Depression During Pregnancy – The Best Kept Secret

Laurie Hollman, PhD, has a new book,
Unlocking Parental Intelligence: Finding Meaning in Your Child’s Behavior,
to be released Oct. 13, 2015

Depression in Pregnancy: Expectant Mothers

Depression in pregnancy a new area of research. According to the New York Times depression during pregnancy affects up to 15% of expectant women. Some have been depressed for many years, some became depressed when they became pregnant, and others resolved their previous depression with the use of medication usually S.S.R.I.’s or selective serotonin reuptake inhibitors such as Prozac, Zoloft, Lexapro, and Paxil among many others.

The Controversy About Medication

Depression in pregnancy may be affected by medications used. The controversy is whether to take these medications during pregnancy. Many women stop the medications for fear of harming the fetus and relapse into depression which of course also has ill effects on the baby such as potentially releasing high levels of the stress hormone cortisol. Some women are depressed during one pregnancy and not another. There is no clearly researched way to predict.

Why Depression in Pregnancy is Such a Secret
Depression in pregnancy or antenatal depression if addressed might improve postnatal depression, more commonly reported. Antenatal depression stays underreported and untreated because society says pregnancy is supposed to be a joyful time and women feel ashamed that they are not ecstatic while nurturing a new life from within. Of course, this view only adds to depressive thinking.
Even while society is becoming much more open minded and feminism is decades old, this perception of pregnancy continues. We do not openly acknowledge that for many women pregnancy is filled with anxiety, a traumatic change in a woman’s self-image, fears of motherhood, and major life style changes.
The general knowledge that is publicized is that pregnant women should carefully monitor or eliminate any medications at all , be wary of certain foods, monitor and seek advice on exercise and other sorts of self-sacrifice to insure a healthy baby.
The Medical Controversy About Depression During Pregnancy
The dangers of taking S.S.R.I.’s are real according to some members of the medical community who report the risk of major birth defects, miscarriage, preterm birth and low birth rate among other serious problems. Other physicians and women report no ill effects. So there are no clear answers on short or long term consequences for the baby. But there is research that suggests ill effects for the baby born from and raised by a depressed mother.
Certainly talk therapy and a solid support system for the depressed pregnant woman is helpful and highly recommended but it may not be enough. Frightening ambiguity results and the women feel judged and criticized by themselves, some of their doctors, and the community at large.
However, the baby and mother’s well-being are part of a whole; it’s not either/or. We are looking at the mother’s capacity to bear and take care of her child. Babies of depressed mothers may form insecure attachments in the early months which bear poorly on their child’s future mental and developmental health.
Are There Any Answers?
Most important is to take this subject out of the cave of darkness into the light. Women with severe depression bordering on suicide may have to use medications and bear the risks for the baby’s well-being. Women with mild depressions may make it through their pregnancies without medication but with good therapy and support. The wide range in between can no longer fall between the cracks with doctors who border on fearing creating harm with medication or without. At least recognizing the problem can reduce the shame and judgment which by itself has some effect on modifying depressive thoughts and feelings.
Women are advised to be open with their doctors and not let them take a pass. The love of supportive friends and partners and open acknowledgment of the illness will help women now and in the future. Careful studies through observation requires women to come forward and report what is and has happened to them to garner data for their future motherhood, the future of their next pregnancies, and those of other depressed pregnant women.
I will close with a quote from the New York Times Magazine article, June 1, 2015:
“Wanting to love your child is not the same thing as loving your child, but there is a lot of love even in the wanting.”