Anxiety and low mood in pregnancy: how to recognise them and where to find help

Pregnancy is often described as the happiest time of a woman’s life. Yet many mums-to-be feel not only joy but also worry, irritability, sadness and sometimes a sense of emptiness. Because of what others expect, these feelings can be hard to say out loud — it seems you are ‘supposed’ to be happy. This article explains why such feelings arise, how to tell when worry has become a problem and where to get help.

Why pregnancy so often brings anxiety

Anxiety during pregnancy is very common. Several things affect your mood at once:

• Hormones. Oestrogen and progesterone levels change rapidly, especially in the first trimester, and this shows up in your emotions.
• Tiredness and poor sleep. Nausea, night-time trips to the toilet and discomfort later in pregnancy are all draining.
• Uncertainty. Worries about the baby’s health, the birth, money, work and housing, and whether you will cope as a mother.
• Relationships and family. Tension with your husband or relatives, advice and expectations from older family members, and life in a large household where it is hard to find time for yourself.
• Past experiences. A previous pregnancy loss, a difficult birth or earlier depression make anxiety more likely now.

A little worry before big events — a screening scan or the birth itself — is normal. It fades once things become clearer and does not stop you living your life.

When worry becomes a problem

An anxiety disorder or depression in pregnancy is not a weakness of character or ‘just moods’. These are common conditions, and they respond well to treatment. It is worth paying attention if, for two weeks or more, for most of the time:

• you feel sad, empty or hopeless;
• nothing brings you pleasure, even things you used to enjoy;
• anxious thoughts go round and round and you cannot switch them off;
• you cannot sleep even when you have the chance, or you sleep far more than usual;
• your appetite has disappeared or increased sharply, unrelated to nausea;
• you feel guilty, like a bad mother or a burden on your family;
• you have panic attacks: a racing heart, breathlessness, a fear of dying;
• you avoid people and tasks, and find it hard to concentrate.

Some of these signs, such as tiredness and changes in sleep, can come from the pregnancy itself. So rather than diagnosing yourself, talk about how you feel with a doctor.

What helps right now

• Talk about your feelings. Tell your husband, your mother, a sister or a friend that you are finding things hard. Often that alone brings relief. There is no need to pretend everything is fine.
• Ask for specific help. Not ‘help me’, but ‘please make dinner tonight’ or ‘could you watch our eldest for two hours so I can sleep?’
• Keep moving. A daily 20–30 minute walk or gentle pregnancy exercise — unless your doctor has advised against it — noticeably lifts mood.
• Protect your sleep. Go to bed at the same time, put your phone away an hour before sleep and rest during the day.
• Limit what you read. Frightening stories online and in group chats only feed anxiety. Choose reliable sources and take your questions to your doctor.
• Eat regularly and drink enough water: hunger and dehydration make irritability worse.
• Try simple breathing. Breathing in slowly for a count of 4 and out for a count of 6 for a few minutes can calm you during a wave of anxiety.

Where to get help in Uzbekistan

Start with your obstetrician-gynaecologist or family doctor at the polyclinic. Say it plainly: ‘I feel anxious all the time’ or ‘I feel low and it isn’t going away’. This is a symptom like pain or fever, and your doctor will take it seriously and may refer you to a psychologist, psychotherapist or psychiatrist. Seeing a psychiatrist does not mean something is ‘wrong with you’, nor does it make you a bad mother — they are specialists just like a cardiologist or an endocrinologist.

If you need medication, your doctor will choose one that is compatible with pregnancy. Do not stop any medicine you already take on your own, and do not start new ones unless your doctor prescribes them.

Remember: looking after your mental health is also looking after your baby. Mothers who get support during pregnancy tend to cope better after the birth.

When to see a doctor

Book an appointment in the next few days if low mood or anxiety has lasted more than two weeks or is getting in the way of work, sleep or caring for yourself and your family.

Get urgent help — call an ambulance on 103, go to hospital or ask someone close to take you — if:

• you have thoughts of harming yourself or feel that you do not want to live;
• you hear or see things others do not, or your thoughts feel muddled;
• you cannot look after yourself: you are not eating or drinking, or cannot get out of bed.

In that situation, do not stay alone — call someone you trust and tell them you need help right now.

The takeaway

Anxiety and sadness in pregnancy are common and understandable, and you are not alone. If they last for weeks and get in the way of daily life, that is not a reason for shame but a reason to seek help: depression and anxiety disorders are very treatable. Talk about your feelings, ask your family for support and tell your doctor how you are really feeling.