As a partner, you're the person who is most likely to see what is often hidden from co-workers, friends, and other family members. You're the one most likely to notice patterns that occasional drop-in friends can't pick up on. You're also the person that knows their "normal" best, so you are, essentially, the one on the front lines that can pick up on subtle red flags.

"Be alert to changes in mood or behavior," Gold says. "If you think someone might be depressed, it's really helpful to say, 'I know a lot of people get depressed during pregnancy, I'm wondering if you might be feeling that way too.' As a society, there are a lot of expectations that a pregnant women is happy and excited all the time, but this is simply not the reality." Gold says that by normalizing the fact that pregnancy can be hard, you're giving your partner permission to talk about their feelings and struggles.

Because detecting depression is the first step to getting help, and because it may be difficult for the pregnant person to self-assess how much trouble they're having, or simply admit it, it's important not to pretend as if nothing is wrong.

"Sometimes when we are uncomfortable, we avoid talking about a subject," Gold says. "If you are worried, make sure your partner knows and knows that you care. If you are worried that the depression is so bad that there is a risk for harm to mom and baby, ask for professional help and evaluation. A severely-depressed parent may not be able to reach out to get needed help, and partners can be life-saving."

Depression, like all mental illness, is an illness. It's not a bad day, it's not something a person chooses or can control, and it's not just being "sad." Someone can't just decide not to be depressed any more than they could decide not to have a stomach flu. "Some people mistakenly think that if the patient just 'gets out more,' 'stops moping around,' or 'thinks about good things' this will erase depression," Gold says. "These might help a bad day, but depression is a biological illness and doesn't have simple solutions."

Prenatal depression isn't well known, either, so people may not realize its seriousness at first. "Society may attribute feelings of being depressed as just 'normal pregnancy' symptoms, rather than recognizing that depression is a distinct clinical condition with treatment options," Gold says. "There have been more celebrities who have shared their experiences with severe postpartum depression, so it's a more common phenomenon for most people. But the reality is that depression can happen at any time during pregnancy and after birth."

Gold says that untreated depression can pose a risk to a pregnancy, which is why treatment is vital for both mom and fetus.

"Social support is critical for patients with depression," Gold says. "Look at ways to reduce overall stress, which may mean pitching in more to help, finding ways to let a pregnant patient have a break from childcare or a time for uninterrupted sleep."

Gold says it's helpful to talk with your partner about what they're going through. "Acknowledge that pregnancy can be a hard time and that it is normal to have ups and downs," she says. "Be supportive about the need to find someone to talk to and to share symptoms." Gold says simple things are helpful, like acknowleding their feelings and letting them know you'er sorry they're struggling. Asking what you can do to help is also beneficial.

Ideally, a pregnant person is already receiving regular medical care, so this can be a great place to access mental health care connections. A doctor or a midwife isn't a mental health professional, but they can refer patients to one.

"When the depressed feelings last for several weeks, it is important for the patient's physician or midwife to be alerted so that they can do a more formal evaluation," Gold says. "A partner can't 'fix' depression, so the patient needs a medical professional or therapist to ask the right questions and figure out if the patient needs medications, a group, or therapy."

Gold says that as a physician, she really appreciates it when partners reach out and share their concerns. "This lets me start a conversation with the patient to better understand what is happening."

As with all parts of pregnancy, the pregnant person gets the final say when it comes to decision-making. This can be difficult for a partner to stomach, especially when their partner is experiencing prenatal depression.

"The partner should offer to help but should not take over," Gold says. "Don't assume you know what will 'fix' the patient."

Besides the usual pregnancy and baby decisions, prenatal depression may add more decisions to your lives, like whether the pregnant person in question will take antidepressants during pregnancy. "[A] common misconception is that taking a medication will hurt the [fetus.] As a physician, I always have to weigh the risks of a medication with the risks of untreated depression," Gold says. "Some parents don't need medications. But for patients who do, it can make a world of difference."

Prenatal depression may also impact other pregnancy-related and baby-related decisions, like whether to breastfeed or how to give birth. You, as the partner and co-parent, are probably going to have opinions on these issues, but, keep in mind, even if the fetus will one day be your baby, it is inside the pregnant person's body. In the end, every decision is hers to make, and your job is to support her in making those decisions that best keep her and the fetus healthy.

Once you and your partner have talked with the primary care provider, it's time to follow up and find supports or a course of treatment. Finding the right therapist, however, or simply locating a provider, can be daunting, though, so it helps if partners assists in this process.

"Patients often want to try interventions other than medication and therapy — either individually or in a group — is often extremely helpful and can normalize feelings," Gold says. "However, some patients need medication to treat depression and in this case, it's important to have a clinician who knows what treatments are safe during pregnancy. A good therapist will recognize when patients may need more than just therapy and will suggest they talk to their physician or a psychiatrist for further evaluation."

Depression can be treated in a variety of ways, but each of these treatments takes time, whether it's going to therapy or picking up medications. Partners can help in the treatment process by taking their pregnant partners to therapy, picking up medications, and handling other responsibilities, like household work.

"Depression is a clinical illness and not something a patient can just 'snap out of,'" Gold says. "Criticism or belittling or calling someone 'crazy' or 'lazy' will just make someone shut down." Gold says that partners who "make fun of or criticize pregnant patients can contribute to worsening symptoms.""

Prenatal depression can strike anyone, but there are factors that may make your partner more prone to depression, or that may make it harder for her to deal with depression.

"Parents who have a prior history of depression or anxiety, limited social support, and experience interpersonal violence are at particularly high risk," Gold says. "[Nearly] half of the pregnancies in the U.S. are unplanned, so patients may have mixed feelings about the pregnancy, may be adjusting to a major life change, may have strained support from a partner, may have new financial concerns anticipating a baby, and simultaneously are having huge physical and hormonal changes related to being pregnant."

While prenatal depression isn't caused by external factors like these, these big-picture issues can affect how the depression proceeds for your partner. Depending on the full circumstances, there may be specific supports that your partner needs, so keep in communication with her about how to support her best.

Supporting a partner through pregnancy and prenatal depression can be a lot of work, physically, mentally, and emotionally. Keep in mind that you are still a human, and you do still have needs. So it's important to meet those needs as you support your pregnant partner. A psychology concept called Ring Theory says that reaching outward into your networks for support can help you have more energy and strength to focus on the person needing help.

It's important to note that prenatal depression can affect non-birth parents too. If you feel you are experiencing depression as a non-birth parent, please don't be afraid to reach out for help. In one study, partners of a depressed pregnant person became depressed themselves up to 50% of the time, so if your pregnant partner is depressed, the right thing to do for them and you is to get support for yourself, too.

Many medical providers consider prenatal depression and postpartum depression to be two parts of the same issue: perinatal depression. So, if your pregnant partner has experienced prenatal depression or other mood issues, you want to be especially attentive to her emotional needs and health after the delivery, too.

If you or someone you know is experiencing depression or anxiety during pregnancy, or in the postpartum period, contact the Postpartum Health Alliance warmline at (888) 724-7240, or Postpartum Support International at (800) 944-4773. If you are thinking of harming yourself or your baby, get help right away by calling the National Suicide Prevention Lifeline at 1-800-273-8255, or dialing 911. For more resources, you can visit Postpartum Support International.