Many women do not seek care for depression during pregnancy. It may feel awkward or intimidating to talk to a maternal healthcare provider about using medication for depression during pregnancy. Some women have never had to deal with symptoms of depression previously and may feel bad or ashamed. Others may have a history of depression but may have decided to stop their medications on their own, afraid of harming their babies. It’s important to know that depression during pregnancy is very common, and it’s not something to be ashamed of. Additionally, treating depression with medications can often be safer for the baby than allowing depression in a mother to go untreated. Opening up lines of communication can improve your pregnancy experience as well as keep you and your baby safe. Your provider is a great resource of information and support during your pregnancy. Here are a few ways to start a conversation with your healthcare provider about your depression medication use during pregnancy:
Know your history
If you have taken medications for depression before, write down their names and your dosages. If you have changed medications due to side effects or other concerns, let your provider know why.
Know your lifestyle
Providers often prescribe medications in tandem with lifestyle interventions and talk therapy.
Think about which self-care techniques work for you. Self-care can take the form of exercise, meditation, diet, or simply committing to an early bedtime. Pick a couple of small changes that you can comfortably work into your current routine.
If you have a therapist, schedule regular appointments and let your OB/GYN provider know. Your provider can also connect you with a mental health provider. Many different mental health providers treat depression in pregnancy. You may also want to look for support groups for pregnant women near your home.
Questions to ask about medication
When starting or continuing any medication during pregnancy, it is important to understand its risks and benefits. Here are a few questions to ask your provider about medication.
- How does this medication work?
- What are the side effects?
- Is this medicine safe in the first, second, and third trimesters? What about during breastfeeding?
- Some medications need their doses gradually decreased over time before they are stopped. This is called a taper. Ask your provider if the medication requires a taper.
- Many depression medications take several days or weeks before they become effective. How long does it take for this medication to have a therapeutic effect?
- Does this medication interact with supplements, foods, or other medications?
- Some medications (like lithium) need to be monitored closely because of side effects risks. Is any special monitoring required?
Questions to ask about your provider
All providers have their own perspectives on mental health medications. Understanding your provider’s attitudes and limitations can prevent miscommunication down the road. Some OB/GYNs are comfortable prescribing a limited number of medications. Ask your provider whether they are comfortable prescribing medication for depression during or after pregnancy. If you are currently taking a medication, check whether your OB/GYN is willing to write refills for something prescribed by another provider. You may also want to ask your provider at what point they usually refer women to a mental health specialist and whether they work with someone in particular.
There is no shame in asking for help with the physical changes of pregnancy such as morning sickness, swollen ankles or headaches. Getting the help you need for emotional changes is no different. You can feel confident that being open and honest with your provider about depression, and depression medications, is the best way to keep you and your baby happy and safe during and after your pregnancy journey.
Read more
- Evaluating medication options during pregnancy
- Postpartum depression treatment matters for your whole family
Sources
- Mayo Clinic Staff. “Antidepressants: Safe During Pregnancy?” Mayo Clinic. Mayo Clinic, February 28 2018. Retrieved 21 June 2018. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/antidepressants/art-20046420.
- Mayo Clinic Staff. “Antidepressants: Selecting one that’s right for you.” MayoClinic. Mayo Foundation for Medical Education and Research, November 25 2014. https://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20046273.
