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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes, for assessment, screening, talking therapy referrals, reviews of established antidepressants and, where it is the right choice, starting pregnancy-compatible medication; thoughts of harming yourself or the baby, sudden confusion, elation or hearing voices need crisis or perinatal services now.
- What it is: anxiety and depression are the common conditions, affecting about 1 in 5 and 1 in 8 women during pregnancy or the first year after birth; the baby blues touch most new mothers in the first week, and postpartum psychosis 1 to 2 in 1,000.
- Rule of two weeks: low mood, loss of interest or anxiety most of the day, most days, for 2 weeks or more, that affects sleep, appetite, concentration or daily life, points beyond hormonal mood swings to a condition that responds to treatment.
- Medicines: never stop an antidepressant suddenly on discovering you are pregnant: relapse and withdrawal are the greater risks; sertraline and several other antidepressants have long reassuring records in pregnancy and breastfeeding, and the decision is individual, weighing the medicine against untreated illness.
- Talking therapies: cognitive behavioural therapy and other talking therapies are first-line for mild to moderate depression and anxiety in pregnancy and work as well as outside it; perinatal mental health teams look after moderate to severe illness and medication decisions.
- Emergency: call 112 if you have taken an overdose or injured yourself, or if someone close to you after birth is suddenly confused, elated, agitated or hearing voices; for thoughts of harming yourself, contact your national crisis helpline or maternity unit now, at any hour.
If you are having thoughts of harming yourself or your baby, feeling hopeless, or noticing sudden severe changes such as confusion, racing thoughts, or seeing or hearing things others do not, you need urgent help now: call 112 in an emergency, contact your national crisis helpline, or tell your midwife or maternity unit straight away. These situations should never wait for any booked appointment, online or otherwise.
What is treated online in mental health in pregnancy, and what needs in-person care
All four condition pages in this section state their online scope honestly; this is the section at a glance.
Usually handled online:
- Depression in pregnancy: screening, therapy referral and medication reviews.
- Insomnia in pregnancy: CBT-I-based plans; no sleeping tablets.
- Mood swings in pregnancy: normal or not, answered properly.
- Tiredness in pregnancy: assessment with locally arranged blood tests.
Needs urgent or specialist care, not an online appointment:
- Thoughts of harming yourself or your baby: crisis care today, via 112, your national helpline or your maternity unit.
- Possible postpartum psychosis, confusion, or seeing or hearing things: emergency care immediately.
- Bipolar disorder, previous severe postnatal illness or complex medication decisions: specialist perinatal services, planned with your maternity team.
Can an online doctor help with mental health during pregnancy?
An online doctor can assess low mood, anxiety, insomnia and exhaustion in pregnancy, distinguish common mood swings from depression or an anxiety disorder, discuss talking therapies and medication choices compatible with pregnancy, and refer into specialist perinatal mental health services. Thoughts of self-harm, or sudden severe symptoms such as confusion or hallucinations, need urgent crisis care rather than a booked video appointment.
More than one in ten women worldwide experiences depression during pregnancy or after birth, and the true number is likely higher because so much goes unreported.[1] Pregnancy does not protect against mental illness; it can trigger or worsen it, and it adds a layer of guilt that keeps people quiet, the sense that this is meant to be the happy chapter. A video consultation from your own sofa removes some of the barriers that keep that silence going: no waiting room, no explaining yourself twice, evenings and weekends included.
Pages in this section
Is it normal to feel low or anxious while pregnant?
Some emotional turbulence is normal: hormone shifts, broken sleep and the scale of what is changing produce tearful days, irritability and worry in most pregnancies, particularly in the first and third trimesters. The line that matters is persistence and function: low mood or anxiety most of the day, most days, for two weeks or more, loss of interest in things that usually matter to you, or worry that will not switch off and interferes with sleep, eating or daily life points beyond mood swings towards depression or an anxiety disorder.[2][4]
Exhaustion and sleep sit inside this picture rather than beside it. Deep tiredness is expected in early and late pregnancy, but tiredness with flatness, hopelessness or no enjoyment of anything deserves assessment, and so does insomnia that has taken on a life of its own, with 3am dread rather than simple discomfort. The doctor also checks physical contributors such as anaemia and thyroid problems before putting everything down to pregnancy, because treatable causes hide in plain sight. The tiredness and insomnia guides cover both in depth.
Can I take antidepressants during pregnancy?
Often, yes. Several commonly used antidepressants can be continued or started in pregnancy when depression or anxiety is significant, because untreated illness carries real risks for both mother and baby, and the decision weighs those against medication considerations, individually, with you.[2] What you should never do is stop an existing antidepressant abruptly on seeing a positive test: sudden stopping risks withdrawal effects and relapse at exactly the wrong moment. Book a consultation first and decide with a doctor.
Talking therapies are first-line for mild to moderate symptoms, and referral into them, and into specialist perinatal mental health services for more significant illness, is a core part of what the consultation offers: many countries run dedicated perinatal teams, your midwife can refer you in most systems, and the doctors help you find and use the local pathway rather than leaving you with a leaflet.[2][3] One honest limit: benzodiazepines, sleeping tablets and other controlled medicines are not prescribed online, in pregnancy least of all; sleep treatment starts with the behavioural approaches that actually fix insomnia.
Online support or urgent help: which do you need?
Swipe sideways to compare →
| Situation | Likely first step | Suitable for online care? | Where to go instead |
|---|---|---|---|
| Mood swings, tearful days or irritability, still functioning | Talk it through; self-care plan and a review point | Yes | Not needed; escalate if it persists beyond two weeks |
| Low mood or anxiety most days for two weeks or more | Structured assessment; talking therapy referral, medication discussion[2] | Usually yes | Perinatal mental health services for significant illness |
| Already taking an antidepressant and newly pregnant | Consultation before any change; never stop suddenly | Yes | Specialist input for complex medication decisions |
| Exhaustion or insomnia dominating daily life | Assessment including anaemia and thyroid checks where needed | Often yes | In-person blood tests arranged locally |
| Thoughts of self-harm, hopelessness, confusion, or seeing or hearing things | Urgent crisis care today | No | 112, your national crisis helpline, or your maternity unit today |
Not in crisis, but not yourself either? A doctor can help you take stock in one consultation.
See available times →What the doctors help with here
- An unhurried, structured assessment: mood, anxiety, sleep, appetite, energy, enjoyment and safety, asked directly and without judgement.
- Separating the treatable from the expected: including blood tests for anaemia and thyroid function when exhaustion is the presenting problem.
- Medication decisions made properly: whether to start, continue or adjust an antidepressant in pregnancy, weighed individually and never rushed.
- A route into perinatal services: help finding and using your local perinatal mental health pathway, alongside your midwife rather than around her.
- A follow-up structure: mental health care is not one call; you leave with a review plan and written advice on what worsening looks like.
When you need maternity services instead
Urgent and specialist care is needed immediately for thoughts of harming yourself or your baby, hopelessness that is hardening, rapid severe deterioration, or any symptoms of psychosis such as confusion, elation with little sleep, or seeing or hearing things, which in pregnancy and after birth can escalate quickly and are treated as emergencies. Tell your midwife or maternity unit the same day in those situations, or call 112 or your national crisis line if you are in immediate danger; booked appointments, online ones included, are the wrong tool for a crisis. Referral into specialist perinatal mental health services is the right step for severe or complex illness, previous severe postnatal illness or bipolar disorder, where planning ahead with your maternity team makes a measurable difference.[2] If your doctor decides you need to be seen in person, you get a full refund and clear directions to the right care.
When to get in-person care
Get urgent help today, through 112, your national crisis helpline, or your midwife or maternity unit, for thoughts of harming yourself or your baby, feeling hopeless or detached from reality, confusion, or seeing or hearing things others do not. If you are having thoughts of harming yourself, call 112 in an emergency. You can also find your national crisis helpline at findahelpline.com. You do not have to wait for an appointment.
What actually helps, from lightest touch to strongest
Support in pregnancy comes in layers, and the right layer is the lightest one that works. The base is unglamorous: protected sleep, daily daylight and movement, food at regular intervals and honest conversations with the people around you. These are not platitudes; each measurably moves mood, and pregnancy attacks all four.
The next layer is talking therapy, which pregnancy makes a priority rather than a luxury: most countries in Europe run perinatal mental health pathways, and doctors can point you into them. Alongside it sits the video consultation itself, useful for naming what is happening, ruling out physical drivers like thyroid problems or anaemia, and agreeing a plan you believe in.
The strongest layer is medication, and pregnancy does not close that door: several antidepressants have long reassuring records in pregnancy, and untreated severe depression carries risks of its own for both of you. That decision is made carefully, in person where needed, with your maternity team involved, and never by stopping or starting tablets alone.
How Mobi Doctor works
- Book a time that suits you: open daily 7am–11pm CET. You can see a doctor over video, usually within 15 minutes. No subscription, exact price up front.
- Speak to a licensed doctor about mental health in pregnancy: a private video call: you describe what you feel, the doctor asks what matters, and you agree the right plan together.
- Leave with your plan: everything agreed before you hang up: your plan, and a prescription to use at a pharmacy near you where medication is clinically right for you. If your doctor decides you need to be seen in person, you get a full refund.
No sign-up needed
Not sure which page fits? Tick what you are going through to see each page that mentions it. A doctor can talk it through with you on a video call.
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Not sure this is the right page? Look up any symptom in the full symptom checker, or book and describe it to a doctor.
Frequently asked questions about mental health in pregnancy
What causes mental health problems in pregnancy?
Hormone shifts that alter mood and sleep, exhaustion, nausea, body changes, the weight of a new responsibility, money and relationship pressures, a previous episode of depression or anxiety, a difficult pregnancy or birth history, lack of support, and past trauma all contribute; a family history and stopping medication raise the risk. None of it is a character flaw, and mental health problems in pregnancy affect women of every background and temperament.
Is it normal to feel low or anxious while pregnant?
Yes, up to a point. Tearfulness, irritability, worry about the baby and waves of doubt are part of most pregnancies, especially in the first trimester and the final weeks, and they come and go with the day. What is not simply normal is low mood or anxiety there most of the day, most days, for two weeks or more, or that stops you sleeping or working; that mental health condition is treatable.
Can an online doctor prescribe medication for depression or anxiety in pregnancy?
Yes, after a consultation, when medication is the right choice for significant depression or anxiety; several commonly used antidepressants, sertraline among them, have long records in pregnancy, and the decision weighs the specific medicine against the real risks of untreated illness, individually. The prescription is usable at a pharmacy near you, a prescription is never issued without a consultation, and complex or severe cases are referred to perinatal mental health services.
Should I stop my antidepressant now that I am pregnant?
Not suddenly, and not alone. Stopping abruptly risks withdrawal effects and relapse at the worst possible time, and untreated depression in pregnancy carries its own risks for you and the baby. Book a consultation first: for many women the right plan is to continue, sometimes switching to a medicine with a longer pregnancy record; for some, a gradual reduction with close support. The mental health decision is made with you, not for you.
How do I know if it is mood swings or depression?
Mood swings pass within hours or a day and leave room for enjoyment in between; depression is low mood, loss of interest or hopelessness most of the day, most days, for two weeks or more, often with poor sleep beyond what pregnancy explains, guilt, poor concentration and feeling unable to cope. The screening questions used in maternity care, which the doctor asks by video, separate the two reliably, and the mental health treatment differs.
What are perinatal mental health services?
Specialist teams that look after mental health during pregnancy and the first year or two after birth, combining psychiatric, psychological and maternity expertise. They take moderate to severe depression and anxiety, bipolar disorder, psychosis, eating disorders, OCD and complex medication decisions, and they plan care before, during and after birth. An online doctor can refer you, and in most European countries the maternity team or family doctor can too.
Will stress or anxiety harm my baby?
Everyday stress and worry do not harm your baby, so this is not something to add to the worry list. Sustained, untreated severe anxiety or depression is linked to poorer sleep, nutrition and antenatal attendance and to a harder start after birth, which is an argument for treating it, not for guilt. Treatment, whether talking therapy or medication chosen for pregnancy, protects both of you, and mental health care in pregnancy is routine, not exceptional.
Can I get help for insomnia during pregnancy without sleeping tablets?
Yes, and that is exactly how it should work: sleeping tablets are not prescribed online, in pregnancy least of all. The doctor treats the causes, such as heartburn, restless legs from low iron, a full bladder, anxiety or low mood, and uses sleep-retraining techniques from CBT for insomnia, which work in pregnancy. Persistent insomnia with low mood is treated as part of the mental health picture rather than as a separate problem.
How long do mental health problems in pregnancy last?
Untreated antenatal depression often continues into postnatal depression, and anxiety tends to persist across the perinatal year; with treatment, most women improve within 6 to 12 weeks of starting talking therapy or medication, and treatment usually continues for at least 6 months after recovery to prevent relapse. The baby blues last days and settle within two weeks of birth; mental health symptoms lasting beyond that are assessed rather than waited out.
What can I do myself for my mental health in pregnancy?
Protect sleep where you can, eat regularly, walk or swim most days, keep contact with people who steady you, say out loud what you are feeling to one trusted person, limit alcohol and caffeine, cut the sources of comparison and doom-scrolling, do one small enjoyable thing daily, accept practical help, learn a breathing exercise for anxiety, and book a consultation early rather than waiting to feel worse. Self-help supports mental health treatment.
Can depression and anxiety in pregnancy be prevented?
Not always, but the risk of depression and anxiety falls when a previous episode is disclosed at booking and a plan made, when medication is reviewed rather than stopped abruptly, when sleep, support and workload are protected, when talking therapy starts at the first signs rather than at crisis, and when partners and family know what to watch for. Women with bipolar disorder or previous psychosis are offered specialist planning before conception.
How can I help my partner's mental health in pregnancy?
Believe her, stay close, and say gently what you have noticed without a verdict attached. Take over the logistics she is drowning in, protect her sleep, go with her to appointments, learn the signs of depression and anxiety and the warning signs after birth, and know that mental health problems in pregnancy are common and treatable. Partners can develop depression too, affecting about 1 in 10 fathers, and are entitled to help.
Is it anxiety, depression, thyroid or just pregnancy?
Pregnancy brings tiredness, tearfulness and worry that come and go. Anxiety is persistent worry, tension, racing thoughts and panic that crowd out daily life. Depression is low mood and loss of interest most days for two weeks or more. An under- or overactive thyroid, common in pregnancy, mimics both with tiredness, weight change, palpitations or low mood, and anaemia mimics the exhaustion; a blood test rules them out. The doctor separates them by video.
- Depressive disorder (depression) fact sheet, WHO, World Health Organization, 2023.
- Antenatal and postnatal mental health: clinical management and service guidance (CG192), NICE, National Institute for Health and Care Excellence, 2014 (updated 2020).
- Depression: antenatal and postnatal, NICE CKS, Clinical Knowledge Summaries, reviewed 2024.
- Anxiety disorders: fact sheet, WHO, World Health Organization, 2025.
- Mental health in pregnancy, NHS, National Health Service (UK), reviewed March 2026.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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