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03.06.2015

How to stop being depressed while pregnant, combating fatigue - For You

Author: admin
Two months after the nadir of my prenatal depression, my husband can finally joke that he knew things were dire when I started envying Mad Men’s Betty Draper Francis. Despite these stats, prenatal depression is still relatively under the radar, and many obstetricians are not well-trained in its complexities.
Over the next three weeks, I tried every other possible, non-drug remedy for depression and anxiety: I continued talk therapy, I tried acupuncture, I listened to relaxation tapes, I reached out to friends and family.
That afternoon I called a friend with three children, trying through hysterical tears to explain how unmoored I felt. Though I entered my pregnancy never having heard the term prenatal depression, scientists are studying it.
For pregnant women taking antidepressants, balancing mental health and fetal health can lead to difficult choices. Further obfuscating this issue is the plentiful evidence that suggests depression left untreated could have as grave an impact on a pregnant woman’s child as antidepressants. Even in the face of such muddy conclusions, to me the choice initially seemed obvious: Stop taking the meds and tough it out for the sake of the child. At the other end of the spectrum would be a woman with severe panic disorder whose previous attempt to stop treatment resulted in a relapse that required a year of recovery. It was this knowledge that convinced Vancouver mom Zoe Le Good to continue taking medication through both her pregnancies—first Prozac and then Zoloft. At first you didn't get the joke, which he'd recently poached from NBC's sitcom The Office.
While Betty was pregnant, I explained to him at the time, no one expected her to do anything but lie around all day in bed in her shortie nightgowns. Some studies show that women who go off antidepressants before conceiving have a nearly 70 percent chance of relapse during pregnancy. I was still laboring under the delusion that my freakout might be on the spectrum of normal reaction to pregnancy hormones.
There are studies that show that the stress of untreated severe depression and anxiety can be just as bad for the fetus as the very, very small risks of much-tested drugs like Prozac. Last year, New York Magazine declared it the signature diagnosis of our time with Xanax as its pharmacological mascot, taking over from depression and Prozac in the 1990s. In fact my drug, better known as Venlafaxine, belongs to a class of drug called SNRIs, which make up only a small proportion of antidepressants prescribed to women annually. After examining 181 studies of SSRI use during pregnancy, scientists found a small increase in the risk of congenital malformations like heart defects and in problems with infant neurodevelopment. Today, SSRIs make up the class of drug most prescribed to pregnant women for chronic disease. When she became pregnant again in 2012, she went against her doctor’s advice and stopped taking her medication completely.
Numerous studies have shown that SSRI use late in pregnancy increases the risk of PPHN, some by as much as fivefold.


My reasoning was straightforward: There seemed to be a consensus, however foggy, that the drugs increased the risks of certain negative outcomes, if only very slightly. If I was going to take a drug during pregnancy that posed any risk at all, I wanted to be sure that it was doing something.
However, she is more concerned that the current state of alarm around SSRIs and pregnancy may discourage women who genuinely need these drugs from using them. She gives the example of a woman who went on antidepressants a decade ago for a mild to moderate depression and only continued treatment because there was never a clear reason to stop. Because there is plenty of evidence suggesting that untreated depression during pregnancy can also be harmful to the child.
Jessica Davis Pluess, the author of the report, recommends that companies should be studying how automation will change their business, and further, they should develop career pathways for those who might be replaced by a machine. I was nine weeks pregnant then, and so irrationally anxious about how I was going to manage the insertion of a much-wanted baby into my already busy working life that I hadn’t slept for three days, and cried pretty much continuously. The psychiatrist told me that if I wanted to stay on meds while pregnant, Wellbutrin or Prozac would be safe options.
In her memoir Love Works Like This, the journalist and psychologist Lauren Slater talks about her bout with prenatal depression, and writes that a specialist once told her that there’s a correlation between women who react badly to the birth control pill and women who become depressed during pregnancy.
I was supposed to be thrilled, cooing at strange babies in the street and gleefully learning how to knit tiny hats. But I also want to hear from you: I have created a survey for women who have experienced depression during their pregnancies, and for their loved ones.
In each study, researchers asked women to assess their emotional distress, anxiety, or depression. The strongest studies try to separate the influence of maternal stress during pregnancy from the stress or adversity, after birth, in children’s home environments. The vast majority are prescribed SSRIs, which you may recognize by their brand names: Paxil, Prozac, Zoloft, Lexapro, and Celexa. According to the American Pregnancy Association, some 13 per cent of pregnant American women are taking them. At least one drug, Paxil, now carries a warning that states use during pregnancy may elevate the risk of certain birth defects, particularly heart malformations.
Her pregnancies were both easy and her children are healthy and happy, yet she can’t help but worry.
Both accounts are full of stories like the iPad in the delivery room, stories of women furiously multitasking, worrying about family over champagne at a United Nations event, or diagnosing children with head lice while aboard a corporate jet. If a mother is so depressed it hurts her marriage, or she’s unable to care for her other children, the collective damage is something to consider.
But when my second trimester rolled around, the nausea finally stopped, and I could start to feel excited about our healthy, growing baby, instead of just guilty for not being able to be excited. Then they followed them through a single cycle of fertility treatment to see whether they got pregnant or not.


It’s time to stop worrying that our worrying will prevent us from reproducing successfully. And in the severely depressed, there’s also the possibility that the mother may not survive the pregnancy. I had just started a new, demanding job, and every morning at 7 when I pulled my MacBook onto my lap, sinking deeper into bed, I felt so unlike myself, so incompetent, that I wished I wasn’t pregnant.
I had read some of these studies before I was pregnant but still clung to the idea that I could get better without pills. But consider this large, population-based work, in which researchers interviewed over 78,000 Danish women. After reexamining existing studies, Kirsch found that the drugs had a clinically significant effect only in people with very extreme cases of depression.
In June, a professor protecting himself with a pseudonym wrote an essay for Vox describing how gingerly he now has to teach. But when she hits me with the concern that’s been bothering her for a while, all I can do is nod, and stall for time.
I never considered abortion for a second, but I longed for some alternate universe where I could claw out of my sad self, leaving the broken shell behind to grow the baby while I resumed being a person again. But even though I knew lots of women who had healthy babies while on Prozac and Zoloft, and I knew that many, many studies showed only a minuscule chance of those drugs affecting my fetus, I didn’t want to go back on. In other words, women with more extreme levels of anxiety or depression were just as likely to get pregnant after a single cycle as women with milder levels. Those who reported higher levels of life stress and more emotional symptoms like anxiety when they were 30 weeks pregnant did tend to give birth earlier. All of those emails will also be kept anonymous unless you explicitly give Slate permission to publish your essay about your experience with prenatal depression.
But in the ensuing discussion of gender politics, which has been conducted almost entirely by women, for women, men are far more anonymous—implacable opponents of progress in the upper echelons, helpless losers elsewhere.
If anything went wrong with the baby, I would always wonder if my being on antidepressants was to blame.
Those who reported the most intense emotional symptoms had pregnancies that were just two-and-a-half days shorter. And in a study of toddlers, the results were more striking still: Two-year-olds who were exposed in utero to more maternal distress, including depression or anxiety, scored higher on a standard measure of child development. But when it comes to pregnancy, particularly your first pregnancy, it’s tough to ignore your emotional brain. In other words, there is little evidence that maternal stress during pregnancy is bad for babies.



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