Pregnant and Depressed or Anxious: To Medicate or Not to Medicate?

Image by anitapeppers.

If you’re depressed or anxious during your pregnancy, don’t be afraid to reach out for help. Counseling can improve our outlook while you prepare for your baby. Image by anitapeppers.

During pregnancy, women frequently report more profound depression and anxiety than they experienced before they became pregnant.

The decision to treat these conditions with pharmaceuticals, lifestyle change, and/or counselling is an individual decision; requiring support from caregivers.

Many Pregnant Women Use Prescription Drugs

In Canada, 63% of pregnant women use prescriptions, according to a study by the University of British Columbia. Doctors often treat mood disorders such as depression and anxiety are often treated with psychoactive drugs prior to and throughout pregnancy.

Doctors use psychoactive drugs to modify these emotions, specifically benzodiazepines and antidepressants. Depression and anxiety are sometimes pre-existing but exacerbated by physiological and hormonal changes, or when patterns in the family or career are affected by the pregnancy.

Treatment without drugs is often the first choice for women concerned about the effect of pharmaceuticals on the fetus. Non-drug treatment might include specialized psychotherapy (individual, couples, family), support groups, nutritional and/or lifestyle coaching.


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Medication: Risks to Baby and Mom

When mom takes drugs of any kind, they will pass, to some degree, with the unborn baby or the infant through breast milk.  No psychotropic medications are approved specifically for use during pregnancy in the U.S., Canada, or Great Britain, but when the managing physician considers these drugs the best treatment option, considering known risks, he or she prescribes the medication to the woman as needed.

Alternatives to Pharmaceutical Treatment

Pregnancy naturally results in physical change, altered career and family dynamics, and often financial stress; any of these can trigger unresolved trauma and relational conflict.

These issues can affect your mood and day to day living, which cause you to decide to seek treatment. Whether you are pregnant or not, when symptoms of anxiety or depression surface it is most empowering to become better informed and be a proactive participant in any treatment process. You can usually manage anxiety or panic disorder through psychotherapy that includes cognitive behavioural techniques, and treatment for pre-existing trauma.

Happy Mom, Happy Baby Image by Keely Assu

Happy Mom, Happy Baby
Image by Keely Assu

New Skills for Managing Moods

Emotional management of anxiety and depression can be learned through psychotherapy, and these skills are beneficial throughout life.  Yoga breathing, mindfulness meditation, and various types of relaxation techniques such as visualization are useful and are often taught in community health centres and hospitals at minimal or no cost.

You can even use hypnosis to enhance other treatments for anxiety and depression; this treatment has long been in place for pain management in childbirth.  However, the American Society of Clinical Hypnosis (ASCH) strongly recommends that hypnotherapy be provided by a professional with advanced training in health care and a licence to practice.

Hypnotherapy is best used as an adjunct to informed, professional therapy and not as a stand-alone treatment for depression or anxiety.

Pregnancy and Family Relationships

Pregnancy also impacts relationships at home.

Family or couples’ counselling can help prevent future conflict and mediate current misunderstanding. Older siblings benefit from extra attention during Mom’s pregnancy, so don’t forget to include them in family counselling.  This is a good time to reinforce the sibling’s new and important role as Big Brother or Big Sister.

Healthy Body, Healthy Mind: Prepare for a Happy Pregnancy

Nutritional counselling can help alleviate symptoms of allergies, nutritional imbalances, and metabolic disorders all of which can contribute to an unhappy frame of mind. Acquiring healthy dietary habits during pregnancy also helps provide the groundwork for good mental health in the months ahead.

Obtaining current, valid information from professionals and accessing recent research, reaching out for appropriate emotional support, and maintaining a healthy lifestyle provides the best chance for both baby and Mom to have a safe and happy pre and post-natal experience.

Resources:

Daw, J.R.; Mintzes, B.; Law, M.R.; Hanley, G.E.; Morgan,S.G. Prescription drug use in pregnancy: a retrospective, population-based study in British Columbia, Canada (2001-2006). (2012). Clinical Therapeutics. Accessed September 18, 2013.

American Society of Clinical Hypnosis. Important Notice Regarding Hypnosis and the American Medical Association(2010). Accessed September 18, 2013.

Johnson, Brian, et allAddiction: Part I. Benzodiazepines—Side Effects, Abuse Risk and Alternatives. (2000). American Family Physician. Accessed September 18, 2013.

Stanford Center for Neuroscience in Women’s Health. Pregnancy and Mental Health. (2013). Stanford School of Medicine. Accessed September 18, 2013. 

© Copyright 2013 Hazel Trego: Families, All rights Reserved. Written For: Decoded Pregnancy
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