How to Navigate the Ups and Downs of Pregnancy Mood Swings

Your body and brain are going through major physical adjustments during pregnancy, so it's normal to have strong feelings about everything you're experiencing. Some people may also experience pregnancy mood swings, as well as other new, intense feelings. After all, your body is being flooded with different hormones 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 Nutter, MD, a clinical associate 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's 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 journey. And if you're looking for a little more insight into exactly why you might be feeling everything so intensely, here's a guide to pregnancy mood swings, why they happen, and how to cope.

Pregnancy Mood Swings 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. These include human chorionic gonadotropin (hCG), progesterone, and estrogen.

"This hormonal bath, which is so beneficial to the baby, is sometimes very hard for you to take," explains Dr. Puryear. HCG, for example, may cause morning sickness. Estrogen, on the other hand, can produce a sense of well-being. It also may cause:

• Intense emotions
• Extreme mood swings (high highs and low lows)
• Anxiety
• Depression
• Irritability

You might feel emotions similar to those you experienced before pregnancy but at an elevated level. A sad commercial could now leave you sobbing; a minor mistake at work could throw off your entire day.

Common Pregnancy Emotions (and How to Deal)

Here are some of the most common emotions pregnant people experience, along with some suggestions for navigating through them.

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 those who've been trying to conceive for a while may feel especially strong emotions of happiness, though 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. If you're the opposite of happy, that's also very normal. Permit yourself to be honest about your feelings. Some ways to express yourself include journaling, talking to other pregnant people, or seeking out therapy.

Teary and irritable

Why you may feel this way: Again, you can blame hormones, says Geetha Shivakumar, MD, an assistant professor in the Department of Psychiatry at the UT Southwestern Medical Center at Dallas, who has a background in clinical research in perinatal mood disorders. 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, then take care of yourself. Regular exercise and a healthy diet can help abate the negative feelings and encourage 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, tell a health care provider. Depression can not only recur during pregnancy but 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. But even with the potential for satisfying sex, remember that many people report reduced sexual desire at some point during pregnancy, and that's OK too.

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 foggier than usual. You might notice you're misplacing your phone or forgetting details you normally wouldn't.

How to cope: You might find it helpful to write down your thoughts and to-dos. Also, move your body, even if you don't feel like it.

"To give your energy and mood a boost, exercise," urges John Hobbs, MD, 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." But the pool is not the only place to get in some mood- and energy-boosting exercise. A simple walk around the block can be just as beneficial (and a lot more convenient).

If you're extremely exhausted and mentally sluggish, share it with a health care provider. They may 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

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

While an estimated 10% to 20% of pregnant people show symptoms of major depression during pregnancy, some mistakenly believe their feelings are the result of normal hormonal changes and don't 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.

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:

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

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

Is It Normal to Feel Angry During Pregnancy?

Some people experience irritability and anger during pregnancy. Hormonal changes are one reason for these mood swings. Additionally, when you aren't feeling well, your ability to stay calm decreases. As a result, pregnancy fatigue and physical discomfort are big contributors to pregnancy anger.

While occasional feelings of frustration are normal, don't ignore anger if it's frequent or interfering with your ability to cope with daily life. Also, if your anger is rooted in resentment (i.e. you're angry about being pregnant), getting therapy before the baby arrives is essential. Otherwise, early bonding between you and your infant may be negatively impacted.

How to Cope With Pregnancy Mood Swings

Mood swings might be an inevitable part of pregnancy, but you can make them more manageable. Here are some tips.

Be patient with yourself

Remember that you’re not alone in your experience, and hormones are largely to blame for pregnancy emotions. There's no perfect way to be pregnant, so go easy on yourself and try accepting your feelings. Give yourself permission to cry, take breaks, or do whatever is needed to feel better. The ups and downs will pass with time.

Be honest about how you're feeling

Talk openly to your friends, partner, and other family members about your emotions. It might help you feel less alone—and help them be more understanding. Also, if you lose your temper or start to cry unexpectedly, let your partner—and your kids—know it’s not their fault. Apologize in advance for those momentary periods of irritability.

Surround yourself with supportive people

Pregnancy can be challenging on many levels, and surrounding yourself with positive, supportive, and uplifting people can work wonders for your mood. Consider taking someone with you to prenatal appointments, while shopping for maternity clothes, and more.

Put down the fear-based pregnancy books

Of course, you want to have a healthy pregnancy and make informed choices about prenatal care, diet, and your upcoming birth. Look for pregnancy books that help you feel educated and empowered, and avoid those that cause worry or anxiety. Ask your health care provider for recommendations.

Prioritize sleep

In the first trimester, you’re likely to be tired no matter how much you sleep. During the third trimester, you may struggle to get comfortable, which might also cause a lack of sleep. But you need sleep to thrive; fatigue is a one-way road to more severe pregnancy mood swings. Prioritize catching zzz's through naps, earlier bedtimes, and other strategies.

Take a childbirth course

It's normal to fear delivery day—but the more you know, and the more supported you feel, the less anxious you’ll be. Taking childbirth education classes can help reduce that anxiety. Also consider hiring a doula or a labor support person.

Connect with other expecting parents

Talking to others about your mood swings can help you feel better. Search for forums and social media groups for expecting parents; you can also meet other people through a childbirth education class.

Try yoga or meditation

Yoga and meditation can reduce anxiety and increase feelings of well-being. There are many free meditation apps online. If you decide to take a yoga class, make sure it's appropriate for pregnant people.

See a professional

Counselors and therapists help people cope with major life changes, and pregnancy and childbirth—whether it’s your first or fifth child—is always a major life change. Don't hesitate to reach out to a professional if you need additional support. Your doctor can also point you in the right direction.

Additional reporting by Rachel Gurevich, RN.