Pregnancy can bring excitement and joy, but it can also increase anxiety, depression and emotional stress
To make matters seemingly more overwhelming, women taking antidepressants – or those experiencing symptoms for the first time – might question if it’s safe to take medication during pregnancy
One of the most important things for anyone expecting a baby should know is this: Untreated mental health conditions can pose serious risks for both moms and babies
Jessica Sedevie, M.D., is a specialist in obstetrics and gynecology at Sanford Health in Bismarck, North Dakota
“Mental health is part of prenatal health,” Dr. Sedevie told Sanford Health News. “Treating the entire pregnant individual is very important.”
Hailey Pomonis, DNP, a psychiatric mental health nurse practitioner, said anxiety and depression during pregnancy are more common than many people realize
“Pregnancy is not always rainbows and butterflies,” Pomonis said. “People are carrying heavy things in their lives, and we need to support them and not make them feel guilty for something they take so they can be a better mom.”
Pomonis treats a variety of conditions, including depression, anxiety, insomnia and mood disorders
What are antidepressants?
Antidepressants are medications used to treat a variety of psychiatric conditions by helping regulate neurotransmitters in the brain that are involved in mood, anxiety, motivation, and emotional processing. They are commonly prescribed for depression, anxiety disorders, obsessive-compulsive disorder, post-traumatic stress disorder, and other mental health conditions
SSRIs, or selective serotonin reuptake inhibitors, are the most prescribed medications during pregnancy
Pomonis said sometimes we need a little help from an SSRI to regulate serotonin
“For example, Zoloft is the oldest and most studied medication out there,” she said
But there are so many SSRIs on the market today. Talk to your provider to find a medication that’s right for you. Find a mental health specialist at Sanford Health
“The best medication for a pregnant or breastfeeding mom is the one that keeps her well,” Pomonis added
Why it’s risky to stop medications
A big misconception they see in the clinic is the belief that women should stop their medications as soon as they become pregnant
Both Dr. Sedevie and Pomonis encourage women to talk with their healthcare providers before making any changes to their medication, ideally before pregnancy if possible
“Pregnancy is not the time to discontinue anxiety and depression medication,” Dr. Sedevie said
Untreated anxiety and depression during pregnancy have been linked to a 56% increased risk of preterm birth and 96% chance for low birth weight and preeclampsia
“My patients with untreated mental health diagnoses are also like less likely to engage in their care, show up to visits, and so they aren’t getting the same routine screening,” Dr. Sedevie said
Signs it’s time to seek help
If anxiety or depression starts interfering with daily life or sleep, it’s time to get help
“I always start off by asking my patients: how does this affect your daily life? Is your anxiety affecting you from going to work? Is it affecting how you’re eating? Is it affecting relationships?” Pomonis said
“And if you’re dealing with it for long periods of time, every single day, then it’s time to make some adjustments.”
Other warning signs include:
- Persistent sadness
- Panic attacks
- Withdrawing from loved ones
- Intrusive or distressing thoughts
Treatment may include therapy, medication, or a combination of both
“One or the other is great but research shows therapy in combination with medication management will get you better quicker,” Pomonis said
Having a supportive circle is important
Whether prenatal or postpartum, support systems matter
“I think validation is key – for any moms experiencing a type of psychiatric illness,” Pomonis said
For example, try saying, “I’m sorry you’re feeling this way. This has to be so uncomfortable for you.”
“Validating them, even though maybe you don’t agree with something they are or are not doing. Just supporting them and asking, ‘What do you need?’” Pomonis added
Both women want others to know they’re not alone and should never feel ashamed for seeking help
And they recommend talking openly with an OB/GYN, primary care provider or mental health professional before making any decisions about antidepressants during pregnancy
“In the end, taking care of Mom and Baby is all that matters,” Dr. Sedevie said
Learn more
- Safe medications during pregnancy
- Skin care during pregnancy: What to do (and not to do)
- Debunking common mental health myths
Posted In
Behavioral Health, Bismarck, Pregnancy, Women’s
