Postpartum depression has become less of a taboo subject. But what if the depression happens before the baby arrives?

"While pregnancy can be a joyous time, hormonal changes can cause mood swings," says Dr. Susan Klugman, an OB/GYN from Bronx, N.Y. "Pregnancy can be a very stressful time. A woman may be concerned with her changing body and gaining weight or, on the reverse side, if she is nauseous and unable to eat, she may worry about not getting enough nutrition for her fetus." Other anxiety-provoking worries of pregnancy are changes of work status, sexuality issues, issues with previous pregnancies or reproductive losses and general fears and anxieties about parenting.

Amy*, of Rhode Island, knows these feelings well. For two weeks during her first pregnancy she experienced hysterical crying on a daily basis. "I was extremely happy to be pregnant," Amy says. "We'd been trying for about seven months. But I was still crying, every day." She found herself overly worried about the baby, what she ate, drank or came in contact with.

While Amy's depression seemed to be of an internal nature, Francine's* depression began as a result of external problems. "During my sixth month of pregnancy, my employer told me ... they were letting me go." This sudden life change triggered the Windham, Maine, resident's anxiety.

Francine found, at 6 months pregnant, potential employers did not want to hire her, which fueled her worry. "My husband was already working two jobs and if I couldn't replace my lost income fast, we would lose the house that we just bought," she says.

It's hard to calculate how many women experience pregnancy depression. One expert quotes 10 percent, while another quotes up to perhaps 30 to 35 percent toward the end of pregnancy.

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