Depression during Pregnancy…

Submitted by Dr Rebecca Wise:

Pregnancy can be an exciting and joyful time as the mom-to-be prepares for the arrival of the baby, but what about women who suffer from depression? Sometimes pregnancy is anything but thrilling. In fact, for women who are being treated for depression the worry and anxiety, combined with normal hormone changes, make the experience of pregnancy seem too stressful.

Stress at the pregnant woman Unfortunately there is no clear-cut way to treat depression during pregnancy, but proper treatment is determined on a case-by-case basis. Weighing risks and benefits for both mom and baby, the doctor will consider medication or alternative therapies. Risks for the unborn child when the mother is taking antidepressants include birth defects, cardiac issues, or even withdrawal symptoms when the baby is born. For mom, the symptoms of not taking medication for her depression include per-term birthing, preeclampsia, and even substance abuse.

The approach for each patient, however, should be a team effort by the expectant mother, her obstetrician, her psychiatrist or family doctor (whoever is treating her depression), and her pharmacist.

If choosing to start or continue a medication, some guidelines to follow include:

o Keeping the depression as controlled as possible, but with the lowest dose of medication possible.

o Using a medication that is well documented (generally the older ones).

o Starting a medication before pregnancy, if possible, to allow mom’s body to adjust before all the hormone changes.
o If using an antidepressant medication during pregnancy, talk to the doctors about breastfeeding the baby. Depending on the medication, it may be a better choice to help avoid withdrawal symptoms.

For women who choose to not use medications, there are some alternative methods to help treat depression during pregnancy:

• Make to-do lists, and include time for yourself to relax. Taking breaks from the craziness of your day will help you reduce stress. Read a book, go for a long walk, play with your pet, take a nap. Once the baby comes, you will find time alone difficult to find. Enjoy it while you can.

• Talk to a friend. Air your feelings to someone you trust, family, friends, your partner, or even a doctor or therapist. Getting what is bothering you off your mind will also help reduce stress.

• Manage your own stress levels – know what triggers you and know how to avoid it. And don’t let the stresses build up. Try exercise (with doctor approval), yoga, meditation, Reiki, etc. Taking ownership of your own thoughts and emotions will help you better deal with them.

Depression does not have to mask the excitement of becoming a mother. Knowledge and understanding about treating your depression can put your mind at ease. And misconceptions about medicines and other treatments can all be alleviated by talking to your obstetrician, psychiatrist, or pharmacist. It is important to remember that keeping mom healthy and happy will increase the likelihood of a happy and healthy baby.

For more information: https://www.womenshealth.gov/publications/our-publications/fact-sheet/depression-pregnancy.html

Submitted by Regina Wunch, PharmD Candidate,
LECOM School of Pharmacy Class of 2014
Student of Rebecca Miller Wise, BS, MEd, PharmD

Be Well, Be Wise,
Dr.Becky

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Dr. Rebecca Wise

Wise Words…. is a general medical information column from Dr Rebecca Wise. Dr. Wise has a master’s degree in education as well as her doctorate in pharmacy. She is an Ambulatory Care Clinical Pharmacist and Educator in Erie, PA.

Soon to be released is Dr Becky’s new website which will address women’s issues, watch for it: www.WiseWordsforWomen.com
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