The popular image of a pregnant woman is someone who is glowing, happy and brimming with new life. But ask any woman who has been pregnant if the real-life experience matches the fantasy, and you will soon hear about the harder stuff like swollen ankles and throwing up at the smell of coffee. One of the difficult parts rarely talked about is depression during pregnancy, and yet it is almost as common as postpartum depression. Anywhere from 10 to 23 percent of pregnant women experience depression. The good news is the condition is very treatable. The bad news is that, given the pressure to be happy and glowing, it can be hard for women to talk about feeling bad. But there are so many reasons why it is important to speak up when you are feeling down during pregnancy. First of all, you deserve to enjoy your pregnancy and feel good about the changes in your life. You also deserve to be healthy, and depression not only increases your risk of preterm delivery, but it can also make it more likely that you won't be able to take the best care of yourself – or your growing baby. Some women don't realize what they are feeling is depression because some of the symptoms – moodiness, crying jags, excessive sleep or insomnia – are the same as normal pregnancy symptoms. The difference is how significant these feelings are for you. If you cry daily, never feel joy, are unable to concentrate, have scary and repetitive thoughts or worries, or simply feel you cannot function how you want -- those are all symptoms of treatable depression. Treatment for depression during pregnancy can be psychotherapy, antidepressant medication, or psychotherapy combined with medication. (This is often considered the most effective option.) Common forms of therapy for pregnant and postpartum women include cognitive behavioral therapy, interpersonal therapy, and supportive or psychodynamic psychotherapy. If your depression affects your basic ability to function and handle your daily responsibilities, impacts your feelings about your developing baby, or makes you have thoughts about harming yourself, these are signs that you may need a combination of therapy and medication. Remember: Depression is a very treatable medical condition and nothing to be ashamed of. Deciding whether to take an antidepressant during pregnancy can be a difficult choice, and it's one that's best made in consultation with an expert on women’s reproductive mental health or an experienced maternal fetal medicine doctor. Either of these professionals can help you make the best medication choice for you and your developing baby. Read more about the safety of antidepressants during pregnancy. The bottom line is that if you are struggling during pregnancy you are not alone. And you can feel better with the right support. Here’s how to find it. Sarah Best, LMSW, is a psychotherapist at the Seleni Institute, a nonprofit mental health and wellness center providing clinical services, research funding, and online information and support for women and mothers. You can follow Seleni on Twitter @selenidotorg. Image source.