How to Treat Prenatal Depression


Women who find themselves pregnant might find themselves forced to make hard decisions when faced with depression. On one hand, antidepressants can be very dangerous for both an unborn child and its mother. On the other, if left untreated, depression itself can have catastrophic consequences. This conundrum is especially pressing, considering as many as a quarter of pregnant women will experience depression at some point. It is, therefore, vital that women understand how to treat prenatal depression.

There is some concern among the obstetrics community that women are not being given the support they need out of fears that being forced to confront a positive diagnosis of depression will cause them make potentially dangerous decisions for themselves or their children. But ignoring the problem will not make it go away. It is better that we should develop a better collection of resources for clinicians to be able to offer prenatal patients who demonstrate signs of depression.

The appearance of symptoms and the use of antidepressants themselves have both been linked to problems once the baby is born, including irritability, unusual growth changes, and subdued facial expressions. In addition, depression itself can cause shorter gestation periods and interfere with the natural growth of the fetus. Some more recent studies have linked antidepressant use to birth defects, hypertension in the baby, and reduced birth weight.

Before treating depression, though, clinicians must be sure that the symptoms they observe are conclusive indicators for depression, which can be difficult in pregnant women. Mood swings, cognitive changes, and alterations in appetite and energy level are established symptoms of depression, but of pregnancy as well. It is critical that clinicians successfully isolate depression as a cause before treatment commences.

New protocols suggest that psychotherapy is effective in treating depression, either alongside medication or on its own. It may also be a good idea to taper down one's medication use, if appropriate, if one is not pregnant but plans on becoming so.

Ultimately, some patients' depression will be so strong that it will be necessary to remain on some medication during the pregnancy, regardless of the risks. In that case, a psychiatric professional will be able to help you decide whether to remain on your current prescription or switch to a drug that has potential fewer side effects. And, as with most things medical, it's best to talk with your doctor before taking any steps to change your medication use.

As more and more therapeutic options become available for how to treat prenatal depression, it will become increasingly important that obstetricians understand the treatments available and take greater responsibility as their patients' whole-body care provider.


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