How effective are antidepressants in treating depression?

[Marie]

Kim’s post triggered my curiosity. Apparently if you take an SSRI antidepressant during the last trimester or throughout the pregnancy - the baby experiences temporary withdrawal symptoms at birth like tremors, gastro intestinal problems, sleep problems and a lot of crying. And if the mother stops the antidepressants during pregnancy, there’s a risk of depression relapse. Pregnant women who stop the use of antidepressants face five times the risk of a depression relapse than women who continue the drugs. Stopping the SSRI will cause headaches, nausea, vomiting, chills, insomnia, irritability tiredness, dizziness, etc. So the point is, if depression is already an existing problem and you are trying to conceive, better get medical advice. Support groups, counseling etc. can help with mild depression. But with severe depression, relapses can be a bigger problem than actually taking the antidepressants. Tough situation.

[David]

Even after pregnancy, the birth of the baby can set off so many strong emotions – the excitement, the happiness and the fear – and all this somehow ends up in depression called ‘post partum’ depression. This is quite natural among new mothers and can be short lived in most of them for some days or weeks after childbirth. Usually feelings of sadness, anxiety, nervousness etc can overwhelm them and get in the way of their daily routine. If this develops into an extreme form of depression, then it is called postpartum psychosis. As such, depression after childbirth is not really a major thing and can be considered as a part of the process of giving birth. Generally, timely treatment can help conquer these feelings and get ahead with the joy of watching your baby grow.

[Kim Wilde]

I wondered whether post partum depression is a problem only after the birth of the first child. Apparently its not – and it can happen after any birth – and is more likely in second time moms. The risk is more if there’s a history of depression during pregnancy or otherwise, if the mother suffered from postpartum depression after the earlier pregnancy or if there’s a history of severe premenstrual syndrome. Even if the mother experienced a lot of stress during the pregnancy, fell sick or had a premature birth making delivery difficult, post partum depression can result. Sometimes even a bad marriage can trigger it off. If the pregnancy is unplanned – that can also result in post partum depressionl

[Susan]

Diagnosing and treating this is the main thing. Whether it is a normal short-term post partum depression or whether it is more severe can be identified through screening. Some doctors prescribe blood tests so that they can figure out whether an under active thyroid is the cause of the signs and symptoms. If post partum depression is not treated, it can actually last for a year or more and worse still it will affect everyone around. It also gets in the way of the mother-baby relationship and upset everyone else. The kids develop behavioral problems, wont sleep or eat well, throw temper tantrums and turn out to be hyperactive. Some kids take longer to learn to do the things other kids do.

[Marie]

For all that, treatment time differs from woman to woman, and of course, depends on how bad the case is. Generally most women find that the post partum depression fades away naturally after a while. Women are advised to rest during this time, though that is easier said than done. Its okay to take help from your family and friends. It also helps talking to other new mums. If you have been diagnosed with underactive thyroid you might need to take medication. Counseling also works with post partum depression. It always feels better to voice your worries since it helps find ways to cope with emotions and find solutions to problems. Counselors help set goals that are realistic and also help in accepting the current situation without being intimidated by it.

[Kim Wilde]

Post partum depression can be treated with antidepressants. They are very effective. Of course, breast feeding mothers must know that any medication they are on will enter the breast milk. But there are antidepressants that work safely even during breast feeding without being risky for the baby. But the thing is there’s not enough evidence to prove that antidepressants are totally safe. Its best to talk to the physician about the risks and benefits you can expect when you choose to be treated. When there’s the right kind of treatment after the right diagnosis, post partum depression can be cured in a few months. But some women actually experience it for about a year. What are the options for postpartum psychosis?

[Susan]

Postpartum psychosis needs to be treated right away. What mother wants to feel constantly depressed around her new bundle of joy? Best way to get treatment is at the hospital – with antidepressants or hormone therapy. They also treat with antipsychotic agents – medications used for other psychotic disorders like schizophrenia, but these are also used for extreme depression. Another treatment is with Lithium that is used to treat bipolar disorder to stabilize moods, but breast-feeding moms can’t use this. There’s also electrical current therapy, which is supposed to reduce the symptoms of depression. Taking good care of oneself is the most important thing. In fact a lot of depression can be avoided by using the support of family and friends. A lot of rest and proper exercise, being busy with the baby and holding a positive attitude helps.

[Kim Wilde]

True, Susan. Am sure most doctors would advise making lifestyle changes rather than risking medication and its side effects. Exercise, relaxation, healthy food – these three things help keep stress at bay – which means the possibilities of depression are less. Taking the baby out and talking to them is fun too. Alcohol is a big no-no. The biggest thing is not to pressurize yourself with very high expectations. Its okay to make mistakes – it is all part of the fun. Its important to make time for yourself, go out a bit even if it is just around the corner to run an errand. Spending time with your partner and sharing your feelings with them helps too. There are local support groups for new moms that helps talk about how you feel.