Many people may have depression during pregnancy. You may feel sad, anxious, and very tired. It may be hard for you to do daily tasks. This is called perinatal depression. Perinatal means during and after pregnancy. (You may also hear it called prenatal or antenatal depression.) If you have symptoms for more than 2 weeks, call your doctor. There are ways to treat this depression.

Many things may lead to perinatal depression. Research shows that it is linked to these factors:

• Hormone changes during and after pregnancy
• Life stress
• History of depression
• Your genes

Symptoms may vary for each person. They may include:

• Feeling very tired, with no energy (fatigue)
• Crying often or for no clear reason
• Feeling very sad, anxious, or overwhelmed
• Feeling hopeless or worthless
• Being moody
• Sleeping too much, or not sleeping
• Having trouble eating
• Having trouble thinking or making decisions
• Not being able to do your normal daily tasks
• Not wanting to be around family or friends
• Loss of appetite
• Eating more than usual
• Thoughts about death or harming yourself

Your doctor will ask about your symptoms and your health history. They may ask you questions about your thoughts or feelings in the last 2 weeks.

There are several ways to treat this type of depression. Your doctor may advise any of these for you:

• Talk therapy. There are different kinds of this therapy. It's also called counseling. You can talk about your thoughts and feelings with a doctor trained to coach you in different ways.
• Cognitive Behavioral Therapy (CBT). This helps you learn ways to change thinking and behaviors that are part of your depression. This can help ease your depression.
• Interpersonal therapy (IPT). This helps you communicate and make your social support system stronger. It helps you learn what to expect, and ways to deal with crises. This can help ease depression.
• Medicine. Antidepressants are the main type of medicine to treat depression. Most antidepressants are considered safe to use in pregnancy and with breastfeeding. It may take 6 to 8 weeks to feel better with medicine. Some medicines have side effects. Ask your doctor what to expect.

Perinatal depression may lead to a higher risk of preterm birth. This means giving birth before 37 weeks of pregnancy.

During this time, you need support to help you with self-care. Here are some tips:

• Talk with family and friends about how you are feeling.
• Accept offers of help from others.
• Keep all of your therapy appointments.
• Go to all of your prenatal care visits.
• Don't stop or change the dose of antidepressant medicine. Talk with your doctor first.
• Ask people to help you reduce sources of stress.
• Get physical activity every day.
• Eat a healthy diet.
• Go to prenatal classes and talk to people.
• Ask your doctor about support groups.
• Talk with a faith or spiritual advisor.

• SAMHSA, national helpline is 800-662-HELP (800-662-4357) or findtreatment.samhsa.gov

If you have thoughts of harming yourself or others, call or text 988 now. You will be connected to trained crisis counselors at the Suicide & Crisis Lifeline. An online chat choice is available at 988lifeline.org. The line is free and available 24/7.

Contact your doctor if you have any of these:

• Symptoms that don't get better, or get worse
• New symptoms