Facing Depression During Pregnancy
An important tool in fighting depression during pregnancy, antidepressants can help an expectant mother -- without hurting her unborn baby.
With pregnancy comes joy, excitement, baby showers, and the
wonder of a new life. But for some, pregnancy is clouded by depression, a
condition that puts not only the mother at risk, but the child as well.
For more than 10% of pregnant women, the coming birth of a
child is mingled with ongoing feelings of sadness, hopelessness, and anxiety,
as well as a decreased appetite and problems sleeping.
Fortunately, expectant mothers need not suffer from this
condition: Depression is treatable during pregnancy, with psychotherapy and
"During pregnancy, doctors try to keep women off
antidepressants unless they have severe depression or if they have a history of
relapsing if taken off antidepressants in the past," says Victoria
Hendrick, MD. "Instead, other interventions, like psychotherapy, are used
to help reduce the need for an antidepressant.
Not Treating is Risky
But if the depression is so bad that a pregnant woman is not
eating or gaining weight, for instance, then it needs to be treated as
aggressively as possible."
For women at risk for depression during pregnancy -- those who
have battled major depression in the past or who experienced depression during
a previous pregnancy -- the news is good: The risk associated with the use of
antidepressants during pregnancy is small.
But what should be considered when deciding whether or not to
take an antidepressant, or to try other therapies first? And, what research is
available to help put an expectant mom's mind at ease?
"For mild or moderate depression, I'd rather use
psychotherapy or group therapy than antidepressants," says Hendrick,
assistant professor in the department of psychiatry and bio-behavioral sciences
But for pregnant women with major depression, the risk of a
relapse after stopping antidepressant medication is greater than the risks
posed by treating it with medication.
"If health behaviors are not good because of the
depression, that could have a negative impact," says Hendrick. "If a
woman is not eating, not sleeping, feeling stressed or anxious -- these could
have an adverse impact on a developing fetus. And obviously, suicidal feelings
are another adverse risk associated with depression."
Untreated depression can interfere with a woman's ability to
care for herself, impair nutrition, increase the use of tobacco, alcohol, and
drugs, lead to premature labor and low birth-weight babies, and interfere with
bonding feelings with an unborn child.
Untreated major depression during pregnancy may also cause
infants to have an increased sensitivity to stress.
In cases of major depression, Hendrick explains to WebMD, women
need both psychotherapy and antidepressant medication.
"The more multidisciplinary the treatment, the more likely
they are to get better," says Hendrick. "Using both therapy and
medication greatly increases a woman's chance of seeing an improvement in her