Mental Health Care During Pregnancy

Medically reviewed by Shahrzad Shadmani, PMHNP-BC, FNP-C

Depression and anxiety are among the most common complications of pregnancy. They are not a sign that something is wrong with you as a parent, and they are treatable — including during pregnancy.

What it can look like

Persistent low mood or tearfulness. Loss of interest in things you normally care about. Worry that is hard to switch off, or panic. Intrusive, frightening thoughts that feel out of character. Trouble sleeping beyond what pregnancy itself explains. Feeling detached, numb or overwhelmed.

Some people experience these symptoms for the first time during pregnancy. Others, with an existing condition such as depression, anxiety, OCD or bipolar disorder, find their symptoms change — sometimes improving, sometimes getting worse.

Why treating it matters

Untreated depression and anxiety during pregnancy are associated with higher risks of preterm birth, pre-eclampsia, substance use and postpartum depression, as well as with suicide. Treatment — therapy, medication, or both — protects you and your pregnancy. It is not something to push through alone until after the birth.

If you already take psychiatric medication

Many people who become pregnant, or are planning to, already take medication for their mental health. Stopping suddenly because of pregnancy is often not the safest choice: relapse during pregnancy carries its own risks, and current obstetric guidance advises against discontinuing treatment on the basis of pregnancy alone.

The right decision depends on your history, the specific medication, and how well it has worked for you. Please do not stop or change a medication on your own — talk to your prescriber first. Read more about psychiatric medication during pregnancy and breastfeeding.

Planning a pregnancy

If you are thinking about becoming pregnant and take psychiatric medication, the best time to talk it through is before conception. That gives time to review your treatment without pressure, make any changes gradually, and have a plan in place from the start.

How we help

• A full evaluation that considers your history, your pregnancy, sleep and physical health.
• Coordination with your OB or midwife, so your mental health and obstetric care work from the same plan.
• Therapy, including cognitive behavioral therapy and trauma-focused approaches.
• Medication where it is the right choice, decided with you through a careful look at benefits and risks.
• Planning for after the birth — sleep, support, and early warning signs of postpartum depression and anxiety.

Care is available by secure telehealth across California, Oregon, Washington and Colorado, and in person at our Mission Viejo office.

Frequently asked questions

Is it safe to take an antidepressant while pregnant?

For many people, the benefits of treatment outweigh the risks. SSRIs are among the most studied medications in pregnancy and are considered a first-line option. The decision is always individual, and we make it with you.

Will my OB be involved?

Yes, with your permission. We coordinate with your obstetric clinician so your care is joined up.

I am having frightening thoughts about my baby. What does that mean?

Unwanted, intrusive thoughts are common during pregnancy and after birth, particularly with anxiety or OCD, and having them does not mean you will act on them. They are treatable, and it is safe to tell us about them. If you ever feel you might act on a thought to harm yourself or anyone else, call 911 or 988 now.

Related: Postpartum Mental Health · Medication in Pregnancy & Breastfeeding · Fertility-Related Mental Health · Women’s Health & Hormonal Psychiatry