Untreated depression during pregnancy is not well-recognized and is certainly under-treated. The risks of letting perinatal depression go untreated can extend beyond pregnancy itself. While there is no gold standard treatment that most experts endorse, there is certainly a lot of discussion going on.
A research article was published in the scholarly journal Human Reproduction in January, 2013. It is a detailed examination of potential risks for infertile women taking SSRI antidepressants. The article also discusses SSRI use in pregnant women.
Whether you agree with their conclusions or not, this is a fascinating read. Each potential risk is described in detail with research citations. Perhaps the most practically useful part of the article is the discussion on alternative treatments for depression during pregnancy.
These treatments could be done with or without also taking medication. The list includes cognitive behavioral therapy with a counselor, yoga, relaxation training, and more. Not every therapy has solid research results behind them, but it’s a good list for further study at the least.
There is one part I completely disagree with, mostly because it is done in such a broad sweeping way as to appear almost not-believable. The authors state that “the best meaningful evidence suggests that antidepressants do not provide clinically meaningful benefit for most women with depression.”
I was a depressed mom that finally came out of the deep hole of depression with the help of medication. I am a counselor who has seen many people of both genders benefit from counseling and medication. I have also been connected with the postpartum depression community for a number of years. I’ve heard countless stories of women who were so grateful for the change they experienced after taking medication. Having seen all of this, I cannot believe such a broad- brush statement refuting the effectiveness of antidepressants for “most women with depression”. I just can’t.
You now know my personal opinion, but I do invite you to form your own. This article is full of many interesting nuggets. And even if you do believe antidepressants can be helpful for women with depression (pregnant or not), this is a good thought-provoking article showing the opposite position. It is long with some scientific jargon here and there. But it is primarily a review of many studies, which makes it fairly readable.
Also, note that this is a rare fully-published article made available to read at no charge. Many full studies or research articles are only visible through a paid service. Here is that link again from the Human Reproduction scholarly journal.
Remember way back at the beginning of this article when I said there was a discussion going on among the experts? As Paul Harvey always said, you’ll hear “the rest of the story” in a few days on my next blog post.