Photo: imagerymajestic, FreeDigitalPhotos.net
Depression is so prevalent in the United States, if you don’t have a diagnosis, chances are good you know someone who does. But it’s still tough to talk about out in the open. That stigma is particularly unfortunate for women who are on their fertility journey.
Nearly all of us approach the notion of parenthood with comforting images in our minds. We envision the best possible circumstances for our growing family. A depressed parent doesn’t exactly fit the picture. But the National Institutes of Mental Health says about 6.5 percent of U.S. adults have depression and that women are 70 percent more likely than men to experience depression in their lifetime.
Toward the effort of bringing maternal depression into the light, Ellen Cooper-Davis agreed to talk about her personal story.
First diagnosed as a college student, Ellen initially responded fairly well to medication and therapy. Later, she used medication successfully on an occasional basis as necessary to manage depressive bouts.
But when she and her husband started to talk about having children, Ellen worried about things she’d heard in the media. She was aware of a lack of consistent, comprehensive studies on the effects of antidepressants on pregnancy. So she made a choice that many women make.
“With both pregnancies, I got off of medication altogether,” recalls the mother of two young daughters.
The result was also what many women fear. “I had some [depression] during my first pregnancy, although it was worse post-partum. During my second, it was severe during the pregnancy, which surprised me.”
Ellen, who is the minister of a suburban Unitarian Universalist congregation, felt caught between her worries as a depression patient and a mother. The information she wanted was either non-existent or conflicting. In spite of consulting with her midwives, who supported Ellen’s decision to avoid medication, and her psychiatrists, who influenced her choices during breastfeeding, the whole experience was very unsettling.
“I felt adrift, unsure whether I or the baby would be at greater risk. I was angry that there was no adequate science available on pregnancies and medicating depression, nor was there adequate research available on other possible solutions, like homeopathic, acupuncture, etc. It was painful and shame-inducing. Here I am, anew mother, and I’m supposed to be happy and doting! There’s no way to express how I was feeling, especially during the second pregnancy.”
With the help of her midwives and psychiatrists, Ellen decided to avoid medication altogether during pregnancy and to use a small dose of Zoloft when she was breastfeeding.
Her advice to other mothers with a depression diagnosis:
“I tell them about the research I did find [on Zoloft], and I urge them to see a qualified psychiatrist, not just a family physician, for evaluation and treatment. Depression is nothing to mess around with, especially when you’re responsible for a totally dependent baby. I urge them to keep talking, to reject the shame, and to do what they need to do in order to feel like they’ll make it through. Little things can help. Light boxes, nutrition, therapy, exercise… I urge people to use every tool they have.”
Dr. Kelly Brogan concurs and adds that staying on top of the very latest research into depression treatments and pregnancy can be a bit simpler with the help of specialized psychiatrists. She strongly recommends Postpartum Support International for finding a reproductive/perinatal psychiatrist.
Dr. Brogan explains:
“This is a psychiatrist with expert training and experience around treatment in pregnancy. The literature in this field is constantly evolving and requires a sophisticated eye for interpretation. Many general psychiatrists, obstetricians/midwives, and internists, despite best intentions, can mislead and confuse patients with tidbits of ‘updates’ they have come across.”
More recommendations for pregnant and post-partum women with depression will be discussed in subsequent posts.
About Tracy Morris
I wear a lot of hats while spinning plates and true stories. In between taking care of myself and my family, I write about fertility and other health care topics. Most of my online time lately is spent at two very different places: FertilityTies.com and TrailerParkKarma.com. Perspective is everything -- my pre-teen reminds me daily.
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