How to deal with mood swings during pregnancy

Pregnancy is a transformational phase in a woman’s life. Many times for numerous women it is also a time of emotional turbulence because of the changes happening inside the body — hormonal, physical and psychological. These changes can trigger a wide range of emotions — from elation to deep anxiety.

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Mood swings, emotional sensitivity, sudden tears, irritability, or overwhelming worry — these are all part of the emotional rollercoaster experience during pregnancy. While some fluctuation in mood is normal, it’s essential to understand the mental health dimensions of a pregnant woman and ensure she receives the emotional support and care needed.

Why mood swings happen

Hormonal changes: During the nine-month period, there is surge in hormones like oestrogen and progesterone. These hormones, while essential for supporting the pregnancy, also impact neurotransmitters in the brain that regulate mood. Oestrogen can heighten emotional sensitivity whereas progesterone has a calming effect but can also make you feel drowsy or withdrawn.

The imbalance can create rapid mood shifts between feeling happy, overwhelmed, irritated, or tearful — all within a short span of time.

Physical discomfort and fatigue: Morning sickness, backache, bloating, and constant fatigue can be mentally exhausting. Sleep disruptions and physical exhaustion further drain emotional resilience.

Fear and uncertainty: From worrying about the health of the baby, fear of labour, life concerns — a pregnant woman can experience all kinds of fears. First-time moms, in particular, may struggle with anxiety about the unknown.

Body image and identity change: As the body changes in pregnancy, a pregnant woman may experience a shift in her body image. While some are not bothered or feel happy or proud, for others it may cause insecurity or anxiety, as some women can experience hair fall, changes in skin including melasma (brown patches on the face due to increased melanin production), stretch marks, acne, etc.

Mood swings are common in the first trimester due to initial hormonal changes but usually stabilise in the second trimester as hormone levels stabilise. Anxiety may come back again during the third trimester, as birth time approaches.

Signs that warrant intervention

Persistent sadness, hopelessness, extreme anxiety, or detachment could be signs of prenatal depression or anxiety disorders. It's estimated that one in seven women experience depression during pregnancy, and many go undiagnosed.

Red flags to watch for

• Loss of interest in activities or relationships
• Difficulty in concentrating or making decisions
• Sleeping too much or too little
• Significant changes in appetite
• Intense irritability or anger
• Thoughts of self-harm or harming the baby

If any of these symptoms persist for more than two weeks, seek professional help. A pregnant woman’s mental health is as important as physical health —for both the mother and the baby.

Practical steps to manage mood swings and stress

Open communication: Talk about how you are feeling to your partner or a friend, or seek a therapist. Bottling up emotions can worsen stress and anxiety.

Prioritise rest and sleep: Lack of sleep can intensify emotional reactivity. A well-rested body handles stress better. Nap when tired and get 7-8 hours of sleep.

Focus on healthy and balanced diet: Nutrition has a major a role in mental health. Ensure your diet includes omega-3 fatty acids (walnuts, flaxseeds), iron and folate, magnesium and vitamin B6

A balanced diet can help stabilise mood and energy levels. Include multivitamin/supplements if your doctor has recommended any.

Exercise is a natural mood booster as it releases endorphins. Try walking, gentle stretching, prenatal yoga, or swimming. These also reduce anxiety and improve sleep.

Practice mindfulness: Mindfulness practices like meditation, deep breathing, or journaling can help ground you. Even 10 minutes a day can make a big difference in emotional stability.

Join a support group: Connecting with other expectant moms can help in normalising the ups and downs, because of shared experiences and helpful tips.

Limit stress triggers: Reduce exposure to stressful news, social media, or negative environments. Set boundaries and ask for help when needed.

Engage in creative or relaxing activities: Art, music, crafts, or reading can be therapeutic, help process emotions and reduce stress.

Role of partner and family

Support from loved ones can significantly buffer emotional stress during pregnancy. Partners can help by listening, attending prenatal visits, and sharing household responsibilities. Family and friends can offer practical help with meals, errands, and of course emotional support.

It’s vital for a woman’s support network to recognise signs of mental distress and encourage professional intervention when necessary.

When to seek professional help

If your emotional struggles feel overwhelming or persistent, reach out to a mental health professional who specialises in maternal health. It is not a sign of weakness but a step toward healing. Counselling provides a safe space to process fears and emotions. The counsellor can further suggest therapies, if required. In some cases, medication may be recommended, which is safe under professional guidance.

Don’t wait for symptoms to “go away on their own.” Getting support early can make your pregnancy journey healthier and stress-free.

Pregnancy is a time of profound emotional and mental change. It’s okay to not feel okay all the time. Rather, it’s normal to feel vulnerable at times.

Don’t fight your feelings — cry if you feel like, laugh when you can. The more we normalise the emotional realities of pregnancy, the more supported mothers can feel. A strong support system can help reduce the stress of this challenging situation in a woman’s life.

— The writer is associate director, department of gynaecology, Cloudnine Group of Hospitals, Faridabad