Mood swings during pregnancy: crying, anger and worry in each trimester, and when to talk to your gynae

Mood swings during pregnancy are common and usually start early, around 6 to 10 weeks, says Thomson Medical's O&G team. Rising oestrogen and progesterone affect the brain chemicals that steady your mood, and nausea, tiredness and worry add to it. They often ease in the second trimester and can come back near the end, as sleep gets harder and the birth gets closer. You may cry more than usual, snap at your partner or go from excited to scared in an afternoon, and that's often part of it. What isn't normal is low mood or anxiety on most days for two weeks: SingHealth says to tell your doctor, because depression in pregnancy is common, affecting about one in eight pregnant women in Singapore according to KKH's guidelines, and it's treatable.

What to expect in each trimester

Not everyone gets mood swings, Thomson Medical's doctors stress. Your mood can also differ from one pregnancy to the next. Our week-by-week guides, such as the second trimester guide, set out the checks and changes each stage brings, and common pregnancy discomforts by trimester covers the physical side.

Crying, anger and anxious dreams

Crying more often is normal in pregnancy, Thomson Medical says, because hormones, tiredness and emotional sensitivity all play a part. Anger can be part of it too, especially in the first trimester, when nausea and broken sleep leave you with little patience. If you're having vivid or anxious dreams, often about the birth or the baby, they tend to be worse when sleep is broken; mention them at your next check-up if they keep you awake with worry.

What matters is how much and how long. Occasional tears or a short temper on a bad day are expected. Crying that's constant or overwhelming, or anger that frightens you or the people around you, is worth raising with your gynae.

Normal mood swings, or depression or anxiety?

SingHealth asks pregnant women to tell their doctor if they have symptoms of depression or anxiety on most days for up to two weeks, or if they're finding it hard to cope with daily life. It lists these symptoms:

Thomson Medical adds a few more reasons to seek help: mood swings that are getting more frequent or intense, frequent crying spells, eating or sleeping much more or less than usual, withdrawing from friends and family, and any thoughts of harming yourself. It matters for the baby too. SingHealth says a woman under great stress in pregnancy may go into labour early, and Thomson Medical says untreated mental health problems raise the risk of premature labour and of depression after the birth.

What helps

SingHealth's tips for staying emotionally well in pregnancy are simple and they work together:

Thomson Medical suggests journaling, gentle exercise, yoga or meditation, and talking to a friend, a support group or a counsellor for anger in pregnancy. Our guides to prenatal yoga and safe exercise during pregnancy explain what's safe in each trimester. Partners can help by listening without fixing, taking over a chore that's become a flashpoint, and coming along to appointments; our guide to supporting your partner during pregnancy has more.

Where to get help in Singapore

SingHealth says depression is highly treatable, with therapy or counselling and medicine where needed, and that there are options for pregnant women that are clinically beneficial. Our guide to antidepressants in pregnancy covers how doctors weigh them. If your mood stays low after the birth, our guides to postnatal depression and postpartum rage cover what comes next.

Frequently asked questions

When do mood swings start in pregnancy?

Often from 6 to 10 weeks, in the first trimester, Thomson Medical says. They usually ease in the second trimester and can return in the third.

Is it normal to cry a lot during pregnancy?

Yes. Hormones and tiredness make crying spells more common. If the crying is constant or overwhelming, or comes with low mood most days for two weeks, see your doctor.

Why am I so angry in early pregnancy?

Rising hormones, nausea and poor sleep can all shorten your temper in the first trimester. Breathe before you react, step away, and talk to someone you trust.

Can stress in pregnancy affect my baby?

Severe stress can. SingHealth says a woman under great stress may go into labour early, so tell your gynae if worry or low mood is taking over.

When should I see a doctor about mood swings in pregnancy?

If you have low mood, irritability or anxiety on most days for two weeks, or you're struggling to cope with daily life, SingHealth says to tell your doctor. Thoughts of self-harm need help straight away.