Any time either of my kids has a problem or shows a vulnerability, the first thought that will come to my head is, “It’s my fault.” For the first kid, now 14, it’s that he had to go through postpartum OCD with me. For the second, now 9, it’s that I chose to stay on my meds while I was pregnant with her so that I would be healthy and hopefully not get it again. (I didn’t, by the way.)
As someone who still struggles with anxiety to this day, I will tell you that it takes very little for my worries to blow up into big hairy nightmares that focus my every waking thought on all the most horrible things that could go wrong for my kids. And my worst fears of all are those where I’m the reason things go wrong.
The only thing that brings me back down out of the Cloud of Terror is data. Numbers. Real information. Could something bad happen? Yes. But what is the likelihood? What is the reality? And could there be other reasons why bad things happen that have nothing to do with me?
This week a study was published in JAMA Pediatrics that found that taking antidepressants during pregnancy may increase the risk of having a child with autism spectrum disorder. Is your heart racing? I know mine is. Uh oh. Here comes the Cloud of Terror again.
Except, wait. Stop. Think. Ask questions about this from people who are experts. Find out the real data.
I reached out to Samantha Meltzer-Brody, MD and Marlene Freeman, MD and asked what they thought about the study. And they said it doesn’t prove much. The rate of autism without exposure to antidepressants is 1%. The rate of autism among children whose moms took antidepressants in trimesters 2 and 3, according to this particular study, is 1.87%. The rate of autism among children whose mothers have anxiety or depression that goes untreated during pregnancy? I don’t know, but it’s a good question.
As Dr. Byan H. King, program director at the Seattle Children’s Autism Center at Seattle Children’s Hospital, pointed out in his editorial about the study, it tells us is that for every 200 moms who continue their antidepressants during pregnancy there may be one more child with autism than would be expected. And yet we still don’t know if the cause for that one more child is the antidepressant or something else. That’s the real data.
I know when you see these headlines it scares the daylights out of you. We’ve already been down this road before, and I’m sure we will again. I would encourage you to stop, breathe, and then read this story from the American Association of the Advancement of Science: “Reality check: Taking antidepressants while pregnant unlikely to double autism risk in kids.” It’s worth the read.
Each mother can only make the best decision she can for herself with the information available to her at that time. I wish it were easier. There’s no right answer. You have to talk to your doctor. You have to recognize there are risks, no matter which decisions we make. There are even risks in making no decisions at all. You have to know that there are so many other moms out there with the same concerns and worries. We know what it’s like. You’re not alone.
You might also like: How to Think About the Risk of Autism, The New York Times
Katherine:
As usual, you hit all the right notes. I will use the data you cited tonight in my postpartum adjustment group. Thanks for everything you do!
Great post, Katherine! I have/had tons of anxiety that my SSRI would pose health problems in my son. My therapist gave me the heads up on this study in our session this week and informed me with the facts which were very reassuring, along with this post. Happy Holidays!
Thanks Katherine for addressing this important issue and helping women who read these studies to find their way through the confusing, and often conflicting, data.
I wanted to make your readers aware of a post on our website which puts this study into a larger context. Hopefully it will help women to make well-informed decisons regarding their care.
https://womensmentalhealth.org/posts/taking-a-closer-look-autism-and-antidepressants/