"I'm almost eight weeks into my second pregnancy (first ended in miscarriage) and have been feeling horrible both physically and emotionally. I know that anxiety and mood swings are par for the course, especially in the first trimester, but am wondering at what point you draw the line and say, "This is not just pregnancy," and seek outside help. I don't mean this to sound scary--I'm not suicidal, by any means. But I do get very black sometimes, and (on top of feeling horrible) spend a lot of time wondering if this is okay, or if crying all afternoon and feeling hopeless warrants a discussion with the doctor."
I think if you're wondering if you should see a therapist, you should see a therapist.
And I mean that for pretty much all of life, not just pregnancy. Because if you're feeling like you think you might need professional help, or even just an objective paid listener, you should find one. I think it's easy to feel like going to a therapist means admitting that there's something really wrong, but it doesn't mean that at all. It just means that you need someone to give you some feedback or help you formulate a plan to deal with whatever it is that's stressing you.
It's not even that big a commitment. You can go see a therapist just once even, and for some situations that's all it takes. When I was very depressed during my first pregnancy, I saw a therapist who specialized in women's issues around pregnancy and mothering. I don't remember if I had two sessions with her or three, but that was all it took to get me to a better place so I could get through the rest of the pregnancy. (The September 11th attacks happened when I was almost four months along, and I really credit those sessions with the therapist and the things she had said to me about pregnancy with helping me deal with the event and my grief and that whole ball of wax.) And deciding to see the therapist was a big step in deciding to take myself and my own feelings seriously for a change. That was a big thing for me.
So to me it sounds like you definitely need to see a therapist. Whether or not it's "just pregnancy," it doesn't matter. You should go see someone who can help you through this time and all the conflicting emotions and the bad physical sensations and the fear and guilt and all of that. You should decide that your feelings are important, and you can take yourself seriously. You can ask your OB for a recommendation, or call a midwifery practice or birth center and ask for one. If you know any childbirth educators, they'll have good recommendations, too. You definitely want someone who's worked with pregnant women before and who understands those special issues.
Did anyone else see a therapist during pregnancy? Or did you tough it out and now wish you'd seen someone? It was only when my therapist sent me a newspaper clipping about prenatal depression that I realized it wasn't just me, that there are tons of us who get depressed during pregnancy.