant medications.

7 Ways To Navigate Challenging Pregnancy Emotions

If you're still feeling a little overwhelmed by all the different emotions pregnancy can bring, here are some additional tips to keep in mind as you navigate this journey.

1. Remember that there's no perfect way to be pregnant

And on that note, there's no perfect or even one "right" way to parent either, so let this be a lesson you take with you. Even the best parents have bad days, challenging emotions, and deal with frustration and stress. You're human!

2. Don't place unreasonable expectations on yourself

Odds are, you're juggling a lot right now. From being pregnant to work to other family and personal responsibilities, chances are, you have a lot going on. The last thing you need right now are any expectations to be perfectly in control of your hormones and emotions too.

3. Give yourself permission to cry

Especially if you cry over sappy advertisements, realize it's just business as usual during pregnancy.

4. Be honest about how you're feeling

Talk openly to your friends, partner, and other family members about your moods and feelings. It will help them to be more understanding.

5. Stop saying this phrase

Remove the words "I'm supposed to feel [fill in the blank] when pregnant" from your vocabulary. There is no right or wrong when it comes to pregnancy emotions.

6. Remember that you matter after pregnancy too

Be aware that the first six weeks after delivery, and beyond, are difficult for every new parent and that taking care of yourself is just as important as taking care of your baby.

7. Repeat this mantra

Commit to memory and repeat this mantra often: "I do not have to be a Super Parent." Sometimes, it's just about getting through the day, and that's OK.