Depression in Pregnancy

I recently attended a seminar (Untreated Depression and PTSD in Pregnancy: Effects on the fetus, newborn and infant. Maureen Shogan, MN, RNC.) on depression in pregnancy and I found it very informative. I struggled with feeling very down in my last pregnancy with Gabe but wasn't actually diagnosed with depression. I went as far as getting a prescription for citalopram, an antidepressant. I even took one pill and then I didn't take any more.

I read about the side effects of the medications even though my doctor told me that it was completely safe in pregnancy. I was terrified of having another baby that didn't sleep so I decided not to take the medication. I think I did have some markers of being depressed but I thought I could do without the medication. Thankfully in my situation, I bounced back. I think in my situation it may have been more related to my hormones.

The seminar I went to on Monday stated that the research is showing that the medications should be continued if a woman is currently taking them for depression. Women are 68% more likely to suffer major depression relapse if they come off their meds and 60% are likely to go back on them if they stopped in the first trimester.1 Pregnant women may choose to come off their medications for their baby. A diabetic wouldn't dream of coming off their insulin and so the person diagnosed with depression shouldn't come off her medications.

I did notice a huge difference in my mental wellbeing getting outside and getting my fill of sunshine and vitamin d.

From the seminar I have learned that there are chemical changes in the brain. At a week post delivery the baby has changes to their frontal cortex similar to the depressed mother's changes to their brain.2 There are actually far more women that are depressed at 32 weeks in pregnancy than at two months postpartum that are depressed.3 What a surprise! I think that people are far more familiar with postpartum depression than with depression in pregnancy. I think people need to talk more about these issues.

1 Cohen, L.S. et al (2006) Relapse of major depression during pregnancy in women who maintain or discontinue antidepressant treatment. JAMA, 295, 499-507. (MA Gen).

2 Jones, N.Field, Lundy (1997). EEG activation in 1 mo infants of depressed mothers, Developmental Psychopathology, 9(3), 492-505. Field, T. (1998). Emotional Care of the at-risk infant: Early interventions for infants of depressed mothers. Pediatrics, 102(5), 1305-10.

3 http://www.bcmj.org/article/psychiatric-disorders-pregnancy

Untreated Depression and PTSD in Pregnancy: Effects on the fetus, newborn and infant. Maureen Shogan, MN, RNC.