Depression

Last Update: 11 Aug 2025

Condition

Table of content

1. What is it? 2. Why managing? 3. Non-Medical Options 4. Medications 5. Breastfeeding/ chestfeeding 6. Key Takeaways 7. Limits of Research

Welcome to our Fact Sheet on depression during pregnancy and breastfeeding or chestfeeding. The information is based on current research and may be updated as new scientific knowledge emerges. This content does not replace personalized advice from your healthcare team.

1. What is depression?

Depression is a mental health disorder that affects mood, thoughts, and disrupt daily life. It often causes deep sadness, hopelessness, and loss of interest or pleasure in activities for weeks or months. It can range from mild to severe and may be episodic (comes and goes) or long lasting. For some people, it follows seasonal patterns (called seasonal affective disorders).

Depression can affect anyone, but during pregnancy, hormonal changes, physical discomfort, and stress can trigger new episodes or worsen existing symptoms. It can be hard to tell the difference between normal pregnancy changes and depression symptoms. Table 1 shows some red flags to look out for.

Table 1. Symptoms That Can Be Signs of Depression

In your body	In your mind	In your actions
Excessive fatigue or loss of energy	Persistent feeling of sadness, emptiness or hopelessness.	Loss of interest or pleasure in activities usually enjoyed.
Changes in sleep (trouble falling asleep, waking often, or sleeping too much)	Confusion, difficulty concentrating or making decisions	Withdrawal from social activities
Changes in appetite or weight (gain or loss)	Strong feelings of guilt or worthlessness, low self-esteem.	Difficulty completing daily tasks
Unexplained physical pain	Irritability or anxiety	Neglecting personal care or responsibilities
	Thoughts of death or suicide	Self-harm or unsafe behaviours

Note: After birth, many parent experience “baby blues” in the first 2 weeks postpartum. It’s a mild sadness, irritability, or tearfulness caused by hormone changes and sleep loss. If these feelings last longer than 2 weeks, or make it hard to care for yourself or your baby, it may be postpartum depression. Professional support is important if symptoms persist.

Depression can happen to anyone, but it is more likely if you have:

A history of depression, anxiety, or high stress
Younger age combined with financial or life stressors
Low income or low educational support
Limited social support from a partner or family

Knowing your risk factors can help you recognize symptoms earlier and seek help.

When to seek a healthcare provider?

Emotional ups and downs are normal and common, but persistent or disruptive symptoms are not. Reach out to a healthcare professional if:

You feel sad, anxious, irritable, or overwhelmed for more than 2 weeks
Mood changes disrupt your sleep, appetite, work, or ability to care for your family
Loved ones express concern about your wellbeing
You think about self-harm or suicide

Depression is not your fault. Support is available and effective. Talk to your doctor, midwife, nurse, pharmacist, or mental health professional to get the help you need.

2. Why is it important to manage my depression during pregnancy?

Depression is one of the most common medical condition during pregnancy, affecting about 1 in 10 Canadian women. It is as common as gestational diabetes or high blood pressure. People from marginalized communities may be equally or even more affected by depression during or after pregnancy, but research remains very limited.

Getting support early, whether it’s pharmacological or not, for depression helps you feel better and makes it easier to care for yourself and your baby.

Understanding Risks in Pregnancy

Every pregnancy has some risks like miscarriages (loss of the baby), preterm birth (baby comes before 37 weeks), congenital malformations (birth defects), and other complications. These risks can happen in any pregnancy for many reasons, unrelated to medical conditions or their treatments. This is called the background risk.

Research helps us understand these risks and the risks when depression is not treated or supported during pregnancy. So far, we know that untreated depression during pregnancy can:

Increase the risk of preterm birth and low birth weight
Make it harder to bond with your baby
Raise the risk of postpartum depression
Affect your own wellbeing and safety.

The table below summarises the possible risks when depression is untreated during pregnancy compared to these background risks. Keep in mind that:

Some risks are well documented, while others need more research
Your personal risk depends on age, genetics, lifestyle, other medical conditions, and ethnicity

Table 2: Possible risks of untreated depression during pregnancy.

For who?	What?	What does research say?
Pregnant person	Fertility (ability to get pregnant)	Depression itself does not cause infertility, but severe or chronic depression can affect hormones, sleep, appetite, and stress levels, which may affect fertility. More research is needed.
	Miscarriages	Depression alone is not known to cause miscarriage, but more research is needed to fully understand this risk.
	Quality of life & Safety	Persistent sadness, guilt, or hopelessness can reduce quality of life. Severe untreated depression can require hospitalization and, in worst cases, lead to suicidal thoughts or actions.
	Risky Behaviors	Depression can lead to missing prenatal visits, poor sleep or nutrition, and substance use (alcohol, cannabis, other drugs).
	Bonding Difficulties	Depression can make it harder to connect with your baby during pregnancy and adjust emotionally to parenthood.
	Postpartum mental illness	Untreated depression is a major risk factor for postpartum depression or anxiety after birth.
Unborn baby	Congenital malformations	Depression itself is not a known cause of malformations.
	Growth	Many studies found a slightly higher risk of low birth weight (5 pounds and 8 ounces or 2,500 g).
	Preterm birth	Many studies found an increased chance of preterm birth (before 37 weeks).
Future child	Brain development	Research shows that children of parents with untreated depression have an increased risk of developing emotional and behavioural disorders themselves.
Family	Family Dynamics	Depression can strain relationships with partners and other children, creating stress in the family.

3. What can I do to manage my depressed mood besides medications?

If you have been diagnosed with depression, or if you notice several symptoms from Table 1, there are small steps you can take to support your mental health before or alongside medications. Even mild symptoms deserve attention, and early care can help you feel more supported.

Whether you’re planning a pregnancy or are already pregnant, a “mental health plan” during pregnancy (just like preparing for childbirth) can help you and your support person feel ready for both good and difficult days. Include your early signs of depression (Table 1), a few small actions to help, and a list of people or resources to reach out to.

Small, regular actions can reduce the impact of mild symptoms and support your emotional wellbeing:

Nutrition: Eat regular, balanced meals to keep your energy steady.
Exercise: Gentle movement, like short walks or prenatal yoga, can improve mood.
Sleep: Prioritize rest and keep a sleep routine as much as possible. Avoid screens before bed and create a quiet, dark sleep environment.
Time for yourself: Include mindfulness activities like relaxing or enjoyable moments, such as breathing exercises, meditation, or journaling.
Support: Reach out to trusted people and let them know how they can help.

Think NESTS to help remember the basics of well-being: Nutrition, Exercise, Sleep, Time for yourself, Support. The NESTS tool can help you write down ideas to reduce stress and support your well-being.

If symptoms are persistent or interfere with daily life, talk with your healthcare provider. Psychotherapy or counseling can help process emotions and provide coping strategies, but it is just one option among many.

It can be easy to forget yourself during pregnancy but remember that taking care of your mental health is part of caring for yourself and your baby. Small, consistent steps can make a real difference.

Discover You, Me, Baby, a free and virtual program to support your mental health throughout your pregnancy.

Learn more

4. Medications prescribed for treating depression

If your depressive symptoms are moderate or severe and persistent, your healthcare provider may prescribed medication in combination with therapy or other support. Some benefits can appear quickly, but full effectiveness usually takes 4 to 6 weeks. Most commonly used antidepressants have not been shown to increase the risk of birth malformations.

What does research say?

There are two main groups of antidepressant medications:

Selective serotonin reuptake inhibitors (SSRIs), such as sertraline (Zoloft®) and citalopram (Celexa®). They are often the first choice during pregnancy because they are well studied and generally considered safe.
Serotonin and norepinephrine reuptake inhibitors (SNRIs), such as duloxetine (Cymbalta®) and venlafaxine (Effexor®). They are used in some cases when SSRIs are not enough or not appropriate.

Other medications, such as tricyclics or specific molecules, may be used based on individual needs.

The table below list some antidepressant medications available in Canada. Not all are first-line options during pregnancy. For details on a specific medication, consult its dedicated factsheet or talk to your healthcare team.

Table 3. Some antidepressant medications available in Canada.

Medication Types	Medication Names	Brand names
Selective Serotonin Reuptake Inhibitors (SSRIs)	Citalopram, escitalopram	e.g. Celexa®, Cipralex®
	Fluoxetine	e.g. Prozac®
	Fluvoxamine	e.g. Luvox®
	Paroxetine	e.g. Paxil^®
	Sertraline	e.g. Zoloft®
Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)	Desvenlafaxine	e.g. Pristiq^®
	Duloxetine	e.g. Cymbalta^®
	Venlafaxine	e.g. Effexor®
Other Antidepressants (Tricyclics or Other Molecules)	Bupropion	e.g. Wellbutrin®
	Trazodone
	Mirtazapine	e.g. Remeron®

How do I know which one to take?

There is no perfectly risk-free choice with depression during pregnancy. The decision requires weighing the risks and benefits of treatment against the risks of leaving depression untreated. Each medication has advantages and possible risks, and your healthcare team (doctor, pharmacist, nurse, midwife) is best placed to help you make an informed decision for you and your baby.

When planning a pregnancy or after learning you are pregnant, do not change or stop your medication on your own. Stopping suddenly can cause withdrawal symptoms or a relapse of depression. Self‑medicating with cannabis or other substances can also be risky during pregnancy. Always talk with your healthcare team before making any changes to your medication plan.

5. Will I be able to breastfeed or chestfeed?

Depression does not prevent you from breastfeeding or chestfeeding. Feeding your baby can release oxytocin, a natural hormone that promotes relaxation and bonding.

However, living with depression can make feeding feel more challenging. Some people experience added stress, fatigue, or feelings of pressure. You are not alone; support is available whether you continue breastfeeding/ chestfeeding or choose another feeding option.

Some antidepressant medications can pass into human milk, but many are compatible with breastfeeding/ chestfeeding. Your healthcare team can guide you to make an informed decision for you and your baby. 

If you have any concerns or questions related to breastfeeding or chestfeeding, speak with your doctor, pharmacist, midwife, nurse, or a lactation consultant in your region.

Key Takeaways

It is normal to experience a range of emotions during pregnancy, but sadness, anxiety, guilt, or irritability lasting more than 2 weeks may be a sign of depression.
Untreated depression can affect your wellbeing and bonding with your baby and increase the risk of postpartum depression, preterm birth, and low birth weight.
Early support and management can reduce risks and protect the health of you, your baby, and your family.
Small daily actions like NESTS (nutrition, exercise, sleep, time for yourself, support) can help ease depressive symptoms
Some people may need medication, and low‑risk options are available during pregnancy and breastfeeding/chestfeeding.
Always consult healthcare professionals before starting, changing, or stopping your medication.

Research Is Great, But It Is Not Perfect

Making informed health decisions also means understanding the limits of current research. Here are some considerations by our experts about the quantity and quality of studies on depression during pregnancy:

Few long‑term studies: We know little about how prenatal depression affects the child’s development or the parent’s health long after pregnancy.
Small and limited studies: Many studies involve small groups or people with similar backgrounds, so results may not apply to everyone.
Different experiences and treatments: People have different levels of depression and use different treatments, making it hard to compare results.
Other factors can affect results: Stress, income, lifestyle, and access to care can influence study findings.
Little research on non‑medication options: We still need more studies on how therapy, support programs, or lifestyle changes help during pregnancy.

More research is needed to better understand how to prevent and treat depression during pregnancy for everyone.

For more information, feel free to consult our associated resources and additional references:

Anxiety Canada
Center for Addiction and Mental Health
Naître et Grandir
Projet Grande Ourse: Mental Health During Perinatality and Pregnancy by CHU Sainte-Justine
INESSS – Major Depressive Disorder During Pregnancy

To seek help from a healthcare professional:

Info-Social 8-1-1, a free 24/7 helpline, allows you to quickly reach a professional in psychosocial intervention.

If you or someone close to you is feeling hopeless or having suicidal thoughts, you can find support at:

- Québec Association for Suicide Prevention and Suicide Action Montréal. Available across Québec, 24/7 at 1 866 APPELLE (1 866 277-3553) or suicide.ca.

- Available across Canada, 24/7 at 9-8-8 or 988.ca.

References

X. Zhao et al., “A meta-analysis of selective serotonin reuptake inhibitors (ssris) use during prenatal depression and risk of low birth weight and small for gestational age,” Journal of Affective Disorders, vol. 241, pp. 563–570, Dec. 2018, doi: 10.1016/j.jad.2018.08.061.
S. S. Coburn, L. J. Luecken, I. A. Rystad, B. Lin, K. A. Crnic, and N. A. Gonzales, “Prenatal maternal depressive symptoms predict early infant health concerns,” Maternal and Child Health Journal, vol. 22, pp. 786–793, Feb. 2018, doi: 10.1007/s10995-018-2448-7.
M. H. Davenport et al., “Impact of prenatal exercise on both prenatal and postnatal anxiety and depressive symptoms: A systematic review and meta-analysis,” British Journal of Sports Medicine, vol. 52, pp. 1376–1385, Oct. 2018, doi: 10.1136/bjsports-2018-099697.
A. Roy, S. Patten, W. Thurston, T. Beran, L. (. Crowshoe, and S. Tough, “Race as a determinant of prenatal depressive symptoms: Analysis of data from the ‘all our families’ study,” Ethnicity & Health, pp. 1–28, Feb. 2024, doi: 10.1080/13557858.2024.2312420.
R. Robinson, M. Lahti-Pulkkinen, K. Heinonen, R. M. Reynolds, and K. Räikkönen, “Fetal programming of neuropsychiatric disorders by maternal pregnancy depression: A systematic mini review,” Pediatric Research, vol. 85, pp. 134–145, Sep. 2018, doi: 10.1038/s41390-018-0173-y.
M. Peer, C. N. Soares, R. D. Levitan, D. L. Streiner, and M. Steiner, “Antenatal depression in a multi-ethnic, community sample of canadian immigrants: Psychosocial correlates and hypothalamic-pituitary-adrenal axis function,” The Canadian Journal of Psychiatry, vol. 58, pp. 579–587, Oct. 2013, doi: 10.1177/070674371305801007.
M. T. van Dijk, A. Talati, P. G. Barrios, A. J. Crandall, and C. Lugo-Candelas, “Prenatal depression outcomes in the next generation: A critical review of recent dohad studies and recommendations for future research,” Seminars in Perinatology, p. 151948, Jul. 2024, doi: 10.1016/j.semperi.2024.151948.
J. Maselko et al., “Effect of an early perinatal depression intervention on long-term child development outcomes: Follow-up of the thinking healthy programme randomised controlled trial,” The Lancet Psychiatry, vol. 2, pp. 609–617, Jul. 2015, doi: 10.1016/s2215-0366(15)00109-1.
R. M. Pearson et al., “Prevalence of prenatal depression symptoms among 2 generations of pregnant mothers,” JAMA Network Open, vol. 1, p. e180725, Jul. 2018, doi: 10.1001/jamanetworkopen.2018.0725.
J. T. Pietikäinen, P. Polo-Kantola, P. Pölkki, O. Saarenpää-Heikkilä, T. Paunio, and E. J. Paavonen, “Sleeping problems during pregnancy—a risk factor for postnatal depressiveness,” Archives of Women’s Mental Health, vol. 22, pp. 327–337, Aug. 2018, doi: 10.1007/s00737-018-0903-5.
K. H. Raine et al., “Associations between prenatal maternal mental health indices and mother–infant relationship quality 6 to 18 months’ postpartum: A systematic review,” Infant Mental Health Journal, vol. 41, pp. 24–39, Sep. 2019, doi: 10.1002/imhj.21825.
D. B. Davalos, C. A. Yadon, and H. C. Tregellas, “Untreated prenatal maternal depression and the potential risks to offspring: A review,” Archives of Women’s Mental Health, vol. 15, pp. 1–14, Jan. 2012, doi: 10.1007/s00737-011-0251-1.
T. Field, “Prenatal depression risk factors, developmental effects and interventions: A review,” Journal of Pregnancy and Child Health, vol. 4, Jan. 2017, doi: 10.4172/2376-127x.1000301.
B. M. Y. Leung, N. L. Letourneau, G. F. Giesbrecht, H. Ntanda, and M. Hart, “Predictors of postpartum depression in partnered mothers and fathers from a longitudinal cohort,” Community Mental Health Journal, vol. 53, pp. 420–431, Nov. 2016, doi: 10.1007/s10597-016-0060-0.
L. Rollè, M. Giordano, F. Santoniccolo, and T. Trombetta, “Prenatal attachment and perinatal depression: A systematic review,” International Journal of Environmental Research and Public Health, vol. 17, p. 2644, Apr. 2020, doi: 10.3390/ijerph17082644.
Tucker Z, O’Malley C. Mental Health Benefits of Breastfeeding: A Literature Review. Cureus. 2022 Sep 15;14(9):e29199. doi: 10.7759/cureus.29199. PMID: 36258949; PMCID: PMC9572809.
Rogers A, Obst S, Teague SJ, Rossen L, Spry EA, Macdonald JA, et al. Association Between Maternal Perinatal Depression and Anxiety and Child and Adolescent Development: A Meta-analysis. JAMA Pediatr. 2020;174(11):1082-92
https://jamanetwork.com/journals/jamapediatrics/fullarticle/2770120
Yu H, Shen Q, Bränn E, Yang Y, Oberg AS, Valdimarsdóttir UA, et al. Perinatal Depression and Risk of Suicidal Behavior. JAMA Netw Open. 2024;7(1):e2350897. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2813745

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