How to Deal with Depression during Pregnancy: The Dilemma of Medication and Emotional Balance

With new life on the way, pregnancy is supposed to be a joyous time for women. For many women, it is. But some women find themselves depressed during pregnancy, and that can make them confused, anxious and even ashamed.

Complicated medical issues arise when a pregnant woman suffers from depression. Women face troubling choices because of questions about whether antidepressants and anti-anxiety medications can be harmful to the fetus.

Not taking medications, on the other hand, may cause dangerous health and emotional situations for pregnant women. If they stop taking prescribed ant-depressant medications, they may begin to neglect their own health, and therefore, the health of the unborn child.

Women experiencing depression during pregnancy “…are more likely to engage in damaging behaviors such as drinking, smoking, drug abuse and lack of exercise,” said Columbia University psychology professor and author Andrew Solomon, in a May 2015 article, “The Secret Sadness of Pregnancy with Depression,“ in The New York Times Magazine.

“They are more likely to be obese. They often cease functioning at work, which can be financially catastrophic. They are less likely to sleep regularly or take prenatal vitamins, and they often miss obstetric appointments,” said Solomon. “Depression during pregnancy also puts an enormous strain on marriages, possibly creating a poor environment for the child.”

Women often bear the dilemma of depression during pregnancy secretly, Solomon discovered in his doctoral research.

“Over and over again, they said to me in an embarrassed and hushed way, they were depressed during their pregnancy and they were ashamed of it and hadn’t sought treatment,” he said. “Many did not even discuss their depression with their husband, doctors or mothers.”

One of the women who Solomon interviewed about the dilemma is Wendy Isnardi, author of the book, Nobody Told Me, based on her suffering with depression during pregnancy.

“When you’re expecting,” Isnardi said, “you’re at the doctor twice a week, and nobody ever mentioned to me the possibility that I could become depressed or anxious while I was pregnant.”

Isnardi now works as a counselor at the Postpartum Resource Center of New York, where she often speaks with pregnant women who are unsure of how to handle their depression. She said many women feel guilty about their melancholia.

“They’re so afraid to be judged,” Isnardi said. “Sometimes we have to text because they are afraid their husband will overhear them on the phone.”

For women dealing with depression during pregnancy, it’s important to take steps to protect their own physical and mental health and the health of the baby. Some suggested steps are:

1. Find support groups that welcome people who are dealing with depression during pregnancy.
2. Get accurate medical advice from your doctor, rather than making decisions based on undocumented suggestions found online.
3. Don’t stop antidepressant medications without first seeking advice from your doctor.
4. For mild to moderate depression during pregnancy, consider seeking out a psychotherapist who can help you determine whether you can manage the situation with cognitive-behavioral therapy or interpersonal therapy. This may be a first step, especially if you have medical insurance that covers this type of therapy.
5. If you take anti-depressants, discuss with your doctor the possibility of a lower dose of medication in combination with cognitive behavioral therapy.
6. Talk with your doctor about options such as light therapy, where the patient is exposed to the stimulating effects of intense broad-spectrum light. But first, be sure to look into reports that this may escalate anxiety.
7. Understand that there is no reason to hide your depression or be ashamed. It’s important to share your experiences and concerns, so you can quickly have proper medical treatment to protect your health and the health of the unborn child.

“There are many things that can help depressive women,” said Solomon. “The love of a supportive partner and friends, of course, but also acknowledgment of their illness and ready access to effective treatment.”

References:

Solomon, Andrew, “Unbearable: The Secret Sadness of Pregnancy with Depression,”
New York Times Magazine, May 28, 2015

http://andrewsolomon.com/articles/the-secret-sadness-of-pregnancy-with-depression/