Depression and Pregnancy

I’ve seen several blog posts about depression lately, and after reading this article, I found myself lost in thought about my own trials with depression. (Pardon me while I go off on a “me, me, me!” story.)

During the second trimester of my pregnancy, I started taking antidepressants. A few years before that I had one serious bout with depression, and took medication for about 6 months before weaning off and feeling back to normal. I thought I was cured, but while pregnant, the depression started to slowly creep back in.

The worst part was that I felt horribly guilty about it. I was pregnant! More importantly, I wanted to be pregnant! I was supposed to be glowing, to feel wonderful, to be as happier than a cat in a catnip field! Yet each day I found myself dwelling more and more on dark topics. What if I couldn’t care for this baby? What if the baby was horribly malformed? What if it died? What if I died? What if Aaron didn’t think I was pretty after the baby was born? Some days I barely got off the couch, and often I’d stay in my PJs all day, eating ice cream and watching Special Delivery on Discovery Health.

Having already forced up the courage to ask about depression once before, I went to my OB and shared my concerns. It was at that point she let me in on a little secret: pregnant women often get depressed. Of course, I really didn’t believe her – I thought she was just saying it to be nice to the crazy person in the room. She told me to talk to my family doc about it.

I made an appt. with my family doctor, and when I started to open up about how I was feeling, I found myself crying in the exam room. I didn’t want to feel so down, but I didn’t want to risk hurting my unborn child with drugs, either. She also told me that depression was common in pregnancy (the doctors must be conspiring against me!), and suggested a mild antidepressant.

I balked at the idea, but she assured me that this was a well-established drug, and there was plenty of research showing it to be safe for pregnancy. She then told me that other research had confirmed that moms-to-be who are stressed or depressed pass the hormones released as a result of that stress on to the baby. So not only was I feeling down, but my poor child was also feeling the results of my depression.

While that should have helped my decision, I felt stuck in a damned-if-I-do, damned-if-I-don’t situation. Either expose my child to damaging cortisol, or expose her to mood-altering drugs.

In the end, I chose the antidepressant. I read some of the research, and was disturbed by what high cortisol levels could do to a baby: preterm labor, low birthweight, reduced blood-flow to the placenta, etc. While there were also risks with the antidepressant, this particular drug had very few and rare risks. It was also safe for breastfeeding, so I could stay on it after birth to prevent post-partum depression (apparently those who have suffered from depression at any point in their lives are far, far more likely to develop post-partum depression).

I was happy, then, to see that article yesterday. Depression during pregnancy really isn’t talked about enough, and it’s clear that a pregnant woman should monitor how she’s feeling and not be afraid to bring up her feelings to her doctor.

And just to be clear, I’m not saying that anyone who feels a little depressed should ring up the doc for some drugs ASAP. Don’t think of me as a drug pusher, because I’m really not. I think it’s a very serious choice, and requires a lot of thought and discussion with your doctor. But I would urge anyone who is pregnant and feeling depressed or anxious, more than they think they should be, to bring it up at your next doctor’s visit.

For me, a low-dose antidepressant was the best course of action. It made the remainder of my pregnancy so much better. And once Cordelia was born, it greatly helped those first few weeks, or as I call them, the Hormonal-Dump-Kill-Me-Now weeks.

As for Cordelia? Well, she was born at term, and weighed in at an impressive 8 pounds 4 ozs. Other than having colic and a strong attitude, she was as normal as any other baby and showed no signs of being affected by the antidepressants. It was a good solution for both of us.