First Trimester | The Mental Symptoms of Pregnancy

Much is written about the physical symptoms of pregnancy – the morning sickness, the swelling ankles, the dry skin – but little is written about the mental symptoms of pregnancy. What can you expect mentally and emotionally throughout those nine months? Are mental issues such as forgetfulness, vivid dreams, and depression as natural to pregnancy as the physical ones?

Dr. Shoshana Bennett, a clinical psychologist and author of Pregnant on Prozac (GPP Life, 2008), says that such changes are very normal. “Many of the mental symptoms in pregnancy come from biochemical changes in the woman’s brain chemistry and endocrine system,” Dr. Bennett says. “Estrogen and progesterone are two important reproductive hormones which change levels during pregnancy and therefore can alter mood. Thyroid levels can also fluctuate, which can cause depression or anxiety. There are also psychological and emotional causes for symptoms. For instance, a woman may feel anxious much of the time if she’s worried that she won’t be a good mother. Or if she just moved and her entire support network is far away, she may be depressed and/or anxious.”

Keep your sense of humor by remembering that the forgetfulness is only temporary. You will get your brain back!


Christina Lorenzen, a mother of two from Babylon, N.Y., noticed a major difference in her mental capabilities during pregnancy. “For me, it just seemed to make me very absentminded where before that I was very organized – a list maker,” she says. “I would boil eggs and then go to do something else and forget them, only to find burnt eggs in a pot with no water. I would start something, walk away and forget to finish it. It was as if my mind was elsewhere and I didn’t have the concentration or focus I used to have.”

According to Dr. Bennett, studies exist showing that “pregnancy brain” may be caused by a decreased brain cell volume (in the third trimester, anyway). She gives the following suggestions to help alleviate forgetfulness and support memory:

Specific nutrients, such as omega-3 is essential. The baby takes what it needs from the mom to ensure healthy brain development. Since our bodies don’t produce omega-3 on its own, the mother can quickly become deficient. This not only can cause forgetfulness, it can also bring on depression.

Keep your sense of humor by remembering that the forgetfulness is only temporary. You will get your brain back!

Exercises that bring lots of oxygen to the brain can help tremendously.

Vivid Dreams

Pregnant women often find themselves the recipient of an active nightlife in the form of dreams. Vivid dreams do not necessarily mean the dreams are disturbing. Vivid may mean dreaming in color instead of black and white, or having more intense, enjoyable dreams than before.

the mental symptoms of pregnancy”There are a number of theories about why vivid dreaming occurs in pregnancy,” Dr. Bennett says. “One, hormones influence how we sleep. When hormone levels shift, so can the quality and quantity of our sleep. For instance, when hormones change, the piece of our sleep cycle called REM is increased, and we dream during REM – hence, more dreaming. Two, during pregnancy there may be more times during the night that the woman wakes up. Therefore, she may be more able to remember her dreams when awoken in the middle of them. Last, on a psychological note, anxieties about mothering may be illustrated in dreams. It’s common for pregnant women to have scary dreams about leaving the baby unattended, and terrible things happening due to her inadequate caretaking.”

Dr. Teri Pearlstein, the director for the Center for Women’s Behavioral Health Women and Infants Hospital in Providence, R.I., agrees that hormones and lack of sleep are factors in a pregnant woman’s increase in dreaming. “Some women find these dreams unpleasant; other women are not bothered by vivid or bizarre dreams,” Dr. Pearlstein says. “The vivid dreams may be due to hormonal changes during pregnancy and due to increased sleep interruption as pregnancy progresses.”

Sleep Disturbances

Many women experience sleep problems during pregnancy – even if they never had trouble sleeping before. Dr. Pearlstein believes this can be due to hormonal factors and the physical changes that occur as pregnancy progresses.

“Women may find that they ruminate more and worry about issues such as needs associated with the new baby, upcoming role change and other stressors,” Dr. Pearlstein says. “Women can try to ensure a good night’s sleep with relaxation before bed (reading, listening to a relaxation tape), sleeping in a quiet, dark room, not drinking a lot of fluids or exercising before bed.”

Many women report they can’t seem to turn their minds off long enough to get a good night’s sleep. One tip for dealing with this is making lists of everything you have to do and prioritize it. Being proactive about the things weighing on your mind can turn the list off long enough to get the rest you need.


Up to 15 percent of pregnant women develop depression, similar to the prevalence rates in women when they are not pregnant.

the mental symptoms of pregnancy “Women who are depressed in pregnancy face a difficult dilemma,” Dr. Pearlstein says. “Untreated symptoms of depression, anxiety and stress can have negative effects on their newborn (e.g. possible premature birth or low birth weight) but there are also potential negative effects on the fetus and newborn of taking antidepressant medications (e.g. possible low birth weight or withdrawal symptoms after birth).”

Many pregnant women with depression prefer non-pharmacological treatments for depression such as psychotherapy. Less well studied non-pharmacological treatments would include light therapy, exercise, and acupuncture. Studies of fish oil have had mixed results.

“There are reports of women developing panic attacks or obsessive-compulsive symptoms during pregnancy,” Dr. Pearlstein says. “Suicidal thoughts may occur with increased frequency during pregnancy, but acting on the suicidal thoughts (e.g. making a suicide attempt) is less common during pregnancy. Women who have had prior childhood abuse may find that trauma-related symptoms may increase around the time of delivery.”

It’s important to remember that almost all mental symptoms of pregnancy have a physiological reason. The physical changes during pregnancy can impact a woman’s emotional and mental well-being, just as it does her physical well-being. To minimize the mental effects of pregnancy, treat each symptom as it arises and keeps in mind that all these changes are temporary.

Handling the Mental Symptoms of Pregnancy

Here are tips on handling common pregnancy symptoms:


  • Make lists.
  • Get plenty of exercises.
  • Talk to your healthcare provider about taking extra omega-3 supplements.


  • Avoid exercising before bed.
  • Limit liquid intake before bed to reduce trips to the bathroom at night.
  • Listen to a relaxation tape before sleeping.


  • If you have symptoms of depression, talk to your healthcare provider.
  • Get plenty of exercises.
  • Try to get as much rest as possible.