Antidepressants during pregnancy: Support not stigma

When it comes to maternal mental health, we still lack a balanced discussion on the benefits of SSRIs in pregnancy.

postpartum-depression-moms

Photo: iStockphoto

I struggled with postpartum depression after the birth of my daughter, and it’s an experience I’ve openly shared on this blog. Even four years later, I still feel shame—not only because of the stigma attached to mental health issues, but because when I should have been experiencing immense happiness, I was instead consumed with grief.

I rarely talk about the months during my pregnancy when I worked closely with my doctor and OB/GYN to devise a mental health strategy for myself. Before stepping into the ring with PPD, I battled anxiety and depression. After carefully researching and weighing the risks of several different selective serotonin reuptake inhibitors (SSRIs), my doctor prescribed Celexa with a dosage that varied throughout my pregnancy depending on what developmental stage my babies were and—just as important—the state of my own mental health. These decisions were not taken lightly.

Read more: Postpartum depression doesn’t care where you live>

Unfortunately, the New York Times recently missed the mark when Roni Caryn Rabin suggested that women like me who take SSRIs during pregnancy willfully endanger the health of their babies.

Rabin writes:

Pregnant women often go to great lengths to give their babies a healthy start in life. They quit smoking, skip the chardonnay, switch to decaf, forgo aspirin. They say no to swordfish and politely decline Brie.

Yet they rarely wean themselves from popular selective serotonin reuptake inhibitor antidepressants like Prozac, Celexa and Zoloft despite an increasing number of studies linking prenatal exposure to birth defects, complications after birth and even developmental delays and autism.

I remember sitting in my doctor’s office while she listed the risks of the medication she was prescribing me. While the fear of the (incredibly) small chance I would have complications from my daily dose of antidepressants was present, it was nothing compared to the despair I was feeling inside. No amount of meditation, light therapy or exercise could fix the chemical imbalance in my brain that caused my anxiety and depression. The one attempt at weaning off medication sent me into a tailspin which took weeks to recover from. The benefits of antidepressants far outweighed the risks, which is the common thinking by health professionals when considering medication use during pregnancy.

Read more: Postpartum depression in dads>

I wasn’t the only one upset by Rabin’s piece—many commentors raised concerns that only the most alarming cases were included in the study. Katherine Stone, founder and editor of Postpartum Progress wrote a rebuttal which captured the biggest flaw in Rabin’s post: lack of balance.

Stone writes:

It is true there are risks to taking medication in pregnancy, including antidepressants. But let’s make sure moms know there are risks to suffering from severe depression and anxiety during pregnancy, too. If we’re going to report on this stuff, let’s report on all of it.

There will likely always be a stigma attached to maternal mental health issues. Sounding the alarm over the small risks involved in monitored SSRI use discourages balanced conversations and piles more shame on the women who struggle with depression. I sincerely hope that talking openly about maternal mental health will help women who feel isolated during pregnancy feel supported and loved, instead of shamed.

Follow along as Jennifer Pinarski shares her experiences about giving up her big city job and lifestyle to live in rural Ontario with her husband, while staying home to raise their two young children. Read more Run-at-home mom posts or follow her @JenPinarski. 

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