Brace Yourselves: ParentDish Covers Antidepressants During Pregnancy

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So a while back I heard from Julie Rosenberg, a writer for ParentDish who was doing a story on PPD. Honestly it's hard to remember when it was, and I'm not trying to be a butthead when I say that, it's just that I already have no memorywhatsoever.

Recently she emailed again asking me for a pic for the story and I said sure no problem and sent one of me with my gorgeous boy. Yes, that boy.

Then I saw the story came out today and it was ALL about using antidepressants during pregnancy. I didn't remember that being the focus, though I'm sure it was … I had just forgotten. And I thought to myself, "Oh goodness, here we go." Brace yourselves.

The story is actually very balanced, but I can see howthose with preconceived notions will think I'm promoting taking antidepressants during pregnancy. I can see how some of the quotes from mothers who did choose to take psych meds during pregnancycould be misconstrued by some as though these womenwere all happy-go-lucky about the decision. As if it was an easy decision to make.

I can't say anything about antidepressants without being accused of pushing them. Or selling them. Or being addicted to them. Or some other such claim. I do take one for my OCD/anxiety and am not ashamed of that in any way whatsoever. NOT ASHAMED, EMBARRASSED, or any other kind of stigma someone would like me to accept but that I will refuse to.

I did take meds when I had postpartum OCD, but I also went to therapy, so I can't tell you whether one was more responsible than the other for my recovery — or maybe both equally so. I think if you need medication and it works for you, good.It works for me. If you do something else that works for you, good too. Do what is right for you. But now that I've been quoted inParentDish's article on taking medication during pregnancy, I'm sure none of whatI just said will have any bearing on how certain people will respond.

It was anerve-wracking decision for me to make, to continue with my antidepressant when I was pregnant with my daughter.There are always risks when you are pregnant, with taking anything at all. There are also risks — onesof which many people are unaware — that can come with suffering from clinical depression or anxiety while pregnant. When you face a risk no matter what you do,you just have to come to accept that and make a choice. I made the choice to take meds based on the research available to me at the time, and on the fact that I didn't want my daughter swimming in anxiety inside my belly, and that I didn't want my family to suffer if I had postpartum OCD again which was likely.I chose to put the oxygen mask on myself first.Considering the positive outcome, it feels like in the end it was the right choice for me.

Sadly, there isn't enough research to make it easy for people to make a risk-free decision. There is a huge relapse rate for women who've suffered previous mental illness who go off their meds during pregnancy. There are also studies that show that babies can be negatively affected when women take antidepressants and then to make things even more confusing, there are studies that refute those studies and state that the risks to babies are minute. It's hard to navigate through it all.

I'm grateful that researchers who care about this issue are looking into as many avenues as possible fortreatments of mental illness during pregnancy, including light therapy and acupuncture. I'm grateful to the ones that are continuing to look closer at the effect –or lack thereof, whichever the case may be — of psychiatric medication on infants. I am also grateful to organizations like ACOG that realize there is no cut-and-dry answerand offer guidelines to doctors who are often uninformed about the spectrum of risk.

I hope one day it will be easier for those of us with mental illnesses like PPD to makethese kinds of decisions without worry. That will be a great day indeed. As for now, I'm comfortable with the decision I made and I hope that every other mother has as much information as possible and is supported in the decision she makes, whatever it is.

Itwill be interesting to see what kind of comments Julie's story gets. Hope you'll join the discussion.

Update: Strollerderby on Babble.com has weighed in on the topic now as well.

Also, click here for more stories on pregnancy and depression.

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Could New Research Indicate A Completely Different Way to Treat Postpartum Depression?

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Psych Central reportson new researchthat maylead to a change indrug treatment for depression in the near future, focusing on a different kind of neurotransmitter instead of serotonin, norepinephrineand dopamine.

The emerging opinion has scientists interested in a group of brain chemicals that are involved in virtually all of our brain activity. The study shows that compared to healthy individuals, people who have major depressive disorder have altered functions of the neurotransmitter GABA (gamma-aminobutyric acid).

Researchers believe an individualized approach to diagnosing depression, one that would include testing to identify low levels of the GABA neurotransmitters, could dramatically improve depression treatment.

Research has also found that GABA may be a culprit in the development of postpartum depression. In 2008, I shared with you the results of research done at UCLA finding that dysregulation of proteins called GABA receptors on the surface of certain neurons in the brain may bring on mood disorders after birth ranging frompostpartum depressionto postpartum psychosis.

So we'll have to see what comes of this, but in the meantime (and only those of you whose children watch Nick Jr. will get this), I say "Yo-GABA-GABA!"

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Antidepressants' Effect on Milk Production

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MedPage Today reports on a small study that found "women taking selective serotonin reuptake inhibitor (SSRI) antidepressants may experience delays in postpartum breast milk production …" Delayed in this instance means more than 72 hours postpartum. Read more here.

also, click here for more information on breastfeeding and depression.

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Fight for Preemies: How Treated & Untreated Depression During Pregnancy Can Lead to Preterm Birth

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Today is Fight For Preemies Day, hosted by the March of Dimes.More than 400bloggers across the country are writing about prematurity, and how important it is for babies to make it full term before they are born. Why is preterm birth a problem? Because it can lead to lifelong health problemsand sometimes death.

Postpartum Progress is joining in the fight today for good reason. Prematurityis a relevant subject for people in the perinatal mood and anxiety community, as depression and anxiety during pregnancy can lead to preterm birth, as can antidepressants taken during pregnancy.

A research study published last year found that moms with depression during pregnancy had a higher risk of preterm birth. As reported on Health.com:

"Depressed moms-to-be are more likely than nondepressed women to have a preterm birth—and the worse their mood, the greater their risk, says a new study published in Human Reproduction. In fact, women in the study who were severely depressed during early pregnancy more than doubled their risk of giving birth to premature babies.

The reasons why aren’t entirely clear, but the researchers don’t think antidepressants are to blame. Only 1.5% of women were taking the drugs during pregnancy, and excluding them from the study didn’t change the results."

On the other hand, a different study from Denmark published this year found, as have other studies,that women who take antidepressants during pregnancy are also at a higher risk of their babies being born prematurely.

Yet anotherpiece of research hasfound that the risk of preterm birth for those with depression who take SSRIs and those who are depressed and don't receive treatment is about the same. According to an article from Medscape:

"Pregnant women with major depression have a 1-in-5 risk of preterm delivery, regardless of whether they are taking continuous serotonin-reuptake inhibitors (SSRIs) or receive no treatment for depression.

In a prospective study published online March 16 [2009]in the American Journal of Psychiatry, Katherine L. Wisner, MD, from the University of Pittsburgh Medical Center, in Pennsylvania, report that women who took SSRIs throughout gestation had a preterm birth risk of 21%. Those with continuous untreated depression during pregnancy had a preterm birth risk of 23%. The comparison group of women with neither depression nor SSRI exposure had a preterm birth rate of 6%."

What does all of this mean? First of all, don't freak out.This doesn't mean your baby is 100% guaranteed to be born prematurely. What it does mean is you needtobe aware of the potential forpreterm birth to occur.If you have depression or anxiety during your pregnancy, whether you receive treatment with medication or are untreated, you need to talk with your doctor about ways to prevent preterm birth. You need to make sure you are doing everything possible to stay healthy and get the prenatal care you need.You should consider methods of treatment like psychotherapy. And it's a good idea to learn the signs of preterm labor.

Finally, if your baby is born prematurelyand ends up in the NICU, know that the March of Dimes has great programs to support you. Visit their website to learn more.

P.S. I forgot to mention that both my sweet babies were born early. Jackson at 38 weeks and Madden at 35 weeks.

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