
Teenagers go through intense hormonal and neurological changes even before pregnancy enters the picture. Estrogen and progesterone begin shaping how emotions are processed, how stress is managed, and how the brain continues to mature.
But estrogen and teen mental health have an interesting relationship. Estrogen influences the brain networks and processes that are related to changes in your stress response, emotional dysregulation, and cognition, which are all at the heart of major depressive disorder.¹ So, when puberty and pregnancy overlap, the extra hormonal shifts can make mood regulation more difficult and increase emotional overwhelm.
Research shows that teen pregnancy and hormones put teen mothers at a higher risk of postpartum depression than adults.² This may be partly due to how pregnancy-related hormones influence the developing brain. Some studies suggest changes in brain structure and connectivity during pregnancy, particularly in areas that manage emotion and social awareness.³ Additional research shows that the brain undergoes fundamental reorganization during adolescence.⁴ These changes can persist well beyond delivery and affect how teens cope in the months that follow.
To answer all of your questions on how hormonal changes in pregnancy affect teen mental health, this guide walks through:
During the teen years, hormones and mental health can be a little all over the place. And the reason for this is simple – adolescent years are a period of serious physical, emotional, and neurochemical changes, which can send the body slightly haywire.
While it’s common for people to dismiss these as “teen years” with a shrug of their shoulders, it’s important to remember that, for the teens involved, this extreme upheaval can have a big impact on their day-to-day lives, so it should be taken seriously.
But what changes are happening, exactly? Let’s explore this in more detail.
There are mass changes occurring in the brain during the teen years as the brain and body learn and develop. The teen brain is still developing areas that help with:⁵
Adolescence brings on the release of estrogen and testosterone. These are hormones that play a role in managing pregnancy mood swings in teenagers and how they react to emotions. The hormonal effects on adolescent brains of this kind impact a teen in the following ways:
Being pregnant as a teen adds a layer of hormonal and emotional intensity that can cause big imbalances. For this reason, youth hormone changes in pregnancy shouldn’t be overlooked. Rising levels of progesterone, estrogen, and cortisol (a hormone associated with stress) can overwhelm emotional circuits that are already in flux and lead to hormonal imbalances in pregnant teens. For some teens, this can translate to:
The overlap of puberty and pregnancy creates a unique challenge. Emotional outbursts, irritability, and sensitivity aren’t just personality quirks. They often reflect the brain’s effort to keep up with powerful internal changes.
Fortunately, there is support available to teens going through this difficult combination. Support that takes these overlapping processes into account can help teens manage their emotions more effectively and feel more in control.
Perinatal depression in teens is more common than most think. Younger women are more vulnerable to the effects of childbirth on their mental health, particularly depression and anxiety.⁶
Most think that postpartum is typical depression but the truth is that the signs of postpartum don’t always present as sadness. Some teens become withdrawn from their usual support system, overwhelmed, or simply feel numb. It’s easy for these symptoms to go unnoticed, especially when the pregnancy itself is unexpected or unsupported.
Just like perinatal depression, perinatal anxiety is common in expectant and new moms. Hormonal fluctuations can make it difficult for a teen to find a sense of peace and can lead to intense worries about the baby’s safety and survival.
While all moms experience some level of fear around keeping their baby safe, for some moms, this can progress into fear that shapes their daily lives. If your worries start to impact the decisions you make throughout the day, it could be a sign that something deeper, such as perinatal anxiety, may be going on.
During teen pregnancy, emotions can feel like they’re running the show. A small comment might hit too hard. A missed text might feel like abandonment. These reactions aren’t dramatic. Instead, they’re biological. They come from a brain still learning how to manage big feelings, now juggling even more than usual.
If you’re a teen mom struggling with your hormones during pregnancy, know that there are plenty of treatment options available to you. It’s just about finding the right one to suit your needs and preferences. Evidence-based approaches can help to stabilize your mood and support your mental health, which can lessen the impact of these big hormonal shifts on your everyday life.
When emotions hit hard, CBT gives teens a way to pause and figure out what’s really going on. A session might begin by looking at a recent moment of distress – maybe a panic spiral or a wave of hopelessness – and asking what thought came just before it. It’s often a flash of self-doubt or a fear that feels real in the moment.
Once that link is clear, the therapist helps the teen step back from it. Not to ignore it, but to hold it up and check whether it’s helpful, accurate, or just automatic. Over time, teens start spotting patterns and the beliefs that leave them stuck like the ones that pull them into shame, and the ones that push them to give up.
CBT is about creating just enough space to make a different choice leads toward calm instead of panic spirals.
DBT can be especially helpful for teens who feel like their emotions are running away with them. It teaches practical ways to slow things down before reacting. Instead of shutting feelings off to get a sense of control, teens learn how to ride them out without getting swept away in the moment.
A typical session might focus on one real-life situation. Maybe an argument with a parent, or the feeling of being overwhelmed by school and pregnancy at the same time. The therapist helps the teen map out what happened, which looks at what they felt, what they did, and what else they could try next time. Over time, the therapist and teen work together to build a toolkit of emotional survival skills.
Mindfulness is a big part of DBT.⁷ This is about learning how to stay grounded when a teen has racing thoughts and feels incapable of handling a situation. Setting boundaries, asking for help, and recognizing when a situation is unsafe or just uncomfortable are additional main focuses.
DBT gives structure to emotions that can feel like they’re in freefall. It doesn’t rush anything, but it does help teens feel less controlled by the emotions they’re feeling.
Interpersonal therapy focuses on the emotional weight of relationships, which often feels especially heavy during teen pregnancy. This kind of therapy helps teens explore the connections (or disconnections) in their lives, without judgment. With IPT, teen pregnancy and hormones don’t have to lead to dramatic or uncomfortable outcomes.
Sessions often center around four key areas:
For a pregnant teen, that might mean talking through a friendship that suddenly faded after the pregnancy was announced. Or exploring how their relationship with a parent has shifted. Or even coming to terms with the idea of transitioning from a typical teen to a mother role.
Instead of analyzing every thought, IPT works through conversations. In a typical session, the therapist might guide a teen to think about what they’ve never had the courage to say to a partner, friend, or parent. This type of exercise helps teens find emotional clarity in relationships that feel difficult or painful.
For many teens, IPT offers relief by turning silent stress into spoken words. And in that space, emotional stability can develop.
Peer support gives teen mothers something they often lose during pregnancy, which is a sense of belonging. When friends pull away or school life changes, isolation can set in fast. Group support offers connection, not advice. It provides a space to feel seen, not judged.
Research indicates that a teen peer support group can mitigate social isolation and stigma and improve overall mental health.⁸
In a well-run peer group, teens talk about things they might keep quiet elsewhere:
Hearing “me too” from someone their age can be more powerful than hearing it from an adult, even a well-meaning one.
Group support also helps break shame cycles. Teens often blame themselves for struggling. But when someone across the room says they’re feeling the same thing, that internal story starts to shift and they can see that they are not alone.
When facilitated by a trained clinician, these groups also weave in coping skills and emotional tools.
Teen pregnancy and hormones fluctuating aren’t the only reason teens may have a challenging time. Some teens enter pregnancy already carrying the emotional aftermath of trauma, whether from unstable homes, abuse, neglect, or unsafe relationships. These histories don’t always stay quiet. Research shows that past traumas can come to the surface during pregnancy.⁹
Trauma-informed therapy creates space for healing without pressure. It doesn’t demand that teens relive what happened. Instead, it focuses on creating emotional and physical safety in the present moment. The therapist works slowly, building trust before addressing anything difficult.
A trauma-informed approach may include:
The focus isn’t on fixing something broken—it’s about helping the teen feel safe enough to stay present and have space between feelings and reactions, especially during a time when emotional overwhelm can be high.
Teen pregnancy and hormones can sometimes feel overwhelming and unmanageable with traditional therapies. Medication isn’t always needed during teen pregnancy, but in some cases, it can make a real difference. For teens struggling with depression or anxiety, a doctor may recommend an SSRI.¹⁰
If SSRIs aren’t a good fit, especially if the teen has a history of ADHD or smoking, bupropion might be considered instead. It works on different brain pathways and has some research behind its use during pregnancy.
Usually, therapy is the first step towards managing hormonal changes and teen mental health. If emotional symptoms are strong or aren’t getting better, medication may be added as part of a wider support plan.
These are generally not first-line treatments for pregnant teens due to higher risk profiles or limited data:
Important note: All psychiatric medications during pregnancy require individualized evaluation, especially in teens. Clinical guidelines recommend starting with therapy first (CBT, DBT, IPT), and only considering medications when symptoms are moderate to severe and persistent.
Teen pregnancy comes with a wave of emotional, hormonal, and life changes, often all at once. When those shifts begin to affect a teen’s ability to cope, it’s important to have the right support in place.
At Mission Prep, we understand how teenage development and pregnancy intersect, and we offer care that meets both. Our team provides therapy designed for teen moms and emotional changes, not just adapted for them. That includes approaches like CBT, DBT, and trauma-informed care, each aimed at helping young people better understand their feelings, manage stress, and build healthier emotional habits. We also work closely with families and healthcare providers to ensure care feels consistent and safe.
If someone in your care is navigating the challenges of pregnancy alongside emotional struggles, we’re here to help. Call Mission Prep to learn how we support teen mental health with empathy, structure, and a focus on lasting growth through grounded mental health care for hormonal teens.
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