Causes and How To Cope

Your body and brain go through major physical adjustments during pregnancy, so it’s normal to have strong feelings about everything you’re experiencing. Some people also experience pregnancy mood swings, as well as other new intense feelings. After all, your body is being flooded with different hormones as it grows another human—or for some people, more than one human!

“Hormonal changes play a huge role in your moods during and after pregnancy,” explains Lucy Puryear Nutter, MD, a clinical associate professor of psychiatry at Baylor College of Medicine in Houston and author of Understanding Your Moods and Emotions When You’re Expecting. “All [pregnant people] are different, but in some, the emotional changes can be extreme.”

If you’re looking for a little more insight into exactly why you might be feeling everything so intensely, here’s a guide to pregnancy mood swings, why they happen, and how to cope.

What Causes Pregnancy Mood Swings?

Once a fertilized egg implants in your uterus, the developing placenta begins to secrete hormones that are essential to your baby’s growth. These include human chorionic gonadotropin (hCG), progesterone, and estrogen.

“This hormonal bath, which is so beneficial to the baby, is sometimes very hard for you to take,” explains Dr. Puryear. HCG, for example, may be a factor in morning sickness. As these hormones rise during pregnancy, they also may cause:

• Intense emotions
• Extreme mood swings (high highs and low lows)
• Anxiety
• Depression
• Irritability

You might feel emotions similar to those you experienced before pregnancy but at an elevated level. A sad commercial could now leave you sobbing while a minor mistake at work could throw off your entire day.

When Do Pregnancy Mood Swings Start?

Pregnancy mood swings may hit at different times for different people. Many say emotional ups and downs are at their peak during the first trimester as your body adapts to fluctuating hormone levels, which can be as early as week 4. Sometimes, the highs and lows subside as the pregnancy progresses but return as your due date approaches. For others, pregnancy mood swings may be present the entire time, and this is also normal.

Common Emotions During Pregnancy

Here are some of the most common emotions pregnant people experience, along with some suggestions for navigating through them.

Blissfully happy

Why you may feel this way: “Estrogen can produce a sense of well-being,” explains Dr. Puryear. “Then again, a lot of [people] are just really excited and happy about being pregnant.” She adds that those trying to conceive for a while may experience especially strong feelings of happiness when they finally conceive, but that’s not always the case.

How to cope: Try to enjoy feeling strong and upbeat, and remember these moments when you’re feeling less than stellar. If you’re the opposite of happy, that’s also very normal. Allow yourself to be honest about your feelings. Try expressing yourself through journaling your gratitude and sharing your joy with supportive people in your life.

Teary and sad

Why you may feel this way: Again, you can blame hormones, says Geetha Shivakumar, MD, an assistant professor in the Department of Psychiatry at the UT Southwestern Medical Center at Dallas, who has a background in clinical research in prenatal mood disorders. For example, the fluctuating levels of estrogen and progesterone in your bloodstream can make you especially moody during the first trimester.

How to cope: Explain to your support system that you’re experiencing some pretty heavy emotions, then take care of yourself. Regular exercise and a nutritious diet can help diminish negative feelings and encourage positive ones. “Good physical well-being is important for emotional well-being,” says Dr. Shivakumar. “Preliminary data also suggest that eating omega-3 fatty acids may improve mood symptoms.”

Surprisingly sexual

Why you may feel this way: During the second trimester, your baby bump is still a manageable size, and you may find certain changes to your body alluring. The increase in blood volume during pregnancy also leads to more blood flow everywhere, which can make sexual sensations more pleasurable and intense.

“Your nipples and genitals are more sensitive, so you may feel more sexual,” says Dr. Puryear. “Plus, the uterine contractions during orgasm feel more intense when you’re pregnant.”

How to cope: As long as you’re cleared for sexual activity by a prenatal health care provider, go ahead and lean into your sexy feelings. Whether partnered or solo, sex and orgasm can be extra satisfying during pregnancy. But even with the potential for satisfying sex, remember that many people report reduced sexual desire at some point during pregnancy, and that’s OK, too.

Angry and irritable

Why you may feel this way: It is normal to experience irritability and anger during pregnancy due to hormonal changes. Naturally, when you aren’t feeling well, your ability to maintain your calm decreases. Pregnancy fatigue and physical discomfort are big contributors to pregnancy anger.

How to cope: Be intentional about getting more rest and relaxation. Practice deep breathing and calming exercises as feelings of frustration come and go. Don’t ignore anger if it’s frequent or interfering with your ability to cope with daily life.

Fatigued and foggy

Why you may feel this way: In tandem with progesterone, hCG levels may be behind the crushing exhaustion and morning sickness many people experience in the first trimester. The fatigue, while expected, may also make you feel a little foggier than usual. You might notice you’re misplacing your phone or forgetting details you usually wouldn’t.

How to cope: You might find writing down your thoughts and to-dos helpful. Also, move your body, even if you don’t feel like it. “To give your energy and mood a boost, exercise,” urges John Hobbs, MD, an OB-GYN at Northwestern Memorial Hospital and a clinical instructor at Northwestern University in Chicago.

“I tell my pregnant patients that taking a swim will make them feel a whole lot better.” But the pool is not the only place to get in some mood- and energy-boosting exercise. A simple walk around the block can be just as beneficial (and a lot more convenient).

Depression During Pregnancy

Other emotional challenges you might experience during pregnancy are feelings of depression or anxiety, says Dr. Shivakumar. “For decades, pregnancy was thought to be a period of emotional well-being. However, studies have suggested that pregnancy poses a risk for recurrence of depression in [people] with prior histories of major depression.”

While a range of moods and emotions is normal during pregnancy, be mindful of their intensity. An estimated 10% to 20% of pregnant people show symptoms of major depression during pregnancy, but some mistakenly believe their feelings are the result of regular hormonal changes and don’t consult a health care provider.

When left untreated, mental health disorders during pregnancy can be dangerous to both the pregnant person and the baby. For example, untreated prenatal depression is linked to postpartum depression, substance use disorders in the pregnant person, lowered nutrition levels, premature birth, low birth weight, and even later cognitive, emotional, and developmental problems for the child.

Fortunately, there are several ways to treat depression during pregnancy, including support groups, cognitive behavioral therapy, light therapy, and pregnancy-safe antidepressant medication.

Ways To Manage Pregnancy Mood Swings

Mood swings might be inevitable in pregnancy, but you can make them more manageable. Here are some general tips on managing whatever emotions come your way:

• Be honest about how you’re feeling. Talk openly to your friends, partner, and other family members about your feelings. It might help you feel less alone—and help them be more understanding.
• Surround yourself with supportive people. Pregnancy can be challenging on many levels, and surrounding yourself with positive, supportive, and uplifting people can work wonders for your mood. Consider taking someone with you to prenatal appointments or whenever you could use a little extra support.
• Be patient with yourself. Remember that you’re not alone in your experience, and hormones are primarily to blame for pregnancy mood swings. There’s no perfect way to be pregnant, so go easy on yourself and try accepting your feelings. Give yourself permission to cry, take breaks, or do whatever is needed to feel better. The ups and downs will pass with time.
• Put down fear-based pregnancy content. Of course, you want to have a healthy pregnancy and make informed choices about prenatal care, diet, and your baby’s birth. Look for pregnancy books and other pregnancy content that helps you feel educated and empowered and avoid those that cause worry or anxiety. Ask your health care provider for recommendations.
• Prioritize sleep. No matter how much you sleep, you’ll likely feel tired in the first trimester. During the third trimester, you may struggle to get comfortable, which can cause a lack of sleep. But you need sleep to thrive, and fatigue is a one-way road to more severe pregnancy mood swings. Prioritize catching z’s through naps, earlier bedtimes, and other sleep strategies.
• Take a childbirth class: It’s normal to fear delivery day, but the more you know, the less anxious you’ll be. Taking childbirth education classes can help reduce the anxiety that may result from the unknown. For additional support, consider hiring a doula or a labor support person.
• Connect with other pregnant people. Talking to others about your mood swings can help you feel better. Search for forums and social media groups for expecting parents or connect with other pregnant people through a childbirth education class.
• Try prenatal yoga or meditation. Yoga and meditation can reduce anxiety and increase feelings of well-being. There are many free meditation apps online. If you decide to take a yoga class, make sure it’s appropriate for pregnant people.

When To Seek Help for Pregnancy Mood Swings

Counselors and therapists help people cope with major life changes, and pregnancy and childbirth—whether it’s your first or fifth child—is always a major life change. Don’t hesitate to reach out to a professional if you need additional support. Your doctor can also point you in the right direction.

Additional reporting by Rachel Gurevich, RN.