Why You Have Mood Swings During Pregnancy and How to Cope

A Trimester-by-Trimester Guide to Pregnancy’s Ups and Downs

Upset woman holding her head in bed
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Mood swings during pregnancy are caused by a variety of factors, including your rapidly changing hormones, the physical discomforts of pregnancy, and the very-normal worries of upcoming life change. If you find yourself feeling excited one moment and in tears the next, you’re far from alone.

There’s a reason for the clichéd image of a crying pregnant woman eating pickles and ice cream. It’s based on real life. Here’s why you may experience emotional ups and downs during pregnancy and how to cope.

Pregnancy Hormones and Mood Swings

One big reason for pregnancy mood swings is your rapidly changing hormones—specifically estrogen and progesterone. Estrogen levels soar during the first 12 weeks of pregnancy, increasing by more than 100 times.

Estrogen is associated with the brain chemical serotonin. You may know serotonin as the “happy” hormone, one that many anti-depressant medications attempt to boost. But serotonin isn’t a straightforward connection to happiness. Imbalances and fluctuations in this neurotransmitter can cause emotional dysregulation.

How exactly estrogen and serotonin interact with each other isn’t fully understood. What does seem to be apparent is that changes in estrogen levels—and not a particular level of estrogen—are what cause mood imbalances. Anxiety and irritability, in particular, are associated with estrogen changes.

But it’s not just estrogen that’s increasing. The hormone progesterone also rapidly increases during pregnancy, especially during the first three months. While estrogen is usually associated with energy (and too much of it associated with nervous energy), progesterone is associated with relaxation.

In fact, that’s just what progesterone does in the body during pregnancy. It tells the muscles to relax, partially to prevent premature contractions of the uterus. This muscle relaxation is also a factor in why women experience constipation during pregnancy. Progesterone doesn’t only act on the uterine muscles but also affects the intestinal tract. When your bowels slow down, constipation can be a result.

Relaxation hormones sound nice. But, for some women, progesterone makes them “too” relaxed. This can mean fatigue and even sadness. Progesterone is the hormone that has you crying at all the Hallmark commercials. Taken together—the anxiety and irritability from estrogen and the fatigue and tearfulness from the progesterone—is it any wonder pregnancy triggers mood swings?

Early Pregnancy Mood Swing Triggers

Hormones trigger mood swings during pregnancy, but it’s not only the hormones. The discomforts of pregnancy can cause emotional distress as well. For example, morning sickness, which can really hit you at any time of day, affects up to 70% of pregnant women.

Feelings of nausea and sometimes vomiting can be triggered by the slightest hunger pangs or even the smell of your neighbor’s cooking. For those that experience more severe morning sickness than others, anxiety may arise over whether they will suddenly feel the urge to throw-up during a business meeting. Or they may worry that they will suddenly smell something “off” as they walk down the street.

The stress of not knowing when they might feel sick, and the stress of possibly throwing up unprepared or in public, can be intense. Fatigue is another common early pregnancy symptom and one that can contribute to mood swings. No one feels well emotionally when they are tired, and you may feel really tired during those first months of pregnancy.

Lastly, women who have experienced miscarriage or infertility may be anxious about losing the pregnancy. This fear may be worse during the first trimester when the majority of pregnancy losses occur.

Second Trimester Mood Swings

The second trimester of pregnancy is often called the “honeymoon” phase. Hormones are still changing but much less so than during the first three months. Most women feel more energy and don’t have morning sickness any more—or at least, it’s not as bad.

Still, there are potential emotional triggers. For one, during the second trimester, the body shape changes really kick in. Some women can avoid maternity clothing during the first trimester, but by the second, the need for extra room is unavoidable.

Some women feel excited about their body changes. Finally, they don’t have to pull their stomach in! But others can feel anxious. This is especially true for women who have a history of body image struggles.

Prenatal testing during the second trimester also can cause emotional distress. Amniocentesis, when recommended, is usually done during the early second trimester. Deciding whether or not to have prenatal testing, and anxiety about the results, can cause emotional distress.

Another thing that can lead to mood swings is reading about everything that can possibly go wrong during pregnancy and childbirth. Some pregnancy books are more like long lists of every possible complication. This can occur during any trimester of pregnancy, of course.

Not all of the “mood swings” of pregnancy are negative, however. Some women experience an increase in libido and sexual desire during the second trimester. This is possibly because they are starting to feel physically better, and because of the increased blood flow to the pelvic region.

Third Trimester Mood Swings

During the third trimester, getting comfortable at night can be a problem. Fatigue and difficulty with sleep can lead to mood swings. Fears and worries about the upcoming birth can get intense during the last trimester, along with worries about becoming a mother or worries about mothering another child.

A “new” mood swing you may find yourself experiencing during the third trimester is “nesting." Nesting is when you are suddenly overcome with a desire to clean, organize, and physically prepare for the baby. Not everyone experiences nesting, and for most, it can be a positive mood experience. For others, especially if there are fears about not having enough to provide for the new child, nesting may lead to anxiety.

Is It Normal to Feel Angry During Pregnancy?

Some women experience irritability and even anger during pregnancy. Hormone changes are one reason for these mood swings. Just like some women experience irritability just before their period arrives every month, these same women may struggle with feelings of frustration and anger during pregnancy.

Additionally, when you aren't feeling well, your ability to stay calm and collected is lower. As a result, pregnancy fatigue and physical discomfort is a big contributor to pregnancy anger. Keeping your temper under control when you feel constantly tired is challenging.

Then, there are some women who may have feelings of resentment during pregnancy because of their life situation. Maybe their finances aren't where they want them to be, maybe they are facing stress on the job, or maybe they didn't truly want to be pregnant. Perhaps their partner pressured them into having another baby when they weren't ready, or maybe the pregnancy wasn't planned.

While occasional feelings of frustration are normal, it's important not to ignore anger if it's frequent or interfering with your ability to cope with daily life. Some research has found that anger during pregnancy may impact the unborn child. One study found that prenatal anger was associated with reduced fetal growth rate.

Also, if your anger is rooted in not wanting the pregnancy, getting therapy before the baby arrives is essential. Otherwise, early bonding between you and your infant may be negatively impacted. Bonding between a mother and child isn't just about emotional health, but also affects the child's physical well-being.

Coping With Pregnancy Mood Swings

Mood swings are pretty much an inevitable part of pregnancy. But that doesn’t mean there aren’t things you can do to make it a little easier. Here are some things you can do to cope.

Be Patient With Yourself

This is a big one. The only thing worse than feeling bad is feeling bad about the fact that you’re feeling bad. Remember that you’re not alone in your experience, that hormones are to blame for much of what you feel, and that this will all pass with time.

Talk to Your Partner and Kids

You might lose your temper, or start to cry unexpectedly. Let your partner—and your kids—know it’s not them. Apologize in advance for those momentary periods of irritability. When talking to your kids, however, be careful not to blame the baby for your moods.

They are likely already nervous that they’ll need to share you with another child. Keeping that in mind, you don’t want to give them additional reasons to be unhappy about the upcoming family change. Instead, just explain that mommy isn't feeling well lately, but everything is OK and will get better.

Put Down the Fear-Based Pregnancy Books

Of course, you want to have a healthy pregnancy. And of course, you want to be informed so you can make educated choices about your prenatal care, diet, and upcoming birth. However, if those pregnancy books are making you anxious, don’t read them. Find something more positive to read or ask your doctor directly during your prenatal checks.

Prepare for Waves of Morning Sickness

Emotionally, one of the worst parts about morning sickness is that it can strike without warning. This can make you feel out of control, and that can lead to mood swings and worry. To lessen the fears, try to be prepared.

Carry around snacks for sudden hunger pangs. Bring plastic bags such as sandwich baggies in your pockets or in your purse for when you feel like you’re going to vomit and there’s no bathroom available.

If your morning sickness is triggered by unpleasant or strong odors, try carrying something that smells good, to quickly grab and block the unwanted scents. A container of cloves or cinnamon might work or a small bottle of a hand lotion you love.

Prioritize Sleep

In the first trimester, you’re likely to be tired no matter how much you sleep. During the third trimester, you may struggle to get comfortable, and that leads to a lack of sleep. But you need sleep. Fatigue is a one-way road to more severe mood swings.

If you can take a nap during the day, take one. Even if it means napping at your desk at work. At home, do whatever you can to make bedtime a calm, quiet period, so you are more likely to get the sleep you need.

Find a Supportive Friend

Feeling fat and “ugly” when you’re looking for pregnancy clothes? Take someone with you who will stand outside the dressing room and tell you how beautiful you are.

You can also take a friend to prenatal appointments. This can be your partner, your friend, or a relative. But having someone with you, especially for ultrasounds or procedures like amniocentesis, can help with nervousness.

Take a Childbirth Course and Hire a Doula

Being fearful of delivery day is common. The more you know, and the more supported you feel, the less anxious you’ll be. Taking childbirth education classes and hiring a doula or a labor support person can help reduce that anxiety.

Connect With Other Expecting Moms

Talking to others about your mood swings and worries can help you feel normal. There are forums and social media groups just for expecting mothers. You can likely find local support groups as well on sites like Meetup, or you may meet other women through a childbirth education class.

Try Yoga or Meditation

Yoga and meditation can help reduce anxiety and increase feelings of well-being. There are many free meditation apps online to try. If you decide to take a yoga class, make sure it's for pregnant women. Or, if you can't find a prenatal yoga class, take a gentle or restorative yoga class, and talk to the yoga instructor before class begins about possible adjustments in positions.

See a Counselor

Sometimes, you need a professional to help you cope. That’s OK. You don’t have to be “clinically depressed” to see a therapist. Counselors are there to 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.

Also, a counselor can help you determine if your mood swings are something more than the “typical” experience. And if you're worried you might actually be depressed or have an anxiety disorder, a therapist can help with this. Your doctor also can help. So, be sure to mention your concerns.

A Word From Verywell

Mood swings are a normal experience during pregnancy. Your body is going through physical and hormonal changes, and your day-to-day life is about to change. Of course, you’re having emotional ups and downs.

While mood swings are common, depression is a different matter. There is also a difference between feeling nervous and having anxiety that interferes with your ability to get through the day. Depression and anxiety aren’t the same as “mood swings.”

Depression or anxiety during pregnancy can increase the risk of experiencing postpartum depression or anxiety. Both depression and anxiety can have adverse health effects on your newborn baby and yourself.

It’s important that you talk to your doctor about your emotional struggles if you think you may be depressed or dealing with an anxiety disorder. According to one study, less than 20% of women who experienced postpartum depression ever mentioned it to their healthcare provider. But your doctor can help, so please, speak up. You don’t need to suffer silently.

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