Weighing The Risks of Treating Antenatal Depression

There’s a new study out this week, published in the Archives of General Psychiatry, on the effect of taking antidepressants during pregnancy that essentially offers the same result as other studies we’ve reported on here:

Women with untreated depression during pregnancy have a higher risk of having pre-term babies.

Women who take antidepressants during pregnancy for depression have a higher risk of having pre-term babies.

Here was the conclusion of the study as outlined in the abstract:

Untreated maternal depression was associated with slower rates of fetal body and head growth. Pregnant mothers treated with SSRIs had fewer depressive symptoms and their fetuses had no delay in body growth but had delayed head growth and were at increased risk for preterm birth. Further research on the implications of these findings is needed.

It seems this is still a chicken and egg problem — is it something underlying the genetics of depression that leads to pre-term delivery or the medication or both? What should women do? [Read more...]

Banding Back Together for Postpartum PTSD

This guest post was written by my beautiful friend Becky Harks, author of Mommy Wants Vodka, survivor of postpartum PTSD and antenatal depression, and founder of Band Back Together.  She is a wonderful supporter of women with postpartum depression and all other mental illnesses related to pregnancy and childbirth, and Band Back Together is a great resource for people with all sorts of troubles who need support.  Read some of the stories members of “the band” have written at Band Back Together on postpartum depression here.

“Becky, there’s something wrong with your daughter’s head,” were the first words that my doctor said as I laid there, grunting and pushing out my last-born child.

Now, I can think of a lot of words that I’d like to hear while pushing out a baby: “Wow, you have beautiful legs,” or “This baby will grow up to change the world,” or even, “Woah, you look funny when you make that face.” Those words I could’ve handled.

But never, “something’s wrong with your baby’s head.” Those words should go together as often as “Tom Arnold” and “string bikini.”

A bachelor’s-degree prepared nurse with a penchant for anatomy, I knew that this was bad, even as my husband tried to comfort me. The NICU team swirled and whirled and ultimately decided that this was, in fact, very bad indeed.

[Read more...]

MGH Looks At SSRIs during Pregnancy & PPD and Sleep

The MGH Center for Women's Mental Health has two new stories out that I wanted to point you to:

Postpartum Depression and Poor Sleep Quality Occur Togetherreviews a recent study on sleep quality and sleep efficiency among depressed new moms.

Should SSRIs Be Tapered Prior to Delivery? takes a look at whether lowering the dose of a patient's antidepressant during the last few weeks of pregnancy will prevent neonatal distress.

… and can I just say I'm posting this from a plane? … technology rocks.

Pregnancy & Depression: Warrior Moms of the Week

This week, Warrior Moms of the Week is focusing on antenatal depression, or depression in pregnancy. It’s just as common as PPD but is even less talked about, if you can imagine. There are lots of people starting to speak up about this illness, which is very important. It can be very difficult to make decisions about treatment when you are carrying an unborn child, and to go through the experience of everyone wanting to celebrate the upcoming birth while you are miserable. Here are two stories on depression in pregnancy that appeared this week:

Erin Margolin on antenatal depression (depression during pregnancy)

Babble on antenatal depression

You don’t need to feel alone. It can help to see how many others have been through this, and that their stories are similar to yours. For more Warrior Moms stories on antenatal depression, check these out:

On How It Feels to Be Depressed During Pregnancy

The Black Hole of Antenatal Depression

Aunt Becky from Mommy Wants Vodka on Being Depressed & Pregnant

Antenatal Depression: Robbed of the Joy of Pregnancy

How It Feels To Be Depressed When You’re Pregnant

And if you are a survivor of antenatal depression and want people to know they can make it, too, pick up your survivor badge here:

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Postpartum Depression Research Roundup: Oxytocin, BDNF & the Value of Screening in the Hospital

There's been a lot of research coming down the pike lately. Can't tell you that any of it means anything significant to you who are suffering at this very moment. But offering it up for the researchey peeps among you …

Link between oxytocin and postpartum depression

Link betweenbrain-derived neurotrophic factor and antenatal depression(depression during pregnancy)

Whether it's worth testing for PPD in the hospital right after delivery (looks like it may not be very effective, as PPD didn't show up in the majority of mothers screened 1-2 days postpartum)

Arianne Segerman: On A Journey of Transformation Through Faith

Dear new mom (or second time mom, or 5th time mom),

I don’t really know where to begin to help you be more prepared for what you’re about to go through. I could start by telling you that if you, like me, are prone to depression, you need to ask those you love around you to keep an extra close eye on you after the baby comes. I don’t want you to live in fear, but I also don’t want you waking up one day wondering why you have thoughts about driving off the cliff you drive by every day. A little dose of fear isn’t a bad thing, just use it to propel yourself to action instead of reaction (or inaction).

When I had my first child I didn’t know that I was more prone to postpartum depression because of my history with depression. When the baby and I came home I didn’t know it wasn’t normal for me to feel like he was someone else’s baby and feel angry every time he woke up. I didn’t know it wasn’t normal for me to not really feel like I loved him. When the bonding finally clicked in several weeks later, I could see how different I felt, but I still didn’t know to be concerned about myself. I struggled through his first year hardly leaving the house, making no friends in my new city and praying for 6pm so I could hand my son off to my husband for the night. I would then wake up dreading my day alone with my baby. It didn’t help that he was a colicky baby that never lost the colic, and when his brother was born at his second birthday and he was diagnosed with Autism, I didn’t know that things would probably get worse.

Having two screaming children, being completely isolated, an alcoholic husband and doing nothing but driving my oldest to therapy was a cocktail for disaster, when combined with my long untreated disease. I would stay up all night not sleeping, just watching TV or reading blogs (the early ones, back in 2004) just so I could avoid going to bed where my baby would wake me again. Just to be alone. Just to watch the sun come up and avoid the inevitability of another day. Somehow not sleeping made me feel in control when I was very much out of control.

The not sleeping and the depression and the lack of self care were easily dismissed as a mom dealing with Autism, so my inner struggle continued to go unchecked. No one really knew about the darkness in my head. When the day finally came that I noticed my weeks-long practice of planning on how I’d kill myself was NOT normal, I didn’t know what to do. I couldn’t believe that suicide had become an option, that it didn’t matter to me that I’d be leaving my husband and children, that it seemed logical and simply possible — just a plan. I wasn’t alarmed by it, but I finally noticed that I needed help.

After getting that help, and deciding a complete change of location and scenery was needed (as in a cross-country move), I started to feel the suffocating fog lift. I likened it to how a meth addict needs to move to another city, to be physically away from the other addicts and the source of the addiction. I thought leaving was the ultimate “cure”, that I could start over with life, be the real me, or at least discover who she was in the first place.

That move didn’t cure me, but it did make things different enough that I started to see the world through new eyes. Through glasses that were tinted a color of change. Things became different. I could breathe again, and could meet new people again and somehow the help I had received in my old city was enough to help me to really start fresh as a new me. The new me was battered and still not exactly healthy, but the new me was able to step out of constantly feeling like a victim to my life so I could make some real changes, continue getting help and reach out to new people and build that all-important (vital, even) support system.

I can’t tell you that it will be perfect one day, and you’ll be cured and you’ll never suffer again — there’s not guarantee that life won’t come by and kick your ass again, sending you spiraling backwards looking behind you as you pass by all that progress you made. I didn’t know I’d give birth to a stillborn baby at almost 19 weeks alone in 2010, bringing PTSD and anxiety disorder into my life, and I never imagined experiencing antenatal depression for the first time right now at 20 weeks pregnant. It seems like the same dance, new song. But I’m changing with it, I’m learning, I’m using the tools that I already had and I’m fighting. Please whatever you do, keep fighting.

My own journey hasn’t been this rock bottom fall then saving glory to mental health where I stood tall and I pledged to change the world. It’s been more of a very slow climb out of that bottoming out, with many many stumbles, and some really big falls, along the way. I can say that my strong personal faith has played a huge part in my recovery, it seems to have been the missing link that I thought I had but didn’t really weave into my heart until I lost my daughter. Finding something I was soul-level passionate about (and I don’t mean a hobby, something that I feel completely transformed my heart, and fostered in the resources, healing and did I mention healing?) has been all the difference. I do credit God for saving me from the deepest pit of depression, that day when I shouldn’t have noticed that something was wrong, that day when I had my eyes opened even a little, in a miraculous way.

I know that for each of us it’s a journey. I hope that you too can find your soul-level heart transformation that brings your journey to a new path. That brings you new weapons for your battle. That brings you victory along the way. And as we all know, life is not about the destination anyway.

Arianne Segerman is a freelance writer living in the beauty of the deep South in Charleston, South Carolina. She homeschools her three special needs boys, misses her baby in heaven, grows baby #5 with fear and courage and is still searching for her inner steel magnolia. You can find her writings on life, faith and the in-between at To Think Is To Create or on Twitter at @tothink.

Becky Harks: On Not Having To Love Every Second of Motherhood

postpartum depression mother's day rallyDear New Moms,

In 2001, I was a freshly-turned-twenty-one-year-old discharged from the hospital with a baby. My baby, I should add, in case you think I’m some kind of baby-stealer. Single-parenthood looming on the horizon, I’d moved back in with my parents, and now, having just expelled my firstborn from my uterus, I had no earthly idea what to do with him.

In a sense (despite all precipitating factors that, when lined up, make my life sound like a bad Country-Western song), it was fortunate. I hadn’t yet met The Internet, I had no mom-friends, and I only owned one book on child-rearing: Dr. Spock’s. I didn’t meet the Judgmental Parents Club until much later, and by that time, I knew enough to tune them out.

The first bit of advice I can give new parents is exactly what I took away from Dr. Spock: trust yourself. You know more than you think you do. I cannot imagine how hard it must be in the digital age; all of the information and judgment flying at you from all sides, but in the end, you need to trust that you know what’s best for your baby. Anyone who tells you that you’re doing it wrong can kiss off.

What took me nearly five years to learn is my second piece of advice for new parents, and it’s one that’s not often mentioned. Sure, you hear people say, “parenting is hard,” and other boring platitudes you can crochet on a pillow, but that’s not the whole picture. Parenting IS hard, that’s a given, but there’s no law that mandates you must love every second of it. Don’t feel guilty if you don’t love every moment, age, or stage. Be wary of anyone who tells you stuff like, “enjoy it while it lasts, because it’s over too soon,” because that is a recipe for needless guilt.

I suffered terrible antenatal and postpartum depression with the pregnancies and births of my last two children. There were days I was so miserable that I could barely get my ass out of bed. Having antenatal depression wasn’t a sign that I was a bad mother or that I didn’t want my baby: it just meant that pregnancy made me feel like crap. Don’t beat yourself up if you’re not glowing while pregnant. The only time I had any sort of “glow” about me was after I’d vomited.

Make yourself aware of the signs of postpartum depression. The more you know and all that After School Special stuff. If you’re feeling low at any point, tell someone. Get help. Don’t be too proud to admit that you’re struggling.

Try to remember that you matter, too. It’s too easy to put the needs of everyone else before your own, especially when you have a new baby. Sometimes, yes, parenthood calls for this, but that doesn’t mean that you should neglect yourself. Eventually, that catches up to you. Not all of us have the luxury of having a live-in housekeeper, nanny or personal chef (I certainly don’t) but that doesn’t mean I don’t deserve a break to be myself now and again. You won’t win Mother (or Father) of the Year by neglecting yourself. I know. I’ve tried.

Celebrate the good times and the bad. Try to remember that the worst days always end. Relax. Tune out unnecessary noise. Don’t be afraid to admit you’re struggling and need help: no one can do it all.

And if all that fails, there’s always vodka. Or cheese fries. Or both.

Becky Harks, known throughout the blogosphere as Aunt Becky, blogs at Mommy Wants Vodka and is the creator of Band Back Together, a user-submitted group support blog which recently won a 2011 Bloggie Award for Best Kept Secret. You can follow her on Twitter at @mommywantsvodka.


Donations to Postpartum Progress can be made here: http://postpartumprogress.org/donate-postpartum-depression-2/

Molly Shalz: On How It Feels To Be Depressed During Pregnancy

postpartum depression mother's day rallyDear new mom:

I remember seeing the blue plus sign on the pregnancy test. It was positive. I waited for the happiness. It didn’t come. Instead of happy tears I had a panic attack right there in the bathroom. The sting from the guilt that I felt in that moment has never really gone away.

My first son had just turned one. I had just quit my job two days before. I was on birth control! We wanted another child but the timing. Oh, the timing. Why couldn’t it have happened later when things were more settled? When we were ready? When we could celebrate it and not be riddled with worry about our finances and future?

I will never have those answers. I didn’t choose my son. But that’s okay. He chose me. I know that now.

If you are one of those soon-to-be-moms who stands in the bathroom holding a positive pregnancy test wondering how in the hell you and your tiny impending bundle are going to get through this, let me be the first to tell you … you will.

As a woman who has faced severe depressive episodes due to bipolar II disorder for all of her adult life, I often wondered if the pregnancy hormones and then postpartum depression would push me into my worst mood episode yet.

So I was pleasantly surprised with how truly happy I was during my first pregnancy. Comfortable? No. But happy? Yes, gloriously so.

With my second, I waited for those happy feelings. The first trimester went by and my anxiety grew. The second trimester came and the worries and depressed thoughts took over my brain like flies swarm over food in the heat.

I tried to force happiness. When you’re pregnant and your belly reaches the point where it’s obvious to everyone else that a baby will be coming out of you, that’s when everyone starts talking to you about it.

“When are you due?”

“Is it a boy or a girl?”

“Any names in mind?”

I would fake a smile, rub my round belly in that natural motherly way, and answer all their questions. It was my hope that as I heard my own voice it would conjure up that nervous and excitable anticipation that all mothers are supposed to feel. But what came was nothing of the sort.

What all those strangers and friends alike didn’t know was that I was terrified. Terrified of this baby. Terrified of another traumatic birth experience like the one with my first. Terrified by a future that was uncertain for many reasons. Job and income loss. House sitting stale on the market. Husband working six days a week so we didn’t lose everything.

It was all too much. I was mentally and physically exhausted. And not the normal type of pregnancy exhaustion. I wanted to pull the covers over my head and sleep. Sleep through the first, second and third trimester. Sleep through the birth. Sleep through the first month and while we’re at it, maybe the first year.

That’s when I realized . . . I am not just pregnant. I am pregnant and depressed.

True depression. Sadness. Hopelessness. The things no mother-to-be should feel. That was me. I was so ashamed. I kept thinking to myself, Do you know how many women would do anything to be pregnant like you are? Snap out of it!

But now I realize that a pregnant woman who is suffering with depression can no more “snap out of it” than someone who isn’t pregnant and suffering with depression.

That’s when I high-tailed it to my OB’s office and proceeded to break down in tears, unable to muster the courage to talk. The shame of what I was saying enveloped my own words.

“I want to be happy,” I sobbed. “I love my baby and I want so much not to feel like this anymore.”

My doctor looked at me with caring eyes and explained that I am not the first pregnant woman to be depressed. “I see cases of antenatal depression all the time,” she said.

There it was. A miserable diagnosis at a miserable time.

I had been keeping this dirty secret all to myself so as not to offend other people, and come to find out there are other depressed pregnant women out there! All this time I had felt so alone. All this time I had hidden my sadness and there was no reason for it.

My doctor prescribed a very low dosage of medication and talked me through her experience with this drug as it relates to pregnancy and birth. She had seen excellent results in mothers and I trusted her word.

Within three weeks of taking the medication as well as starting up weekly therapy again I started to feel better. I started talking about my baby, thinking about my baby, preparing for the birth. A funny thing happened on the way to wellness and stability. I finally fell in love with the little baby boy inside of me. It’s not that I didn’t love him all along. It just took me awhile to accurately feel those feelings because they were weighed down by depression.

My second son, Brigham Douglas, was born on May 2nd, nearly one year ago as I write this letter. I will never forget the instantaneous bond we shared as our eyes first met. There he was, only seconds old. But he had already taught me more about patience and trust than anyone living on this earth.

If you are pregnant and think you might be depressed, please know you are not alone. Talk to your doctor and trust your instincts. Your baby’s birth day can be joyful too.

Molly Shalzis a working mama to two beautiful boys born 21 months apart. Trying to manage a busy life with two kids under the age of three while also struggling with bipolar disorder. Married to a man made of glue who helps her hold it together. Writer. Traveler. Dreamer. Trying not to trip over tonka trucks. Her blog is called A Day In Mollywood.



Donations to Postpartum Progress can be made here: http://postpartumprogress.org/donate-postpartum-depression-2/

Warrior Moms of the Week 3/18/11

Katie from Sluiter Nation writes a beautiful letter to herself on the one year "anniversary" of recognizing she had postpartum depression.

Lauren from My Postpartum Voice, who asks out loud whether the bad thoughts of postpartum anxiety ever go away.

A lovely story about Jenny's Light's Elizabeth Hopfenspirger and her advocacy for women with PPD.

Mama Robin J on what it feels like to be stuck in PPD's circle of despair.

The Deliberate Mom writes about struggling with antenatal depression.

Kimberly from All Work & No Play Makes Mommy Go Something Something on the first time she smiled from her soul after going through PPD.

Also worth checking out:

Gail Rosenblum, columnist at the Minneapolis Star-Tribune, on poverty and postpartum depression.

PPD: You Can Do This. We Can Help.

I have been writing this blog for almost 7 years now. So long that it's easy for me to forget that many of you have just found it, or are just coming here for the first time. If you are here because you are pregnant or just had a baby in the last year and you think something is wrong, I'm so glad you found us. You might be scared out of your wits, or completely miserable and disappointed, or numb. It doesn't matter. We love you no matter how you feel or what you are thinking.

We've been there.

We know that many, many women get postpartum depression and related illnesses. Many more than people think.

We know that there are a wide variety of symptoms of postpartum depression and anxiety. We don't all look the same.

We try to make it our business to give you the hope and inspiration you need to get through postpartum depression, and to connect you to PPD support groups and to the people who can help you get better. There are people who know how to help you.

Please know that when I use the term postpartum depression on this blog, I'm using it as shorthand. Most people don't know what perinatal mood and anxiety disorders are — that term includes all of the mental illnesses women can experience during pregnancy and in the first year postpartum — so I use the term sparingly. And I can't really write antenatal depression/postpartum depression/postpartum PTSD/postpartum OCD/postpartum anxiety/postpartum panic disorder/antenatal anxiety/postpartum psychosis/post-adoption depression every single time I write a story. So please know when I say postpartum depression, it usually means I'm referring to all of you regardless of exactly what you are going through. I'm not leaving anyone out. And if you want stories about your specific illnesses, we've written those and will be happy to help you find them.

post-adoption depression

postpartum psychosis

postpartum post-traumatic stress disorder (PTSD) and childbirth trauma

postpartum OCD

antenatal depression (during pregnancy)

depression & anxiety after miscarriage or stillbirth