While pregnant, you will experience a gamut of emotions—many of which may be completely new to you. What's to blame? For one thing, you might be experiencing financial and other worries as well as a total upheaval of your old, familiar life. For another, your body and brain are going through major physical adjustments.
"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 (Houghton Mifflin). "All women are different, but in some, the emotional changes can be extreme."
To help you cope with the potential swings in your temperament, here's a guide to your new pregnancy emotions, why and when each happens, and how to cope when the going gets rough.
Once a fertilized egg implants in your uterus, the developing placenta begins to secrete hormones essential to your baby's growth. Ironically, soaring hormones are a pregnant woman's best friend – and her baby's lease on life. Human chorionic gonadotropin, or 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) 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 or extreme moodiness.
Why you feel that way: "Estrogen can produce a sense of well-being," explains Puryear. "Then again, a lot of women are just really excited and happy about being pregnant, especially those who've been trying for a while."
Coping strategies: Who needs 'em? Enjoy it while it lasts!
Why you feel that 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.
Coping strategies: First, explain to your partner that you're experiencing some pretty heavy emotions. By making sure that he understands your fickle humor has nothing to do with him, you can nip any potential relationship tension in the bud. Same goes for other family members and friends.
Second, take care of yourself: Regular exercise and a healthy diet can help abate the negative feelings and intensify 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 your doctor, since it can not only recur during pregnancy, but also linger and become more severe after you give birth.
Why you feel that way: They don't call the second trimester the "honeymoon phase" for nothing. During this stage of pregnancy, your belly size is still manageable and your breasts may be larger, so your partner might find you incredibly sexy. For you, the increase in blood volume during pregnancy leads to, well, more blood flow – everywhere. "Your nipples and genitals are more sensitive, so you may feel more sexual," says Puryear. "Plus, the uterine contractions during orgasm feel more intense when you're pregnant."
Coping strategies: Get your doctor's OK, then go for it!
Why you feel that way: In tandem with progesterone, hCG levels may cause the crushing exhaustion and morning sickness many women experience in the first trimester. The fatigue can cause the drop in acuity many women complain about, but it may not be the only reason you're not as clear-minded as you used to be. "Your priorities change," explains Puryear. "You were once focused on meetings and deadlines; now you're fantasizing about baby names and being a mother."
Coping strategies: If you have a job, compartmentalize: Try to keep work at work and concentrate on your baby registry list and other "mommy" tasks when you're at home. It's also helpful to write down your thoughts and to-dos; this will not just help you feel organized but will 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, tell your doctor, who may want to perform tests to rule out such conditions as anemia (caused by having too few red blood cells) or hypothyroidism (a low-functioning thyroid gland).
"For decades, pregnancy was thought to be a period of emotional well-being," says Dr. Shivakumar. "However, recent studies have suggested that pregnancy poses a risk for recurrence of depression in women with prior histories of major depression."
Though 10 percent or more of women show symptoms of major depression during pregnancy, women often believe they result from normal hormonal changes and hence do not consult their doctors. But untreated, depression can be dangerous to both mother and baby, as it can lead to poor nutrition, drinking, and smoking (which, in turn, are linked to premature birth, low birth weight, and developmental problems).
If you have any of the following symptoms for two weeks or more, discuss them with your doctor immediately:
Treatment options include support groups, cognitive-behavioral therapy, light therapy, or pregnancy-safe antidepressant medications.
Here are some simple rules to get you through pregnancy and new motherhood with your sanity intact.
1. Remember that there's no perfect way to be pregnant. If you're temperamental and uncomfortable, it doesn't mean you won't be a wonderful mother.
2. Be flexible and patient and liberate yourself from unreasonable expectations.
3. When you cry over sappy advertisements, realize it's just business as usual during pregnancy.
4. Talk openly to your friends, partner, and other family members about your moods and feelings. It will help them to be more understanding.
5. Excise the words "I'm supposed to feel [fill in the blank] when pregnant" from your vocabulary.
6. Be aware that the first six weeks after delivery are difficult for every new mom and that taking care of yourself is just as important as taking care of your baby.
7. Commit to memory and repeat this mantra often: "I do not have to be Supermom." and after you deliver will help you cope.