Woman experiencing pregnancy anxiety and depression holds belly and feels relief through therapy in San Francisco

So you aren’t feeling all glowy and joyful like the people you see on tv ? You feel like you should be nothing but grateful and happy, but you are feeling worried about the health of the pregnancy, waiting white knuckled for the next appointment so you can get (short-lived) reassurance.

Or maybe you are feeling like isolating yourself and don’t feel particularly connected to the pregnancy at all. 

While ups and downs, worry and sadness, can move in and out of a typical pregnancy, if they are long-lasting and feel heavy and disruptive of life as usual, you may be experiencing perinatal anxiety or depression, which often first appear in pregnancy (they are also referred to as antenatal anxiety and depression).

Therapy for Pregnancy Anxiety and Depression

Common Symptoms of Anxiety During Pregnancy May Include:

  • Excessive worry about the baby’s health, development, or pregnancy outcomes

  • Intrusive or repetitive thoughts (what-if scenarios, fear of loss or complications)

  • Constant sense of dread or hypervigilance

  • Difficulty tolerating uncertainty or needing constant reassurance

  • Restlessness or feeling on edge

  • Sleep disturbances (trouble falling or staying asleep due to worry)

  • Physical anxiety symptoms (heart racing, shortness of breath, nausea, dizziness)

  • Avoidance behaviors (avoiding appointments, information, or certain activities out of fear)

Common Symptoms of Depression During Pregnancy May Include:

  • Persistent sadness or low mood

  • Loss of interest or pleasure in activities or the pregnancy itself

  • Feelings of hopelessness or emptiness

  • Guilt or shame (not feeling “excited enough,” feeling like something is wrong with you)

  • Low energy or fatigue beyond typical pregnancy-related tiredness

  • Changes in appetite not fully explained by pregnancy

  • Difficulty concentrating or making decisions

  • Thoughts of worthlessness or feeling like a burden
    (may include passive thoughts such as “I don’t matter”)

Common Overlapping Symptoms of Anxiety and Depression During Pregnancy May Include:

  • rritability or mood swings

  • Sleep problems

  • Difficulty concentrating or mental fog

  • Feeling overwhelmed or unable to cope

  • Emotional numbness or detachment

  • Physical complaints (headaches, stomach issues, muscle tension)

  • Withdrawal from others

  • Persistent self-doubt or reduced confidence

How Does Therapy Help With Pregnancy Anxiety and Depression?

1. By reducing overwhelming thoughts and worry. We help you to identify anxious or depressive thought patterns, teach you ways to notice them for what they are, and make them feel less “sticky.” We may explore your more core self (the part of you that remains when the symptoms recede) and locate past experiences and present life circumstances that might be impacting your pregnancy state of mind. 

2. By validating and empowering you through your experience. We provide education on your symptoms to help you understand them as common, treatable, and not a personal failure. We are packed with education and practice that grounds our belief that you will feel better.

3. By building coping tools for pregnancy-specific stress: We teach skills for sleep hygiene, emotional regulation, uncertainty tolerance, and preparing for postpartum transitions. Also in our tool kit are referrals to other helpful pregnancy support resources of many kinds.

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Frequently Asked Questions

  • There is no shortage of well meaning but uninformed people who will tell you it’s all normal, and some degree of worry and/or moodiness is. However, we want to look at the degree and duration of your symptoms as well as the impacts on your functioning in important areas of life (this last one can be tricky as we see clients overriding their symptoms with their high achieving, perfectionistic ways. But there’s always fallout at some point). If symptoms are intense vs mild and last for weeks instead of hours or a day or so, and/or if you just know something is off, it may be time to reach out. Hopefully your doctor or midwife is also screening with a valid tool such as the EPDS, which can also help identify symptoms.

  • Yes! Postpartum anxiety and depression often start during pregnancy so reducing symptoms and building a supportive resource toolkit can lower this risk. Also? Life is way more simple and quiet before the arrival of your baby. It’s a great time to take advantage of.

    We have written about the decision to start and elaborated on a few specific benefits here.

  • We are not doctors, so no! We do, however, refer to and work in collaboration with perinatal psychiatrists if and when medication is also part of your treatment plan,

  • We do not accept insurance and are considered out-of-network providers. Go here for more information on this and fee-related information.