Why You Have Mood Swings During Pregnancy and How to Cope

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

Depressed woman crying on her 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 are 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 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 is also 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 is the 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, the fatigue and tearfulness from the progesterone—is it any wonder pregnancy triggers mood swings?

Other Triggers of First Trimester Mood Swings

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. Morning sickness (which can really hit you at any time of day) affects up to 70 percent 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 get morning sickness worse 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 cause 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

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! Others can feel anxious. This is especially true for women who have a history of body image struggles.

Prenatal testing during the second trimester can cause emotional distress. Amniocentesis 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.

Something else that can lead to mood swings are 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

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.

How to Cope With All These Mood Swings

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

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 (and not “weakness of character”) is to blame for much of what you feel, and that this will all pass with time.

Talk to your partner and your 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 irritable periods. When talking to your kids, be careful not to blame the baby for your moods. They are already nervous that they’ll need to share you with another child, you don’t want to give them additional reasons to be unhappy with the upcoming family change. Instead, just explain that Mommy isn’t feel well lately, but everything is okay 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, or ask your doctor directly during your prenatal checks (instead of Googling every worry).

Be prepared 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. Carry around plastic bags (sandwich baggies can work) 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 around with you 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 lack of sleep. But you need sleep! Fatigue is a one-way road to 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.

Take a supportive friend to prenatal appointments. This can be your partner, your friend, or a relative. But having someone with you, especially for ultrasounds or amniocentesis, can help with nervousness.

Bring a friend shopping when you buy maternity clothes. 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.

Take a childbirth education 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 (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.

See a counselor. Sometimes, you need a professional to help you cope. That’s okay. 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 a major life change.

Also, a counselor can help you determine if your mood swings are something more than the “typical” experience. Worried you might actually be depressed or have an anxiety disorder? A therapist can help with this.

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 percent 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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Article Sources
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