When do mood swings start in pregnancy

Your emotions might not necessarily only revolve around excitement when you’re pregnant. So you’re not alone if you’re feeling strong moods and emotions. Find out why this happens and how to manage mood swings in pregnancy.

Normal hormonal changes in pregnancy

As soon as you become pregnant, your body begins to prepare for safeguarding and maintaining the pregnancy. This increases your levels of the hormones oestrogen and progesterone in your blood. Read more about what these hormones do in your body in our article about pregnancy hormones.

High levels of progesterone and oestrogen are important for a healthy pregnancy, but are often the cause of some common unwanted side effects. This is especially true in the first trimester. 

Apart from the morning sickness and tiredness, you might have mood swings and feel tearful or easily irritated (Society for Endicrinology, 2018). Once your body has adapted to the higher levels of these hormones, the symptoms usually wear off. But some women will experience them throughout their pregnancy. 

Normal emotional changes in pregnancy

Aside from emotional ups and downs caused by rising hormone levels in the first three months, the feeling of growing a new life can be exciting and awe-inspiring (Healthtalk.org, 2019). It is also common for women to feel anxious, vulnerable and overwhelmed by the big changes that pregnancy and a new baby will bring (NHS Inform, 2019). 

Even if you feel excited by your pregnancy, you will undoubtedly have some unsettling thoughts. Perhaps there will also be some difficult decisions to make. Most women have many questions that they ask of themselves. They might doubt their ability as a mother, how their relationship might change or how they will manage financially (Tommy’s, 2019a). Other normal worries include:

• What if I do something accidentally to harm the baby, like eating or drinking something I shouldn’t?
• Should I stop having sex while pregnant?
• What will the birth be like?
• Will my life go back to normal afterwards, for example can I return to work?

If you experienced problems with a pregnancy before, you might also worry about it happening again (Tommy’s, 2019a).

Managing emotions during pregnancy

It’s hard to think clearly or feel positive when you are feeling unwell and tired. Taking good physical care of yourself, especially getting plenty of rest and sleep, will help to keep troubling emotions in proportion (MIND, 2019).

It’s also important to eat several small healthy meals a day and try to avoid sugary foods, alcohol, tea, coffee and fizzy drinks (NHS, 2019; NHS Start4life, 2019).

Gentle to moderate exercise can help to improve mood and general fitness, and benefits your growing baby and your labour (Tommy’s, 2019b). Try to build in some activity every day. Avoid contact sports or any strenuous exercise, particularly if you weren’t active before your pregnancy(NHS, 2019).

Reduce other sources of stress if you can, and find ways to boost your emotional wellbeing. Try to deal with worries one at a time, rather than feeling swamped by them (Tommy’s, 2019b).

Finding out about benefit entitlements, midwife appointments, what you should eat and what you need for your baby can feel overwhelming. So starting a to do list can help you get these things organised. This NHS one has lots of useful information.

Talk it out

Bottling up your concerns will only increase your anxiety (Tommy’s, 2019). Discuss your feelings and worries with whoever you feel comfortable with. That might be your partner, friends, wider family, or your midwife.

Talking to other women or couples may also reveal that you are not alone in your experiences. Joining an antenatal course like those from NCT, a pregnancy yoga class, or a ‘bumps and babies’ group can give you an instant support network. 

Live in the moment

Try to limit the time you spend mulling over your concerns, and give yourself a rest from being future-oriented. Instead, focus on your unborn baby and take time to enjoy being pregnant.

Many expectant mums find it helpful to practise mindfulness techniques or do something they enjoy (MIND, 2019). Using mindfulness can give your brain a rest from worrying, which will improve your mood and may help you to see things more clearly and in perspective (Dunn et al, 2012).

Listening to music can be helpful in calming emotions and enhancing wellbeing in pregnancy (Nwebube et al, 2017). Some mums also like to keep photos or diaries to remind them of better times on days when they’re feeling down. Writing about your emotions and noting down how you feel about stressful events can also be a good tool for managing stress and anxiety (Ulrich and Lutgendorf, 2002).

When you might need more support with your emotions

It is important to recognise that there is a difference between normal pregnancy emotions and a mental health issue. Pregnancy can be a time when women experience mental health issues for the first time (NHS, 2019).

More than one in eight women experience depression or anxiety when they’re pregnant, or sometimes both (NICE, 2014). Always see your GP or your midwife if you:

• have prolonged feelings of sadness
• have intrusive thoughts that you can’t control
• have lost interest in things you normally enjoy
• find yourself engaging in repetitive patterns of behavior, like repeatedly washing your hands or checking social media
• feel worthless
• feel unable to concentrate or make decisions
• have difficulty falling or staying asleep
• have lost your appetite
• are having panic attacks
• feel morbidly fearful of giving birth
• have thoughts about suicide.

(Tommy’s, 2019b; MIND, 2019)

If you have had depression or anxiety or any other mental health diagnosis in the past, then talk through this with your midwife early in your pregnancy. A relapse can be possible during pregnancy or after you give birth (NICE, 2014).

This page was last reviewed in January 2019

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

We also offer antenatal courses which are a great way to find out more about birth, labour and life with a new baby.

NICE published a booklet Mental health problems during pregnancy and after giving birth covering antenatal and postnatal depression.

Sands is a charity which can help and support parents suffering grief and bereavement following the loss of a baby. 

References

Dunn C, Hanieh E, Roberts R, Powrie R. (2012) Mindful pregnancy and childbirth: effects of mindfulness-based intervention on women’s psychological distress in the perinatal period.  Archives of Women Mental Health. 15(2):139-143. Available from: https://www.ncbi.nlm.nih.gov/pubmed/22382281 [Accessed 1st January 2019].

Healthtalk.org. (2019) Pregnancy: symptoms and feelings. Available from: https://healthtalk.org/pregnancy/symptoms-and-feelings-in-early-weeks [Accessed 1st January 2019]

MIND. (2019) Mental health problems – an introduction: Look after your physical health. Available from: https://www.mind.org.uk/information-support/types-of-mental-health-problems/mental-health-problems-introduction/self-care/#e [Accessed 1st January 2019]

NICE. (2014) Antenatal and postnatal mental health. National Institute for Health and Care Excellence clinical management and service guidance CG192.  Available from: https://www.nice.org.uk/guidance/CG192 [Accessed 1st January 2019]

NHS. (2019) Your pregnancy and baby guide. I’m pregnant. Available from: https://www.nhs.uk/Conditions/pregnancy-and-baby/?tabname=im-pregnant#  [Accessed 1st January 2019]

NHS. (2018) Mental health problems and pregnancy. Available from: https://www.nhs.uk/conditions/pregnancy-and-baby/mental-health-problems-pregnant/ [Accessed 1st January 2019]

NHS Inform. (2019) Pregnancy: emotions and worries. Available from: https://www.nhsinform.scot/ready-steady-baby/pregnancy/relationships-and-wellbeing-in-pregnancy/your-mental-health-and-wellbeing-in-pregnancy [Accessed 1st January 2019]

NHS Direct Wales. (2017) Pregnancy guide. Available from: http://www.nhsdirect.wales.nhs.uk/livewell/pregnancy/whenpreg/  [Accessed 1st January 2019]

NHS Start4life. (2019) Week 8 – your 1st trimester. Available from: https://www.nhs.uk/start4life/pregnancy/week-by-week/1st-trimester/week-eight/  [Accessed 1st January 2019]

Nwebube C, Glover V, Stewart L. (2017) Prenatal listening to songs composed for pregnancy and symptoms of anxiety and depression: a pilot study. BMC Complementary and Alternative Medicine 17(1):256. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28482901 [Accessed 1st January 2019]

Society for Endricinology. (2018) Hormones of pregnancy and labour. Available from: http://www.yourhormones.info/topical-issues/hormones-of-pregnancy-and-labour/  [Accessed 1st January 2019]

Tommy’s. (2019a) Emotional changes in pregnancy. https://www.tommys.org/pregnancy-information/im-pregnant/mental-wellbeing/emotional-changes-pregnancy Available from: [Accessed 1st January 2019]

Tommy’s. (2019b) Getting help and support with mental health. Available from: https://www.tommys.org/pregnancy-information/im-pregnant/mental-wellbeing/getting-help-and-support-mental-health [Accessed 1st January 2019]

Ullrich, Philip M, Lutgendorf, Susan K. (2002) Journaling about stressful events: effects of cognitive processing and emotional expression. Annals of Behavioral Medicine. 24(3):244-50. Available from: https://www.ncbi.nlm.nih.gov/pubmed/12173682 [Accessed 1st January 2019]

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