As summer approaches, I am delighted to see men and women alike out and about working out, showing off their bikini bodies, demonstrating their public displays of affection, and looking very care-free. An abundance of pregnant women seem to glow every summer, and they certainly don’t go unnoticed, especially in their midriff-bearing summer-wear. Historically, pregnancy was thought to be a time of emotional wellbeing. Although I don’t want to be a Debbie-downer during this exciting time for those of you “in-bloom”, this is not always the case; therefore, I believe this is an important topic to cover in any wellness forum for those it directly affects as well as their loved ones, friends, and family.
Am I at risk?
Depression, the leading cause of disease-related disability amongst women, is highest during the reproductive years. About 10-15% of women experience depression during pregnancy, according to recent studies. While the risk is highest in those who have been depressed or anxious in the past, about 7% have their first depressive episode during pregnancy. The risk is increased in those with a family history of depression, particularly depression during pregnancy and post-partum.
Frequently, doctor and patients alike will discontinue antidepressant medications when someone becomes pregnant or is thinking about getting pregnant. This can lead to dangerous relapses during a very vulnerable time for a woman and her family, and patients should discuss these decisions at length with a specialist before determining the best course of treatment. Finally, the greatest risk for post-partum depression is untreated depression during pregnancy; therefore, hiding behind the symptoms while pregnancy is not going to make them go away.
What are the symptoms?
Depression during pregnancy manifests similarly to any depressive episode, but can be complicated to signs and symptoms related to the pregnancy, specifically. It is important to realize that untreated depression can affect prenatal care; studies have shown that women will decrease prenatal vitamin use, not gain weight appropriately, use drugs and alcohol to manage symptoms, and even make decisions to terminate pregnancy solely due to untreated depression. Some symptoms of a healthy pregnancy (including increased fatigue, awakenings, and weight gain) are difficult to differentiate from depressive symptoms and should be evaluated.
To treat or not to treat?
Many pregnant women and their partners have come to me concerned about being on medications during pregnancy. They are almost always surprised to hear my answer. While any medication counts as an “exposure” to the fetus in the pregnancy and must be evaluated on a risk/benefit basis, depression and anxiety are also “exposures”. In some studies, the risks of depression and anxiety (whether due to the chemical imbalances they create in our body or the effects that the mood changes have on our lifestyles) created more harm than the risks of antidepressants. While therapy is sometimes the most positive option, as it may eliminate exposure to both the depressive chemical changes as well as the medications, it is not always effective enough. Medications for depression can be very safe and can certainly be considered in those patients with moderate to severe depression after thorough discussion with a physician.
I’m not pregnant. Why should I care? What can I do to help?
If you know someone who you are concerned may be depressed during pregnancy or post-partum, the simplest thing you can do it reach out to her. Many new-to-be mothers and new mothers are overwhelmed and feel alone and scared to reach out to others. New moms often feel they are supposed to be happy and are ashamed to feel otherwise. However, mood changes like depression can be devastating to a pregnant woman and can even put her at risk for suicide or homicide to her newborn. It is therefore important that we raise this issue with the general public, inform mothers that they are not alone, and view this as a real disease with serious consequences. While it’s always nice to see expectant mothers hiking Runyon Canyon or enjoying a healthy smoothie on the beach, there are still those in hiding this summer waiting for a friend or loved one to reach out to them. Help is available, and whether it’s you or someone you know, you can certainly make a difference.
No comments:
Post a Comment