Seeking Help for Depression and Postpartum Depression
I’m currently reviewing Dr. Ruta Nonac’s A Deeper Shade of Blue, “a woman’s guide to recognizing and treating depression in her childbearing years.”
Early in the book, within the first chapter, Dr. Nonac’s made these important points about seeking depression treatment and about postpartum depression:
People who suffer from depression often are “discouraged” from seeking help for their depression because they may be told that what they are experiencing is normal, not serious, and / or go away.
Dr. Nonac states that depression is never “normal” and should never be ignored. Dr. Nonac in fact re-emphasizes this in other chapters of her book. Although Dr. Nonac’s book is about depression during a woman’s childbearing process, and thus is focused on the woman audience, this premise about seeking help for depression applies readily to men who suffer from depression.
Postpartum depression resources, and information about depression during pregnancy and during nursing, remain scarce.
It wasn’t long ago when we saw Brooke Shields’ and Tom Cruise’s public spat about postpartum depression and whether psychiatric conditions were made up by evil drug companies (according to Tom, psych conditions were imaginary). Other incidents of postpartum depression had come into our public consciousness as horrendous crimes committed by the mother to her children. This does not bode well for women who suffer from postpartum depression, because they were now afraid of being classified in the same group as those mothers. The positive thing is that this publicity brought postpartum depression to primetime, and Brooke’s public admission about her postpartum depression helped dampen some of the social stigma around postpartum depression.
However, information about what happens to a woman with depression during pregnancy and and during nursing is scarce. Women with a history of depression not only worry about their chances of experiencing postpartum depression, but also face questions like, “should I stop taking my antidepressants while I’m pregnant?” and “Should I wait until I finish nursing to start taking antidepressants again?” These are questions unique to women who are no stranger to depression, and are now facing childbearing decisions.
Treating Depression in Pregnant Women
US Food and Drug Administration (FDA) published a Public Health Advisory on treating depression in pregnant women, because doctors and moms-to-be have to weigh the risks and benefits of antidepressants during pregnancy.
A risk of stopping antidepressants for a patient suffering from depression and taking depression medication is that the patient may experience a relapse. Earlier this year, researchers studied pregnant women who stopped taking their antidepressant medication during pregnancy and pregnant women who continued taking their antidepressant medication during pregnancy. Women who stopped their meds were 5 times more likely to suffer from depression relapse than women who continued antidepressants during pregnancy.
Another study suggested potential risks from SSRI class of antidepressants taken during pregnancy. Pregnant women who took antidepressants during pregnancy gave birth to babies that were 6 times more likely to suffer from a condition called persistent pulmonary hypertension (PPHN). This is a serious and life-threatening lung condition where the blood pressure of the babies’ lungs are very high and cannot get enough oxygen into their blood. The caveat is that this is a small study and additional studies have not yet been conducted to confirm the findings of this study. Late last year, the labeling for paroxetine (Paxil or Seroxat) was changed to reflect findings that use of this drug during the first trimester may be linked to increased risk of heart birth defects.
The FDA is advising that pregnant women on antidepressants should not stop taking their medication without first seeing their doctor, and weighing carefully the risks and benefits of continuing medication treatment during pregnancy.
New Jersey Doctors Must Counsel on Postpartum Depression
Tom Cruise isn’t going to like this one.
In April 2006, New Jersey governor Jon Corzine mandated doctors to educate pregnant women and family members about postpartum depression. New mothers will be screened for postpartum depression. The law will become effective this October, making NJ the first state to enact this legislation. You can read the details on the Psychiatric News website. Thanks to Sue for pointing this out.