Depression affects more than 19 million adults in the US every year. It hits women particularly hard – women suffer from depression at roughly twice the rate men do. If you’re prone to depression, the hormonal and emotional swings of pregnancy may act as a trigger. Depression is commonly treated with therapy and medication. Therapy won’t negatively affect your pregnancy, but what about the medication? Are antidepressants and pregnancy a safe combination?
Depression In Pregnancy
In the US, 14-23% of women struggle with some depression symptoms at some point during their pregnancy. In other words, it’s extremely common. The symptoms are different for everyone, but may include:
- feeling moody or hopeless
- crying frequently
- lacking energy
- sleeping too little or too much
- eating too little or too much
- trouble focusing or making decisions
- withdrawing from friends and family
- headaches, pain, and malaise
- thoughts of suicide
Severe cases of depression may affect your ability to take care of yourself and complete ordinary daily tasks. That means you may not eat enough and may not gain enough weight, may not sleep well, and may miss prenatal care visits during pregnancy, which can put the baby at risk. Depression during pregnancy increases the risk of preterm birth and low birth weight, both of which are linked to certain health problems for the baby.
Depression is a difficult burden to bear and, untreated, can put you and the baby at risk. If you’re feeling any of the symptoms of depression, please seek medical attention right away. Your doctor can determine if your symptoms are a result of depression or a different medical issue and can help you decide whether and how to pursue treatment.
In general, treatment for depression may include various types of talk therapy and medications. Talk therapy has no side effects and is often effective alone. However, some cases of depression won’t respond to therapy alone and may benefit from antidepressant medications.
The most common types of antidepressants are “selective serotonin reuptake inhibitors” (SSRIs). They’re believed to work by stopping your body from reabsorbing serotonin, a neurotransmitter that affects your mood, so that the serotonin levels in your brain stay higher and your mood improves. Some of the most common SSRIs include:
- Citalopram (Celexa)
- Escitalopram (Lexapro)
- Fluoxetine (Prozac)
- Paroxetine (Paxil, Pexeva)
- Sertraline (Zoloft)
In general, SSRIs may cause nausea, agitation, reduced libido, weight changes, headaches, and changes in sleeping patterns.
Certain other types of medications have also recently come into use as antidepressants, including serotonin-norepinephrine reuptake inhibitors (SNRIs), noradrenaline reuptake inhibitors, tricyclic antidepressants, tetracyclic antidepressants, melatonurgic antidepressants, and more. However, these are much less prevalent than SSRIs.
Finally, there are also several other types of treatment available. Bright Light Therapy, for example, involves regular exposure to natural-spectrum light. Ketamine infusion therapy is another recent development and is currently being studied for safety and efficacy. Some patients who do not respond to other treatments may benefit from electroconvulsive therapy or transcranial magnet stimulation (TMS).
The bottom line is that the causes and mechanisms of depression are not well-understood, and may vary from person to person. Treatment for a bacterial infection is pretty simple – take an antibiotic and it will go away. The treatment for depression can be more complicated, and you’ll need to work with your doctor to find the right course for you.
Antidepressants And Pregnancy
When you’re pregnant, the baby gets whatever you put into your body. That’s true of alcohol and it’s true of medications. But sometimes, therapy alone isn’t enough to manage your symptoms. What’s the deal with antidepressants and pregnancy?
Several types of medication, including certain SSRIs, have generally been considered safe for pregnancy. more than 10% of pregnant women in the US take antidepressants during their pregnancies every year. There may be some small risks to the baby, but there are also serious risks associated with untreated depression.
A recent study in Finland, however, followed more than 60,000 women and their children for 15 years. That study compared women who had never had psychiatric symptoms or taken an antidepressant to women who had symptoms but took no medication, had symptoms but stopped taking SSRIs before pregnancy, and women who took SSRIs throughout pregnancy. The study found that 8.2% of the children exposed to SSRIs in utero developed depression symptoms by the time they were 15, compared to 2% of those who were not exposed. That study was inspired by one from Columbia University, where researchers found that mice exposed to Prozac during the first weeks of their lives (roughly equivalent to the second and third trimesters of a human pregnancy) were more likely to exhibit symptoms of depression as adults.
That study is alarming at face value, but it also leaves a lot of questions open. Most notably, it doesn’t account for the genetic predisposition of the children toward depression. Depression tends to run in families, and those women with depression who needed medication throughout pregnancy were more likely to have children with depression regardless of their SSRI use. In other words, the jury is still out on whether SSRIs are dangerous during pregnancy. Studies are still ongoing regarding other types of antidepressants and pregnancy. However, experts agree that it’s crucial to seek treatment for depression during pregnancy to avoid potentially serious complications.
What To Do
If you suffer from depression and may become pregnant or if you’re pregnant and experiencing symptoms of depression, talk to your doctor. You and your doctor can discuss your current treatment regimen, if applicable, and whether it might affect your pregnancy. It may be difficult to distinguish the symptoms of depression from the normal hormonal swings of a pregnancy, but it’s better to be safe than sorry. If you feel like your mood changes are unusually severe, talk to your doctor.
More than anything, it’s important to remember that depression is not your fault and that it’s treatable, with and without medication. Antidepressants and pregnancy may not be the right choice for you, but there are plenty of other options.
If you’re experiencing symptoms of depression, there are resources out there to help you get through it. The National Suicide Prevention Lifeline will connect you to a trained counselor, 24/7. You can call them at 1-800-273-8255.