Major Depression Prior to and During Pregnancy
At least one 1 in 4 women often beginning in their early twenties will be diagnosed with having some form of a major depressive disorder. Major depression is recognized as a mood disorder triggered by chemical changes in the brain often in connection to life stresses but can also happen with no obvious cause or obvious reason.
Symptoms of major depression can include: Continuous depression all day, every day for a period lasting longer than two weeks, Inability to find pleasure in activities, hobbies, family or friends that were once enjoyed, Fatigue, restlessness, or a feeling of slowing down, Concentration degeneration, Sleeping and eating abnormalities, either too much or too little, Thoughts of death and or suicidal tendencies
Special Issues of Pregnancy Depression
Women with past depression history or who are on antidepressants while trying to conceive are especially at risk of depression reoccurrence and this also the treatments become more complicated. Antidepressants must cross the Placentia therefore there are risks of them harming the fetus but if untreated major depression could lead to other risks for mother and child. These risks could include poor nutrition, smoking, drinking, suicidal tendencies, prolonged or premature births and low birth weights.
Recommendations for Use of Antidepressants While Trying To Conceive
A woman who has had only a single episode of depression and feeling of well being for a period of at least six months the patient should taper off the antidepressants
Women who have had severe depression with multiple previous episodes should continue with the medications she is on through conception but consult with her physician about possibly changing to a safer drug
Depression Treatments during First Trimester
The first 12 weeks of a pregnancy is one of the most crucial in terms of risk to fetus of malformation caused by antidepressants. If a woman is being treated with antidepressants for mild depression at the start of her pregnancy or because she was unaware of being pregnant and now has only mild depression it is recommended that she is weaned off this medication over a period of several weeks. A woman who history involves multiple episodes of severe depression and has depression when she conceives it is believed it is better to continue on the antidepressants or perhaps switch to one that is considered a little safer.
Depression Treatments during Second and Third Trimesters
Although the danger of malformation and other problems to the fetus lessen in the second trimester there are still risks of miscarriage or problems that may arise with development of the child at a later date. So the advice is similar to that for the first Trimester, the risks must be weighed for and against taking antidepressants in consultation with the attending doctor. If a woman develops depression during pregnancy psychotherapy should be commenced immediately hopefully avoiding the necessity of antidepressants during this period.
Woman who experience severe depression during pregnancy are also vulnerable to postpartum depression.
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