I Thought I Was Supposed to Be Happy: Understanding Depression During Pregnancy

Written by: Virginia Kuhn, LPC

You can want your baby, feel grateful for your pregnancy, and still be struggling emotionally. Those experiences can exist together.

Pregnancy is often portrayed as a season of excitement, glowing skin, and joyful anticipation. But your experience may feel very different. You might feel sad, disconnected, irritable, or overwhelmed—and then feel guilty for having those feelings in the first place.

Maybe you find yourself thinking:

• “I wanted this pregnancy. Why don’t I feel happier?”

• “Everyone keeps telling me how exciting this is, but I feel empty.”

• “I don’t feel like myself anymore.”

• “If I’m struggling already, what does that mean about the kind of parent I’ll be?”

These feelings deserve care and attention. You do not have to perform happiness to be worthy of support.

Depression Can Begin During Pregnancy

Many people have heard of postpartum depression, but depression can also occur before a baby is born. Depression during pregnancy is often called prenatal or antenatal depression. The broader term perinatal depression includes depression during pregnancy and after childbirth.

Depression is a health condition with multiple contributing factors. Hormonal changes, genetic vulnerability, life stress, and a personal or family mental health history can play a role. It is not your fault, and it is treatable. National Institute of Mental Health (NIMH)

What Depression During Pregnancy Can Look Like

Depression does not always mean crying all day. It can show up as:

• Persistent sadness, emptiness, or hopelessness.

• Losing interest in activities or relationships you usually enjoy.

• Irritability, frustration, or feeling emotionally worn down.

• Strong feelings of guilt, worthlessness, or inadequacy.

• Difficulty concentrating or making decisions.

• Changes in sleep, appetite, or energy.

• Withdrawing from others.

• Thoughts of death or suicide.

Some of these changes overlap with the physical experiences of pregnancy, which can make them difficult to recognize. A healthcare provider can help you sort through what may be related to pregnancy, depression, another medical concern, or a combination.

Pay attention to symptoms that persist, intensify, or affect daily life. You do not need to wait until you are unable to function to ask for help. National Institute of Mental Health (NIMH)

The Pressure to Enjoy Every Moment

When people say, “You must be so excited!” there may not feel like much room for an honest answer.

You might be excited—and also scared. You might feel grateful—and also miss having energy, independence, or a body that feels familiar. You might love the idea of becoming a parent while struggling with the daily experience of pregnancy.

For someone who has experienced infertility or pregnancy loss, it may feel especially difficult to admit that pregnancy is emotionally hard. “I worked so hard for this,” you might think. “I shouldn’t complain.”

You are allowed to speak honestly about your experience. Gratitude does not erase distress, and distress does not cancel out gratitude.

When Pregnancy Changes Your Everyday Life

Nausea, pain, exhaustion, medical appointments, or activity restrictions can make familiar routines harder to maintain. Work may feel more demanding. Relationships may shift. Activities that usually help you feel connected to yourself might become less accessible.

These challenges do not automatically mean you have depression. But they deserve attention, particularly when persistent low mood or loss of interest develops alongside them.

Instead of asking, “Why can’t I handle this better?” consider asking, “What has become harder, and what support would help?”

That support might include talking with your prenatal provider about physical symptoms, adjusting responsibilities, asking someone for practical help, or seeking mental health care.

How Therapy Can Help

Therapy offers a place to talk honestly about pregnancy, including the feelings that do not fit neatly into a happy announcement.

Evidence-based treatments, including Cognitive Behavioral Therapy (CBT) and Interpersonal Therapy (IPT), can help with perinatal depression. Depending on your needs, therapy may involve addressing harsh self-talk, reconnecting with manageable activities, navigating changing relationships, and strengthening support.

Treatment may also include medication. A qualified prescriber can discuss the benefits and risks of treatment during pregnancy, including the risks of untreated depression. Talk with your provider before starting, changing, or stopping medication. National Institute of Mental Health (NIMH)

You Can Ask for Support Before Your Baby Arrives

You do not need to wait until postpartum to address your mental health.

Tell your OB-GYN, midwife, or prenatal care provider how you have been feeling. Depression and anxiety screening is recommended during pregnancy, with follow-up assessment and care when needed. A screening is a starting point for a conversation, rather than a diagnosis on its own. www.acog.org

If finding the words feels difficult, you might start with:

“I haven’t been feeling like myself. I’m feeling low or disconnected, and I’d like help figuring out what’s going on.”

If you are supporting someone who is pregnant, make room for an honest answer when you ask how they are doing. Listening without immediately offering reassurance or advice can help them feel heard. Practical help and encouragement to seek care can also matter.

You Deserve Care in This Season, Too

At Bloom & Breathe Therapy, we support individuals navigating pregnancy, postpartum, and the emotional changes that can come with becoming a parent. Our approach is compassionate, collaborative, and tailored to your needs.

You do not need to convince us that your pregnancy is hard enough. You can bring your excitement, sadness, uncertainty, resentment, hope, or exhaustion into the same conversation.

If pregnancy has left you feeling persistently low, disconnected, or unlike yourself, contact Bloom & Breathe Therapy to learn about scheduling a consultation.

If you are having thoughts of suicide or need immediate emotional support, call or text 988 in the United States. If there is immediate danger, call 911. For free, confidential support during pregnancy or postpartum, call or text the National Maternal Mental Health Hotline at 1-833-852-6262. National Institute of Mental Health (NIMH)

This post is for educational purposes and does not replace individualized assessment or treatment.