The pregnancy is often described as a joyful experience, growing an infant, feeling the first kicks and dreaming of names and nursery. mental challenges are often hidden behind smiles and baby showers for many women. When you are dealing with anxiety or depression while pregnant, the situation becomes more complex.
Let’s discuss it – honestly, compassionately and without judgement.
Sarah* was in a panic when she found out that she was pregnant six months after the birth of her first child.
Since the birth of her son, she’s been suffering from Postnatal Depression. It felt as if the dark cloud that had just begun to lift was now rolling back into place.
She recalls: “I was overwhelmed, exhausted and truly terrified.” “I didn’t wish to return to the place where I did not recognise myself. “I wanted to have a good pregnancy, and not just get through it.”
Sarah made an appointment to see her GP with the help of her partner. After a long and open discussion, Sarah was prescribed antidepressants along with the recommendation to begin regular counselling sessions.
Your doctor is there to help. Lean on them
There are no two identical pregnancies or people. It’s important to have a close relationship with a healthcare professional who knows your medical history and past mental health issues.
Sarah’s GP stressed that a personalised benefit-risk analysis was essential. Women with a family history of mental illnesses or a previous history of depression, PND, or anxiety are at a higher risk for a recurrence during pregnancy or after childbirth.
The stakes may be higher than you think
It’s not just uncomfortable; uncontrolled anxiety and depression during pregnancy can be dangerous. Researchers have linked maternal depression with lower weights at birth, and ongoing maternal stress may be associated with elevated levels of stress hormones in children as young as age 10. This can hurt a child’s growth. It may also affect emotional bonding and breastfeeding.
In other words, not doing anything is not always the best option.
Is it safe to take antidepressants while pregnant?
What’s the short answer? Yes, in many cases. But with caution.
Certain antidepressants are well studied in pregnancy, and many of them are considered safe if prescribed correctly. Decisions are still made on a case-by-case basis, considering:
- Your mental health history
- Type and dosage of medication
- When is the first, second or third trimester?
- Other health concerns or medication
The Most Commonly Prescribed Antidepressants during Pregnancy
When prescribing antidepressants for pregnant women, doctors tend to favour SSRIs (Selective Serotonin reuptake inhibitors). These include medications such as:
- Sertraline
- Citalopram
- Escitalopram (Lexapro)
SSRIs with relatively good safety profiles are preferred during pregnancy. Several antidepressants in the SSRI group, such as paroxetine or venlafaxine, are less frequently recommended due to potential increased risks.
The older classes of antidepressants, like tricyclic, are less common today, especially during pregnancy, because they have more side effects and a less favourable safety profile.
What the research says about the risks
Many pregnant women are concerned about how medications could affect their child. While no medication comes without risks, those associated with antidepressants that are commonly prescribed are generally manageable and low.
Here is a breakdown of the three trimesters:
First Trimester
Early studies indicated that SSRIs did not have adverse effects in the first trimester. Later research raised concerns about a slight increase in the risk of birth defects. Nevertheless, the majority of studies concluded that these results were not statistically significant. This means that, while a risk might exist, it is extremely small.
Second Trimester
The effects of low birth weight or preterm birth are mild. There have been instances where babies born to mothers taking SSRIs had mild breathing issues, such as rapid breathing or jitteriness. The symptoms usually go away on their own in two weeks, and the long-term outcomes are positive for these babies.
Therapy is not just about the pills
The right medication can be an effective tool, but it is rarely the only solution. Psychotherapy and counselling are often prescribed alongside antidepressants, or even alone for milder cases.
You can benefit from talking to a perinatal or qualified therapist:
- Learn coping techniques to cope with stress and anxiety
- Fears or traumas surrounding pregnancy or birth can be processed.
- Strengthen emotional resiliency during the postpartum period
- Create your “village“-your support system
These sessions were a lifeline for Sarah.
She shares, “My counsellor gave space to me to say things that I was afraid to share with anyone else.” She never made me judge. “Those conversations helped me to stay grounded when life became chaotic after the birth of my baby.”
Sarah’s doctor guided her to gradually taper her medication when she was emotionally ready.
She says, “It was not a quick fix.” The combination of medication, counselling, and support was the key.
What to consider when making a decision
You may be overwhelmed by the decision to take antidepressants if you are pregnant or trying to get pregnant and suffering from depression or anxiety. What to consider is outlined below:
1. The severity of your symptoms
- Can you function daily?
- Do you get out of bed to eat, sleep, or do?
- Do you have suicidal feelings or thoughts?
If your depression is mild to moderate, you may need medication as part of your treatment plan.
2. What has helped in the past?
- Have you ever responded well to a particular medication?
- How effective was your therapy?
You can use your experience to guide you in choosing a treatment.
3. Support system
- Are you receiving emotional and practical support from your family or friends, or partner?
- Feeling lonely?
Support is more important than we realise. Mental health issues can be exacerbated by loneliness during pregnancy.
4. Trimester Timing
- During pregnancy, certain medications may carry a slightly higher risk.
- Your doctor may need to adjust the dosage or timing.
What happens after the baby is born?
Postpartum can be an emotional rollercoaster. It’s common for anxiety and depression symptoms to increase after childbirth, even if you were able to manage well during your pregnancy.
Continuity in care is important. Staying in contact with your doctor or psychiatrist, pursuing therapy and creating a postnatal care plan will help you maintain your mental health while you adjust to the new life of a mother with a baby.
Many women continue to take antidepressants during nursing. Moreover, many medications that are considered safe for pregnancy can also be used during lactation. You can discuss these decisions with your doctor when you are ready.
You deserve support
Mental health is important. Period. You are not failing if you’re managing depression, anxiety or any other emotional struggles while you’re also growing a child. You’re doing something that is both challenging and brave.
It’s not a sign that you are weak, but rather that you are taking good care of your baby and yourself.
Let’s normalise this conversation
Many women suffer in silence because they believe that “just being grateful” is enough or are afraid of being judged if they need medication. When we have real, nuanced discussions about mental health during pregnancy, we allow each other to seek help and speak up when needed.
You deserve to be well, whether you need therapy, medication, or a support group. You need to be able to care for your baby, not just as a mother.
Final Thoughts
It’s difficult to cope with pregnancy, especially when depression or anxiety are present. With the right support, care and treatment, you can have a healthy and happy pregnancy.
Gleichzeitig
Remember: you are not alone. Speak up and reach out. Help is always there.
