Not that this would come as a surprise to most of you, but a newly published study finds that women who are suffering from some sort of medical condition during pregnancy are more likely to have depression or anxiety. This comes from the Archives of Mental Health's January 2010issue.
"Some women with a medical disorder during pregnancy showed considerably elevated levels of anxiety and depression. Health professionals need to be aware that these women need extra psychological support."
They found this was particularly true for women with hyperemesis gravidarum, a severe form of norning sickness that prevents adequate intake of food and fluids.
If these women don't receive adequate support during pregnancy, one can surmise that they are at a greater risk for postpartum depression or postpartum anxiety. This is important for OB/GYNs to pay attention to.
Thanks for posting this. I went into my pregnancy with pre-existing depression and anxiety, which I was coping with enough to allow me to go off all medication, then had several months of HG, to the point where I was hospitalized a few times for IV fluids and supplementation. The depression came back very strong during this time, as well as panic attacks that were worse and more frequent than I'd had in years, but I never know there was a link between the two.
Interestingly enough, both the hyperemesis and the mental symptoms eased off a lot once I was put out of work and left a very high stress job situation. I am one of those people who would often be nauseous or throw up during the adrenaline dump after a panic attack, and I wonder if ti wasn't just creating a biog cycle of stress, panic, illness, more stress that was feeding off itself.
I had HG with this last pregnancy (baby is now 10 weeks). Around week 15 I realized I was severely depressed. My OB recognized it also and referred me to psychiatry. I had a really hard time getting to appointments because I was so ill, weak, and depressed. So it was really hard to go to a psychiatry appt. It was a complete waste of time. I asked for antidepressants and she completely discouraged me from taking them. She showed me what I now realize are old studies and told me it was not worth the risk unless I was suicidal. Our plan was for me to start antidepressants the day the baby was delivered.
Well . . . I had the baby and had complete euphoria for two weeks – I did not feel like I needed an antidepressant because I had never felt better in my life. This all came crashing down around me at 2 weeks postpartum when I experienced SEVERE anxiety and depression. I knew the signs of postpartum depression and knew I was at risk because of the horrible pregnancy. I got in right away to see a new psychiatrist. She immediately diagnosed it as pp depression and explained that it had probably triggered bipolar disorder. What I had experienced after dd's birth was a manic episode. I should have realized this when I cleaned out the attic 4 days postpartum and was running around like a mad woman.
I went through weeks of HORRIBLE anxiety until we could find the right medication combo.
I'm frustrated because I feel like this could have been somewhat avoided if I had gotten help when I asked for it. I also think my quality of life and my family's life (I have two other children) would have been much better during the pregnancy if I didn't have depression on top of everything else. I was too sick to reseach antidepressants during pregnancy on my own (which I normally would have done) and relied on the psychiatrist's knowledge.
I now wonder what continuing education is required for psychiatrists and doctors? I have another close friend who suffers from severe postpartum depression with each pregnancy. Her OB has told her the same thing – no antidepressants during pregnancy. The option for her to make an educated decision doesn't even seem to be there.
I now feel like it is my mission to educate as many women as possible as soon as I get the anxiety completely under control. Every day does get better and better. Thanks for this wonderful blog – I wish I would have found it when I was pregnant.
Thank you for sharing this Raine!
There is continuing education available. I inform clinicians of the trainings and conferences available here: .
But unfortunately I think only a small percentage actually go to such events.
The OBs and psychiatrists you mention are not following recommended guidelines. (http://postpartumprogress.typepad.com/weblog/2009… It is very important to be cautious of medication during pregnancy. There are risks. But I'm surprised these physicians aren't discussing with patients the risks of both taking and not taking medication for depression or anxiety. And they should also be offering alternative suggestions, like therapy.