If you have Major Depressive Disorder (MDD), you may be wondering about starting a family. "Will I have to stop my medication?", "Will the baby be at risk if I don't stop taking it?", "Can I take this medication while breastfeeding?" You may have many questions on your mind. You may have been struggling with depression for a long time, or you may have just recently been diagnosed with it. Whatever the cause, there are some things you need to be aware of as you embark on this journey. Let's talk about them.
Why is treatment so important?
Simply put, if you don't treat your depression, your symptoms can come back again and again. We call this a relapse. When you're depressed, you're more likely to miss out on things like eating and drinking, getting the medical care you and your baby need, and you're more likely to turn to things like drugs.
More importantly, there is a much higher risk of postpartum depression , which can directly affect your bond with your baby.
As medical experts point out, children born to mothers who suffer from depression, stress, or anxiety during pregnancy have high levels of the stress hormone 'Cortisol'. This can make those children emotionally hypersensitive (extra reactive) at a young age. This can pave the way for them to develop mental problems in the future.
Choosing the right treatment for you depends on several factors.
- The severity of your depression.
- What treatment are you currently receiving?
- How you responded to the medications you used before.
- Whether you are pregnant, planning to become pregnant, or breastfeeding.
If your depression is mild, and you have previously found relief from things like psychotherapy, support groups, or prenatal yoga, you may be able to get through this period without medication. But that's something you should discuss with your doctor. If you need medication later, there are plenty of options to start on a less risky medication.
For severe cases of depression that don't respond to medication, there's also a treatment called electroconvulsive therapy (ECT) . This involves sending tiny electrical pulses into the brain, changing the activity of nerve cells (neurons) and certain chemicals. This treatment is considered safe for both you and your baby .
Medications and their risks
Generally, the risk of birth defects or other problems in the baby from taking antidepressants during pregnancy is very low. However, research has shown that some medications are safer than others. Let's take a look at what they are.
| Time period | What to do and medications to consider |
|---|---|
| Before pregnancy | If possible, talk to your obstetrician and psychiatrist before you start thinking about having a baby and come up with a treatment plan. If you need to change medications, this is the best time to do so. The two classes of antidepressants that have been shown to be the safest during pregnancy are SSRIs (Selective Serotonin Reuptake Inhibitors) and TCAs (Tricyclic Antidepressants) . However, because TCAs are older medications with more side effects, doctors don't recommend them first. Most people are prescribed a well-researched SSRI. Examples: Citalopram (Celexa), Escitalopram (Lexapro), Fluoxetine (Prozac), Sertraline (Zoloft) . |
| During pregnancy | If you are already taking medication, do not suddenly switch to another medication, no matter what it is. This will prevent the baby from being exposed to multiple medications unnecessarily. Most importantly, do not feel guilty about taking medication for depression during pregnancy. Some people, even doctors, think that this medication is something that should be taken "only when absolutely necessary." But depression is a medical condition that needs to be treated, just like diabetes or high blood pressure. |
| After having a baby | It's very difficult to cope with the symptoms of depression while caring for a newborn. So it's very important to continue taking your medication. If you feel your symptoms are getting worse, talk to your doctor right away. Medications can pass into breast milk, but the amount is very small. To be precise, less than 10% of the dose you take. So there is no reason to stop breastfeeding your baby because you are taking medication. |
Let's learn about other types of medicines too.
If you're taking an SNRI (Serotonin-Norepinephrine Reuptake Inhibitor) because SSRIs don't work for you, like Duloxetine (Cymbalta) or Venlafaxine (Effexor), that's not a big deal. Doctors say, "If this drug works for this person, and we know that another one might not work, I don't want to switch it." Because there are studies that show some level of safety for SNRIs.
However, newer medications like Vortioxetine (Trintellix) have not yet been studied enough to determine their safety during pregnancy. In such cases, your doctor may recommend switching to a safer medication.
The feelings that haunt you...
"Am I a bad mother because I take medication?" These thoughts may come to your mind. But that's not really the case.
"Due to the stigma surrounding mental illness in our country, many people think that taking medication for depression is an extra, unnecessary thing. When you say, 'Only take this medication if you really need it,' the mother feels very guilty about herself," experts point out.
The most important thing you need to understand is that depression is not a weakness on your part. It is a disease that requires treatment. Being a healthy mother creates the best environment for a healthy baby. If medication is needed, taking it is the best thing you can do for yourself and your baby.
Take-Home Message
- Depression is a real illness. It's important to treat it for both you and your baby.
- Whenever possible, talk to your doctor before getting pregnant and develop a treatment plan.
- Many medications used for depression are safe during pregnancy and breastfeeding.
- Never stop taking medication or change the dosage without consulting your doctor.
- Don't feel guilty about taking medication to stay healthy. A healthy mother is the best gift for a healthy child.
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