Depression During Pregnancy

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• First Trimester Depression
• Depression in the first trimester after quitting Celexa
• Depression during second pregnancy
• 6 1/2 mos pregnant, feeling more and more depressed
• Pregnant and feeling unhappy all the time
• Depression in the Third Trimester
• Depressed, pregnant, worried about hospitalization

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First Trimester Depression

August 2009

I am 10 weeks pregnant and am finding myself to be super depressed. I am still taking an anti-depressant, but just feel like running away from everyone. I am exhausted and yet sleeping terribly. I am not loving my husband or enjoying my time with our 3.5 year old. I seriously just want to check into a plush hotel or go stay at my parents nice house for a few months.... which isn't really an option.

There are some complicating factors... I have had 4 miscarriages at about 10-12 weeks, we had put in all of our documents and a ton of money towards an adoption and were waiting for a referral, and I am waiting to take a CVS (early amnio) at 11.5 weeks that takes two weeks to get results back about whether or not my kid is a genetic mess (my miscarriages were about genetic issues). Can someone give me some suggestions, as disappearing is not an option. Anon

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Acupuncture could help you adjust to the changing hormones- give it a try. I hope your CVS brings good news. good luck!

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Hi, I wish that I had some magical words that would help you with your depression. One of the things that I can say is that you're not alone! I consider myself to be in good mental health and was amazed by the effects that my pregnancy had on me. I sank into some nasty depressions at times, which were very hard to deal with. I had done a lot of research about anti-depressants and found some articles that surprised and shocked me: http://www.ahrq.gov/research/may08/0508RA8.htm http://www.wnd.com/news/article.asp?ARTICLE_ID=56536 Obviously, there is a lot of controversy about the use of anti- depressants, so you need to do what works best for you. In my search I also found a great article about alternatives to anti- depressants: http://www.hypoglycemia.asn.au/articles/hit_miss_supplements.html I hope that you'll be able to derive some help from these articles as they helped me. not alone

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Depression in the first trimester after quitting Celexa

Dec 2007

I am 8 weeks pregnant and abruptly quit taking Celexa when I found out I was pregnant at 5/6 weeks. I felt ok for a bit, but now i feel just horrible. I am terribly depressed, moody and short tempered. I have no idea what to do and would never forgive myself if something was wrong with my child. I am sure that if something was wrong with my child I would blame it on having taken the Celexa even if there was no connection. Any thoughts or suggestions would be great. Anon

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WHY are you asking that question to a community of laypeople instead of to a qualified psychiatrist?! You are not being rational in doing so.

The only medical type advice I'm going to give you is to never ever change your own meds without seeking qualified medical counsel, which for psych meds really should be a psychiatrist, not just a GP. Going off a psych med abruptly is a shock to the nervous system and can cause potentially serious problems, can make you feel worse than you did in the first place.

Get thee to the best psychiatrist you can find and afford- you're pregnant, you've got to think for two! Use the BPN archives to find doctors to check out (it's important that you have good communication and rapport with your doctor, don't necessarily choose the first you call). The archives might not be totally up to date, but most of the doctors recommended are very likely to still be in practice.

In addition to individual psychiatrists, you can call Langley-Porter Institute, the psych branch of UCSF Medical School, and inquire about their evaluation and treatment services for mood disorders. Medical schools are great places to get cutting edge treatment. anon

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I'm very sorry to hear about what you're going through. If it helps at all to know, you're certainly not alone. It's not uncommon for women who have been on antidepressants and come off them during pregnancy to experience symptoms of depression again.

I would strongly suggest that you speak to a mental health provider who's knowledgeable about depression during pregnancy and postpartum. Medical providers are often not trained to recognize or treat depression related to pregnancy.

Given your understandable concern for your child, it's important to know -- if you don't already -- that if depression remains untreated your symptoms can worsen and can also lead to serious consequences for you and your baby. There are a number of treatment options, but the important thing is that your depression CAN be treated effectively.

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Depression during second pregnancy

August 2006

i am pregnant with my second child and i feel like a depression is always luring under the surface....this pregnancy has been an imense emotional up and down and i feel very overwhelmed....my first child will be 2 soon and she starts to be a handful...just always wanting her own way so that doesn,t make it any easier....i would have liked to have a second girl but as it is we will have a boy and 5 mo into the pregnancy i still feel a great deal of dissapointment and fear that i will not love that child and that because of me feeling depressed a lot that i will be in a risk of having post partum depression once the baby is born....any advice how to deal for the next 4mo or any recommendations who to talk to(where to get help?)?my husband is very busy with work and i don,t have family close by thanks for any input
feeling blue

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I too had depression in my 2nd pregnancy and was worried about many of the things you mention. I attributed it to more severe hormonal swings and fears and being tired from the first kid. I can happily say it passed at the birth of my second son - I recall the relief of holding the new baby and the clarity of love shining through the fog of the depression. (Though I must say my 2nd child is definitely a lot more work (his more demanding personality and just the fact of having two kids) but I am not depressed about it, just the normal swings of motherhood - moments of frustration, lots of fun, being tired, getting energy back from the kids, etc....)

I did therapy for a few months which helped alot just not feeling so isolated, and of course other issues came up (not just related to my depression or kids but my own life-long stuggles with grief over losing my parents at a young age.)

So, my advice is give yourself the gift of time for yourself: therapy/or a support group, long baths, crying, massage, sleeping late whenever your husband is there, read a novel, whatever is comforting to you. Tell him you really need the extra lee-way I hope your husband and local friends will give you becuase you are pregnant and ask for them to help with the first child so you can take care of yourself. ''When mom is feeling better, the whole family works better'' is a pretty good way to explain why you need this, now and for the first few months after baby comes. This won't last forever which is exactly why you need to address it now - these are normal feelings and you deserve the help and support to do whatever you can do to get through it ''Been there - now better''

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I've had a very good experience with Lee Safran, a therapist who specializes in all things related to pregnancy and kids. She is knowledgeable and kind and that worked well for me. She has an office in Kensington. http://www.leesafran.com/ Good luck and I highly recommend getting some help during your pregnancy - it'd be a smart move anon

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I would HIGHLY recommend Gina Hassan, Donna Rothert & Lee Safran, who work together at a practice called Perinatal Psychotherapy Services. www.perinatalpsychotherapy.com 594-4006 info [at] perinatalpsychotherapy.com Best of luck to you for the remainder of your pregnancy. I hope you find the support you need
Virginia

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I felt the same way. After talking to my ob I went on medication, which helped enormously - I felt better in just 4 days. I've been feeling blue again since my baby was born - but imagine it would be much worse without having sought help.

DOn't be shy about telling people in your life how you feel. Many times what got to me during pregnancy was how everyone expected me to be so happy and excited about #2 - when all I could think about was the impact on #1, my family, plus pregnancy did awful things to my mood and self image.

Even now - I still have a stronger bond with my toddler - I can't help it, love grows over time and I just don't have the same time invested in the new baby. Though everyone tells me that the love will even out over time.

When I told people - it was amazing how many people understood. Pregnancy is not always a happy time.

Get help now and you'll be in a better place to care for your little girl, your new baby and yourself good luck

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Feeling Blue, Go straight to your OB, do not pass go. (Mine was Angelyn Thomas and she was amazing w/ my depression) Tell her how you are feeling. She can help you determine what-if any-treatment is needed. Do you see a therapist? One of my biggest regrets is that I was depressed during my first pregnancy and didn't look for a therapist until after the baby was born--when of course I was too overwhelmed to take care of myself. The fact that you are thinking about this shows that you are a self aware and caring mother. Just keep up taking care of yourself by making sure you have a plan with your ob for what will happen if you start to feel depressed right away after the baby is born. And don't be afraid to share these feelings with your husband. Even if you don't get that much time together, what could be more of a priority to talk about than your happiness? been there

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Having an almost-two-year-old can put anyone's nerves to the test. Adding a pregnancy and the accompanying hormones would make it extremely difficult for any normal person. Please realize that most mothers in your position feel horribly overwhelmed and pretty depressed at times. Pease check out this Yahoo Group http://health.groups.yahoo.com/group/SSRI-Crusaders/. Just this morning I received an e-mail from this group and part of it said: ''Thyroid, I'm finding, is the number-one cause of depression,'' said Dr. Mary Ann Block of Hurst. The doctor went on to say that treating a woman with an anti-depressant when what she really has is a hormone imbalance, should be criminal, in my opinion.'' Dr. Block said depression is really a symptom of something else, and doctors need to spend more time in the examining room with patients instead of being quick to prescribe drugs. She is known nationally for her views on anti- depressants, and she is writing a book entitled, Just Because You're Depressed, Doesn't Mean You Have Depression.'' There are varying opinions about the cause of depression, but doctors report that mental health problems often have a common cause: insufficient nutrients in the brain. Nutritionally- oriented physicians assert that the cure for these problems is to give the body the extra nutrients it needs, especially when under abnormal stress. Pregnancy and a 2-yr old often add up to ''abnormal stress''. My holistic doctor provided me with a good list of vitamins to take while pregnant - both for the baby and for my own (mental) health. They made a world of difference. JOJ

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I'm so sorry you're experiencing depression during your pregnancy. I had my child fairly late in life and was not prepared for how much pregnancy would change my diet, ability to exercise, everything. During my third trimester, I became very depressed (clinically) and saw a psychiatrist who prescribed an SSRI. Within days, I felt like a new person. I know there's a lot of controversy about taking any medication, but we weighed the pros and cons and realized that I wouldn't be in any shape for labor and delivery, much less parenting at the rate I was declining. I was also advised to taper off the medication as my due date grew near, but I wasn't able to. Again, dire warnings, but I gave birth to a VERY healthy, happy boy. He continues to be one of the most joyous, curious, intelligent kids I've ever known (slight bias). I hope this helps you, should you choose to go that route. I continued on the medication after he was born because I was definitely suffering PPD, and managed to breastfeed (took some logistical planning, but I did it). If you would like to discuss this further, can you post again and I'll give you my address. Not comfortable doing it in this forum, but I'd be happy to tell you about my experience and give you my doctor's name Anonymous

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I'm sorry to hear you are feeling blue. I know some of your same concerns well as I too had strongly hoped for a second daughter. I mourned the ''loss'' of another girl for a while and still think about it regularly. However, I can tell you that I love my son dearly and even my husband enjoys saying ''you never thought you'd love a boy this much, did you?''. He's right - I never thought I would! The fears of not loving a son as much or having a son when you wanted a daughter usually go away when you actually meet your child (others have also told me that too)! Little boys sure love their moms and my little two year old boy is a gentle, happy boy who loves all of his sister's activities and interests. For us older girl and younger boy has turned out to be a happy combination. Good luck! Mom of a girl and a boy

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Hi - I am so sorry to hear that you are suffering. I am now pregnant with my second and am on a low dose of Zoloft - which I started taking before I got pregnant. I also have an almost 2- year old who is a handful and am very nervous about having a second. I have heard that 10-15 percent of pregnant women get pre-partum depression - it sounds like you are being very smart by thinking that you might have post-partum dep, too. I will say that Zoloft really has made a huge difference to me (I started taking it for post-partum depression after my first baby was born...) Are you seeing a therapist? I think it is a great idea to have someone to talk to about this stuff - and then you will have someone who knows you once the baby is born. I wish you luck and you are not alone! another pregnant mom

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I just went through a similar thing (tho mine was post partum). I am normally a pretty upbeat, non depressed person, but had problems with my first and second pregnancy (both physical and mental). I didn't seek help the first time, but did it the second. I recommend seeing Shoshanna Bennett. She specializes in post partum depression as well as depression during pregnancy. Unfortunately, she's pretty expensive ($250 for the first visit), but rather than sending you on some long, drawn out counseling experience, she cuts to the chase and gives you a game plan to work through your issues. Her number is 510-889-6017. She also has a book called BEYOND THE BABY BLUES which might help if you don't have the money or time to see someone. Feel free to email me if you want to chat as well. mizlandry

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I didn't feel so hot during my second pregnancy either. I saw a therapist, Colleen West, who was very helpful. Her number is 510-412-2155. I had doubts about loving baby 2 as much as #1, being overwhelmed, etc. Turns out I feel better this time around and the adjustment has gone really well. Good luck. Anon

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I am a therapist who specializes in working with women who struggle with depression/anxiety during and following pregnancy. I also run a weekly pregnancy support group, where women come together to discuss the emotional challenges and joys that this period can entail. Pregnancy can be a time of intense and fluctuating emotions, and a second pregnancy can be even harder, due to the additioinal stress of having to look after your todler, while needing to care for yourself. Many women experience disappointment when they find out the gender of a child, and this can raise feelings of guilt, and concern about bonding. Having a place to talk through these worries can be immensely helpful. I would be happy to meet with you individually and/or to speak with you in order to see if the group would be a good fit. Please feel free to check out my services and those of my colleagues at www.perinatalpsychotherapy.com Gina

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It sounds like you need to be taken care of and need lots of support around you. Pregnancy is a vulnerable time when the woman is going through multiple levels of changes and can't possibly go through it without the help of her community. During my second pregnancy I felt something similar to yours so I joined a support group for pregnant mothers, went to therapy, asked a trusting neighbor to watch my child while I napped, used PBS/videos as a last resort, got massages from a friend, and begged my mom to visit me so she can cook me foods I missed eating in my youth. I reached out a lot and it took a lot of work but in the end it paid off. I hardly experienced any depression compared to my first time. This might or not happen for you but the thing to remember in motherhood is to reach out and get the care that you need. And regarding loving the new baby, this is very normal and can say from experience that you will love your baby differently but equally with your first. Please reach out for help. There are plenty of good people who would love to help you if you just ask.

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I just wanted to let you know that you're not alone and there is help available. Depression during pregnancy is becoming more recognized as a common and treatable issue (articles in JAMA and Newsweek this past year speak about the recent research). Also, postpartum depression often begins during pregnancy. Gina Hassan, Ph.D. leads a Pregnany Group specifically for women who are having such issues. You might also just want to see her or another recommended therapist in this area for consultation or individual treatment. You can reach her at 510-644-1097 or get more info. at www.perinatalpsychotherapy.com an

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I wanted to respond to you because I, too, became depressed during my second pregnancy. I also have an oldest girl and my second child is a boy. I had very little emotional support during that pregnancy and my daughter became very sick for a few months, the stress of which triggerered an intense emotional rollercoaster in me. It turned out that I had an ovarian cyst that was too big to be removed until my son was 2 months old, so I had to have major surgery when my son was an infant. Also, my son had terrible colic until he was 6 months old. But, we did get through it, and the process taught me a lot about myself, ultimately making me a better parent. I ended up getting acupuncture treatments when my son was 15 months old, which triggered the beginning of a powerful healing journey. I want to make clear that my story is my own and not yours, but to say that lack of emotional support can lead down a dangerous road that I hope you can avoid! My advice would be to go to therapy if you can or feel you need to, and surround yourself with other mothers. Make some friends if you need to, or deepen the connections you already have. Do a Music Together class with your daughter, or kindergym or La Leche or ANYTHING to get out of the house and get support. Then, enroll her in preschool a couple of mornings a week so that you can get some time to yourself, and exercise. Exersise will clear your head and give you endorphins to combat the depression. Even walking is good, also prenatal yoga. Eat well and try to decrease your stress as much as you can. Each day is an opportunity to begin again, and if things don't go well one day, you have the next to start afresh. Don't worry about your daughter's behavior, she isjust two. More support and time to yourself will give you better perspective and energy to deal with her. Good luck! anon.

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Yes, it is overwhelming to have a 2 year-old, an unavailable husband, and pregnant with your second child whom you find a disappointment because he is not the sex you wanted. I hate ultrasounds for that particular reason. If the mother doesn't get what she wants, she's disappointed. I am not being judgmental as I too went through a distraughtful first pregnancy as I had to go through a divorce and handle the pregnancy and birth on my own. I suggest you seek help and change your perspective because you are setting yourself up for failure with your mindset as you forecast that you will be depressed after the birth of your son. Your husband needs to step up to the plate and be more involved and not only involved to conceive a child. You need to make some time for yourself and make some friendships. Your 2 year-old will be a handful, that's just part of being a toddler. God bless you and you'll be in my prayers. Please cherish your pregnancy and celebrate that you're bringing a healthy child into the world as there are so many infertile couples out there who would kill to be in your shoes anon

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Depression during pregnancy is a very real thing, and treating can definitely lower your risk of postpartum depression. There are professionals in the bay area who deal with just these kinds of issues. Some suggestions are:
Donna Rothert, PhD www.donnarothert.com Lee Safran, MFT www.leesafran.com Shoshanna Bennett, PhD, www.postpartumdepressionhelp.com
Best of luck -

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Personally, the birth of my second child meant a gut wrenching loss of intimacy with the first. Having a baby & a toddler often means ''choosing'' which child you are going to take care of. They both want want want at the same time. OFTEN. It is incredibly stressfull. Adding a bonafide deppression to the mix, oh dear!

I wasn't well prepared...people either forget or they just 'talk about your joy and keep your sorrow to yourself' which makes us/me feel alone or like a failure...and it is not fair! It is an incredibly stress full time. Often, you have to leave someone crying just to pee. ''Just a minute, I only have 2 hands...'' means nothing to a toddler or a baby.

These nurturing years last longer at the time than in retrospect. It is physically and emotionally debilitating. Know that and do your best. Ask for help. Get out and notice that a lot of other mothers haven't brushed their hair either. Many moms forget the snack. Get together and share your resourses. If you are in a competitive play group, like I was, chuck it sooner than I did and get with nicer people/a nicer dynamic. You will feel so much better and less competitive people are more naturaly generous, more helpfull. Also, take help and pay it forward.. I am wishing you well!

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Please call Shoshana Bennett in Castro Valley - a very good counselor (ph.d) specializing in post partum depression. She helped me immensly. You are not alone and you can get help. Antidepressants after delivery, a person to help at night take care of the baby so I could sleep, and part time nursery school for my 2 and a half year old. Shoshana's number is 510-889-6017 (the number I have from about 8 years ago). Get help and don't feel bad about getting help - it is a sign of strength. Anon

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I can really sympathize with feelings of ambivalence. I talked out my feelings with a counselor, and it helped a lot. You may want to seek counseling once a week in your remaining months of pregnancy. Talk out your feelings of ambivalence about having a boy with a professional. Fears can loom large as they are spinning in your mind, but it can be helpful to put them 'out there' and get helpful insights from a good counselor. You might also want to read about parenting siblings or seek out a prenatal support group.

Also, you can help to transition your daughter to the idea by letting her know the good news about the arrival, and your enthusiasm will communicate to her beyond your words. Let her know that you will love her always, no matter what. Spend some special time with her. Perhaps take her on some outings while you are still mobile.

Lastly, pamper yourself. Get prenatal massage, take a nice bath, journal, swim. Do things that will soothe you and give you peace tabsweb [at] yahoo.com

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I experienced prenatal depression with my first pregnancy this year. I highly recommend these books: Pregnancy Blues by Shaila Kulkarni Misri and Beyond the Blues by Shoshana Bennett & Pec Indman. Shoshana Bennett is local, and I believe she sees patients in the East Bay. Shoshana Bennett is a good resource for information on whether or not to take medication.

I was also recommended to talk to Gina Hassan Wallin PhD 510- 644-1097 who does pregnancy support groups, but never did have the energy to call.

I also very highly recommend contacting Sherry Reinhardt as a resource. Her website is: http://www.supportgroupformothers.com There are a lot of resources on her website, and she is the one who recommended Shoshanna Bennett and Gina Hassan to me. I just joined a new mothers' group, and the first meeting today was great!

Yahoo has a pregnancy depression group, also. I did a lot of reading on the site after I joined the group.

On a final note, I did decide to take medication while pregnant, and they worked incredibly well. I am still taking them because of the increased risk of post partum depression because I went through prenatal depression. This is a very personal and difficult decision to make. However, I wanted to let you know that I have a beautiful, healthy 6 week baby girl.

:) gabbie

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Your post really resonated with me. I had a very similar experience - except my depression actually started before i got pregnant and lasted throughout. I too was expecting a boy and was nervous about what that would bring since I was hoping for a second girl. I was convinced that I had made a terrible decision and that I wouldn't be up to raising two kids. It's amazing how depression can cloud even the most joyful times. Anyway, long story short, I did get a lot of help and managed to be fairly proactive about dealing with the depression (i'm not sure how since i was such a mess...). My son is now 9 months old and is such an amazing baby. He has brought so much joy into our family. I can't imagine my life without him- obviously it was the BEST decision ever.

First, I think it's really great that you wrote BPN. I'm sure a lot of women can relate to your story. My advice to you is first to talk to your doctor and ask her for a list of mental health providers that specialize in pregnancy and postpartum depression. I hope your doctor can provide specific people who take your insurance otherwise it can be daunting to find someone (at least it was for me). I know that cognitive behavioral therapy works really well for some and there are anti-depressants that you can take while pregnant and postpartum. I really recommend that you find a provider that has experience with this specific issue so they can help you determine what course of treatment best fits you and your situation. Otherwise, I recommend getting as much exercise as you can and maybe a massage (or two). Being proactive now is really the best thing and will help your transition to life with two kids- which by the way, is a lot of work but also a lot of fun! Take care anon

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I didn't see the original message but I think I got the gist from the responses. I wanted to post because I had depression in my FIRST pregnancy. I think the depression was due to hormones and upheaval in many areas of my life during my pregancy (I moved here from another state, started a new job, husband started new job, all during pregnancy). What saved me was my ob-gyn putting me on Paxil (this was before the recent FDA warnings about Paxil). I was hesitant because of the potential impact on the baby but I almost had no choice about it because I was in really bad shape. I also saw a therapist, which was helpful but not as helpful as the antidepressant.

Now I am pregnant with #2 and planning to stay on anti- depressants the entire pregnancy (yes this is controversial). I'm planning this with the approval of my ob-gyn.

My advice to you is talk to your ob-gyn about your options, whether they be medicine, therapy, etc. Also, my depression with my first pregancy lifted about 3 weeks after birth. Been there

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6 1/2 mos pregnant, feeling more and more depressed

Sept 2003

I've never had a problem with depression and am 6 1/2 months pregnant. For the last couple of weeks I've felt progressively more and more depressed--like the worst moments of PMS depression but they don't let up. It feels really chemical, or hormonal. I cry about EVERYTHING and would cry constantly if I didn't have to control myself for work, etc. Nothing that I used to find pleasure in feels good any more. I have constant nerve pain in my legs so I haven't been able to get any exercise except a little yoga...Has anyone had similar experiences? I've read about postpartum depression but what about prepartum? I am wondering if this is some hormonal swing and it'll even out...I don't like feeling this way... anon

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Let me preface this with the fact that I'm not a medical professional, and that I believe depression should be taken seriously in anyone.

I experienced just what you described in my 1st pregnancy around the same time - 6 mos. Luckily, my midwife had me keep a food diary, and pointed out that I was eating high carb (fruit & cereal) breakfasts, with maybe a big orange (sugar!) as soon as I got to work, and similar sugar-crash-snack-crash patterns throughout the day. I was also feeling quite sad and exhausted during that time.

She pointed out that around 28 weeks ''you really need to kick into high gear'' as baby is now really starting to tax your system.

She had me do three things which really turned my moods AND energy around 100%:

1) high protein breakfasts - peanut butter and whole grain bread, cottage cheese, tofu slices, a couple of Morningstar tofu sausage patties - or more elaborate stuff on weekends. That really evened out my blood sugar, and stopped the carb cravings at work.

2) Floradix (sp?) liquid herbal iron. It's a bit pricy, but is very well assimilated by the body and can really get your energy up quick. (second pregnancy I was given some chelated iron pills, and they worked well too)

3) she had me get up in the middle of the night and eat! (you're already up a lot anyway...) Your baby is eating all night while you're sleeping, so you can feel depleted in the am, and crave those carbs that are getting you all imbalanced.

I couldn't believe the difference in my mood after a week of these simple changes. And with my second I never had the weepiness and malaise, as I knew these changes worked so well before.

Good luck, and congratulations!

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I can totally relate to what you are going through. I had terrible depression starting right around my sixth month. It was exactly like you said, hormonal and all encompassing. I can't really give you any advice on how to make it better. You just have to hang in there. It got much better for me in my third trimester. Also literally the moment my daughter was born I felt ''right'' again. I have had no post partum depression like I did when I was pregnant. It was really so bad for me that I am hesitant to get pregnant again.

I did make a point of talking to my doctor about it at each visit and we talked about post partum depression. It helped to talk to my doctor and hear that this is really normal and doesn't mean that I will feel like this forever.

Don't despair. It will get better. Julie

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You are not alone! Try calling Shoshanna Bennett, 510 889 6017 for resources and information. I went to her ''post-partum depression'' support groups when I was pregnant with my first and extremely depressed- she was very helpful. She has a website and wrote a book on the subject: www.beyondtheblues.com/. These links are also on her website:
www.postpartum.net www.depressionafterdelivery.com www.postpartumassistance.com
Every situation is different and there are many ways to treat depression. I have found getting emotional support to be critical. I highly encourage you to speak to your midwife/ob, but don't be surprised if she/he is at a loss for how to help you. There may be many different things you can do, depending on how much energy you can muster (so hard when you are depressed).

Here are some things I find helpful:

- eat regularly throughout the day to balance your blood sugar (protein at every meal helps).

- get outside- I find sunlight and fresh air makes a huge difference

- get some form of exercise if you can (I know this can be really hard, but it does help)

- get support where you can (family, friends, pregnancy exercise groups)

- If you find yourself depressed for more than 2 weeks or are unable to function, you might consider contacting a therapist or psychiatrist. I highly recommend Alisa Genovese (286-7599) she is a therapist who specializes in pre and postpartum depression issues.

I would be happy to speak with you about this. I am now 8 months pregnant with my second and still struggle with depression and mood swings. Maybe we can support each other through this. aw

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My heart goes out to you, and I know exactly how you are feeling. I have struggled with prenatal depression during three pregnancies, and now, in my third pregnancy, I am happy to say that I am finally succeeding in managing it enough to actually enjoy this time of my life. Like you, I have no history of depression when I'm not pregnant -- it's only the hormones of pregnancy that bring it on. Yes, it is physical, and yes, there are things you can do to alleviate it. Prenatal depression is a very complicated and powerful thing, but I think the more you know about it, the better you can take care of yourself. Would you like to talk? I'd love to help you in any way I can. If you do, please call me anytime. I've been there, and I promise, it does get better. I hope to hear from you. Lorelai

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Hi I don't know if the following alternatives will be helpful. Folks have successfully managed moderate depression, clinical depression, anxiety and mood swings by using amino acids (which are simply proteins broken down to their main components). These are easy to get over the counter. Did you know that a lot of depression is related to nutritional deficiencies - mainly in protein which is what is needed to produce serotonin? Which is the main feel-good chemical, along with others...which can be increased by taking 5HTP? For more information feel free to ask a health food store nutritionist, or search online at www.Amazon.com for books on amino acids, omega-3 oils, etc. It is still relatively 'recent' research so it's not 'out there yet'. The book I found helpful was ''The Mood Cure'' by Julia Ross. Taking amino acids has totally turned my life around. I was mainly dealing with chronic anxiety, low confidence, sensitivity, and generally obssessive worrying, etc. The best part is you can go off them pretty soon if you eat right after that and they are non-addictive! Amazing how little we know about the nature of our emotional world! I don't need twenty years of therapy after all!!! Do whatever you need to do to be stable. Best wishes. So-much-happier-now-thanks-to-amino-acids!!!

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Pregnant and feeling unhappy all the time

Dec 2002

I've heard of post-partum depression but has any had any experience with PRE-partum depression? Ever since my 18th week of this pregnancy, I have been feeling depressed. I feel flat/ unhappy all the time , I cry a lot, I can't sleep, I can't concentrate, I'm impatient with everyone, and not even playing with my toddler makes me happy anymore. This is a much wanted pregnancy and there is nothing going on in my life that should be making me so unhappy. My only explanation is the high hormone levels in my body right now (I was at my all time best while nursing, when hormone levels are quite low!). Unfortunately, I still have a couple of months to go. Anyone have any similar experience, any advice? Thanks! -depressed

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I too was sad, tearful and irritable during both of my pregnancies. It was the worst in the first and second trimesters and lifted in the third. The only time I had felt so down in the past was when I was taking a progesterone-based birth control pill (which I stopped, and felt better soon after) and when I was briefly put on progesterone to reduce miscarriage risk. This made me suspicious that perhaps, as you have wondered, if I had an idiosyncratic reaction to the hormone levels. I saw a therapist who entirely misinterpreted my feelings as ambivalence about motherhood or pregnancy. When my depression cleared as mysteriously as it arrived, I knew she was on the wrong track!

I did not feel depressed enough to consider medication (if you are, you should pursue this). You might also consider: daily walks in bright sunlight, yoga for relaxation and body awareness, joining a pregnancy support group, making sure you are eating and sleeping well. I'm hoping that you are feeling better soon. anonymous mom

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I, too, experienced depression during my second pregnancy (although not the first). In my case, a major transition in my professional life coincided with the hormonal roller coaster of pregnancy -- not an easy time. After the baby was born, things got much better, and a few months later (summer/early fall '01) I read about new research findings showing that depression is almost as common during pregnancy as in the postpartum period. Sorry that I don't have more specific information about the studies.

Counseling helped for me. You don't need a tragedy or five-alarm crisis to start it -- if everyday things are what's getting under your skin, then talking to a therapist about everyday things may make you feel better. been there too

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I definitely suffered from prenatal depression with both my pregnancies. I don't know why, I just did. I was sort of looking forward to the hormonal highs that everyone told me would come, but they never did. I was sick a lot which didn't help, but mostly I felt lethargic and down. The good news is I didn't have post-partum depression at all and was more like bouncing off the walls I was so happy to have those kids out of me! I think it's a good idea to talk to your o.b. about it though.
signed, ''love my kids, hated my pregnancies''

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Depression during pregnancy is a medically recognized problem -- and some believe it might occur almost as frequently as postpartum depression, even though there's less popular information about it. Talk to your OB about it, and see if you can get some help for your specific symptoms Karen

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I too was sooo larthargic during my first pregnancy. I remember working myself up all day to get the energy to walk one block to the store. (I did find having a goal of getting outside and getting some excercise each day, however minimal, helped.) The bonus of my bodies reaction to hormonal levels was on the other side of of delivery. I was unbelievably estatic. While I feel bad that I didn't feel like cooing to my daughter when she was in utero, I feel very lucky to have the absolute best months of my entire life shared with my baby girl during the start of her life. Hang in there. Deborah

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I'm sorry to hear that you've suffered from prenatal depression. So many women (and their children) suffer needlessly from this very devastating disease. Unfortunately, many health care providers are poorly educated on this topic, and you are absolutely right, it is hormonally/chemically based. Many therapists will try to find a psychological reason for the depression when there isn't one because they haven't been properly trained on this topic. The good news is that there is help for all women suffering from pre or postnatal depression if you go to someone with training. The treatment is often two- prongued, medication and short-term therapy. This is a very treatable illness and most women experience profound relief fairly quickly. There are even protocols for women who want to prevent pre or post natal depression with a subsequent pregnancy. Of course, taking drugs during pregnancy/nursing is a very personal issue between an individual and their doctor, but the current studies show no ill effects to date.

I am a clinical psychologist with special training in this, but am not currently in private practice. Shoshanna Bennett, Ph.D. is a clinical psychologist in the East Bay with much experience in this area. Sorry for the soapbox but I want all women to know about this important women's issue. Terri Buysse, Ph.D.

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Depression in the Third Trimester

April 2003

I am struggling with anxiety and depression in this 3rd trimester of my 3rd pregnancy. It's been much worse than the first 2 pregnancies, I think due to dealing with two young children and our uncertain world...

I take Paxil when not pregnant (but while breastfeeding) and LOVE it, but I am concerned about taking an SSRI with my baby in utero, even though I only have about 15 weeks left. I have sought the advice of 3 psychiatrists and they all recommend Zoloft highly. Not to be sexist, but they are all men--albeit men that I professionally regard very highly--but they may not truly understand how important it is to many women including myself to be a total ''purist'' during pregnancy.

Now that the weather is improving, I am forcing myself to go for a walk everyday, and I just started taking Omega-3 Fatty Acids. Any other experiences out there similar to mine? What did you end up doing? Should I wait it out until after delivery, or is the anxiety worse for the fetus than the medication? Any noticed effects (either way) on your child? I checked the archives and only saw one entry slightly related to my situation. Thank you!

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Hi- a difficult decision for sure.

I take Paxil and have just read through the manufacturer's insert sheet for you. You may already know this, but the rat tests (at very high doses) showed no teratogenic effects. But because there are no well-controlled studies in pregnant women, it comes down to risk/benefit analysis. The same thing applies to lactating mothers.

Depression can be very serious mentally, physically, and emotionally (sounds like you know this). It can cause physical problems such as generalized pain, sleep problems, muscle weakness and muscle tension, and lowered immunity. It can wear you out and leave you with less capacity to deal with the stresses of delivery and a new baby.

But also, depression is mysterious. Some women are happy and high during pregnancy but then have serious post-partum depression. For others it can be the reverse, or the good mood or the depression can continue consistently. It's unpredictable, but if anyone in your family has had serious post-partum depresssion I'd take that into account- there is good evidence that it is genetically based.

I have taken Zoloft in the past and it was quite different in effect for me than Paxil- Paxil works much better for me on both the anxiety and the depression. I don't see why a doctor would suggest a different SSRI if you're going to take one. I don't think that there is any better data relating to pregnancy on one versus another.

The purist issue is tough. But gritting your teeth and bearing it is more puritan than purist in my book, and affects your family as well as you. And it is pretty well documented that the in-utero experience of the fetus is affected by the well-being of the mother. The whole point of being careful during pregnancy is to produce a happy baby!

Be careful with herbal remedies- some are powerful drugs but in less controlled dosages than manufactured medication. St. John's Wort acts chemically like an SSRI, and Valerian acts like a benzodiazepine. Just because it's straight from the plant doesn't mean it's innocuous.

If you decide not to take medication, I'd suggest establishing a relationship now with a psychiatrist who you really like and trust- not just someone who you hold in high regard- so that you have someone there for you if you need help after delivering. Best of luck, anon

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I took Paxil before finding out I was pregnant, and thought I would be able to stop taking it until after I had weaned my baby. Big mistake, being pregnant didn't solve my depression and anxiety and after a move across country during my 7th month my depression was controlling me. My new OBGYN counciled me for 2 visits, offered lots of advice and research and I took it during my last 2 months. He told me that my depression and anxiety could harm me much more than the Paxil. I delevered a 9+ lb. baby and I breastfeed and my baby is in the 90th percentile for all growth and is a happy wonderful person. It is a personal decision, but I am happy with my choice.

Good Luck been there

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I can relate. I took Prozac for major depression for several year. When I found out I was pregnant with my daughter (now 4), I went off cold turkey (without talking to a doctor about it). I became super depressed and suicidal- wanting to leave my husband and give up my daughter for adoption. I went on Zoloft in my 7th month. After my daughter was born, I started to increase my dosage and have been on Zoloft ever since (I nursed my girl for three years, taking the zoloft after the last night feeding. She is strong, healthy, and smart as a whip!). I am now three months pregnant and plan on staying on the Zoloft. With the help of my psychiatrist, Dr. Phyliss Cedars (925-254- 7522), I decided that the risk of my depression would be greater than the risk of the Zoloft. She has studied this issue and has given presentations at conferences related to depression and pregnancy/post partum. She is not super ''touchy-feely'' but I do trust her. I guess my advice would be to consider the severity of your depression, get as much support as you can (I joined a postpartum depression group while pregnant!), and do more research. Shoshanna Bennet, Phd (727-4610, I think area code 510, but maybe 925) is a specialist (she runs the postpartum depression groups) in this field and is founder/director(?)of Post Partum Health Aliance (510-889-6017). They also have a hotline 1-888-733-7090. She will know of all the latest research and may be able to hook you up with a good phychiatrist. Here are a few internet sites that may help: postpartum.net; postpartum.org.

Good luck and hang in there! You are not alone. anon

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You can do a search of medical journal articles on PubMed (free on the internet) if you really want to read everything that is known about prenatal exposure to paroxetine (paxil). I did so when I was pregnant and decided to stay on paxil for my anxiety and depression. the baby turned out great and I continued paxil while I nursed for 18 months. the baby still is fine. One of the studies showed that paxil-exposed toddlers showed no differences from unexposed kids. happy mom and child

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I'm currently in my third trimester and taking 20mg of Paxil daily. I tried to reduce to 10mg, but it just didn't work for me. I'm still exercising and working, and feeling good, whereas if I wasn't I'd be in pretty tough shape! Certainly my pregnancy hasn't been affected by them--everything is going very well.

I wish I could do without antidepressants for my pregnancy and for breastfeeding, but it's hard enough to deal with all of the changes of pregnancy and to deal with being depressed, too. It's important to look after your health, since that directly affects your child's--and your other children as well. If you are just limping along without the antidepressants, you're making yourself suffer needlessly, imo. If you had asthma or diabetes, would you forgo your medication?

I wish we had more information about the long term effects. I've talked to doctors, done my own research, and there isn't much. I'd like to think that since the ssri's have been out for a while now, that if there were serious consequences we'd know it by now.

Everyone's situation is different... listen to your instincts and do what you feel is best for you. If you can struggle through your pregnancy without them, great! If you feel you need them, don't beat yourself up about it. Anon

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Please look for a therapist with whom you feel compatible & take the drugs. I've struggled with depression off and on throughout my entire life. I've always tried to just suck it up & deal, because taking Prozac or Paxil -- or even seeing a shrink -- seemed like copping out.

In fact, I would *still* be forcing myself to suffer if it weren't for my baby daughter. My heart melts for her like butter on warm toast. I couldn't bear to squash my effervescent creature's buoyant spirit with the unbearable heaviness of my being. So I started getting help.

Because ... If you broke your leg, would you still try to climb up & down stairs & do everything yourself? I doubt it. Depression can be just as crippling. But you force yourself to do everything because nobody can see it. Yes, you need to exercise & get fresh air. But you also need to daydream & sleep & relax. Hopefully, you can talk these things out with your partner or family & your doctor.

Talking with someone who knows women's issues, like pregnancy, birthing, menstrual cycles, mothering, etc. is important. But so is having someone around who knows the scientific end of things & can prescribe medicine. To get the best of both worlds, it's best to go with a practice that has both warm, fuzzy, liberal arts types who are therapists, & doctor/science/clinical types who are psychiatrists. Because you need warm fuzzies, but you also need drugs.

Now that I've been taking prozac for a while, I realize that suffering is so unnecessary. We humans have enough to be miserable about, anyway. Despite common belief, Prozac, Paxil, & other mental health drugs are NOT like the ''SOMA'' of ''Brave New World.'' These drugs just open up a little space in your brain so you can think things through & deal with things instead of reacting before you've had time to think & decide things for yourself.

Good luck, sweetie. anonymous

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Depressed, pregnant, worried about hospitalization

September 2002

I am pregnant with my second child, I have a year and a half old daughter.

I am getting very depressed with the pregnancy, and I am just starting the 2nd trimester. With my first baby I got very depressed, but not until later on during the pregnancy.

My concern, is that I will end up needing hospitalization. I have medical condition, on top of all this that requires vigilant care- for mine and the baby's safety. So, I know that if I cannot care for myself due to the depression, my doctor will not hesistate admitting me. What does that mean for my daughter? My husband is awesome, a great father and able to care for our daughter. Does this mean that I am not a fit parent? I know that because of him, we are not likely to have her taken from us. Though, what about it we split up (not that I'm planning on this, I'm just realistic) could this cost me custody? Thanks!

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Hi, I was completely stressed out about being pregnant and my family members have had serious bouts with depression--with the hormones on top of the usual mix it can be even more horrible. I found that prenatal yoga (I didn't see your posting, just a reply, so maybe this isn't an option?) helped me a lot, the prenatal yoga video by Shiva Rea in particular. The first time I put it on I was a wreck but the breathing exercises and new agey music and calm pregnant women all helped me feel less frantic and more relaxed, which helped a lot. Things will get better! anon

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Hi, I cannot address most of your concerns but I hope that you are in treatment with a competent therapist and that you've had a consultation with a psychiatrist for a medication evaluation. The newer anti depressant medications (Zoloft, Paxil for example though apparently not Prozac) seem to have no impact on the developing fetus, (and are not traceable in breast milk) especially if you are later in your pregnanacy. Late in my 2nd trimester I developed panic attacks- symptoms which I had never, ever had before. I sought all kinds of consultation for a month (meanwhile I was miserable and barely sleeping 4 hours a night) and read the medical literature provided by a psychiatrist who specialized in psyciatric conditions during and post pregnancy. (You can call the hospitals or ask your OB to find a psychiatrist with this background or call UCSF or SF General) After much worrying, I took a small dose of Zoloft and my symptoms were completely resolved. Our daughter was/is perfect. It was a tough decision but I thought it would be best for both she (even in utero) and I to begin our life together with a saner mother. P.S. I stopped taking Zolft after giving birth and have not had the symptoms ever again. Good luck anon

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It is hard to care for small children, or do anything else for that matter, when one is seriously depressed. However, this certainly does not mean that you are not a fit parent. It sounds instead that you are a parent who needs to take especially good care of herself in order to be an effective mother (we all need to take care of ourselves before we can really take care of others well). I can't answer your question about custody, but I don't think that being temporarily hospitalized would work against you any more than having an untreated serious depression would. I hope you are working with a good psychologist and/or a good psychiatrist and that you get well soon. Liz

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I don't know the answer to your question about custody, but wanted to urge you to make sure that you are obtaining the best medical and psychotherapeutic help available. Depression during pregnancy with a young child is a very serious, but relatively common and treatable condition. Hopefully your psychiatrist is well-versed in prenatal and post-partum depression, but if not, I would try to find someone who works in this area. Also, there are a number of counselors in the area who work with pregnancy and depression issues and if you're not seeing someone, I would urge you to start seeing someone like that immediately. Finally, make sure your OB is aware of the extent of your depression. She or he should be able to make some referrals if you need to find another psychiatrist or therapist. Good luck and take care of yourself. Depression is treatable; you just have to make sure you're getting the best care you possibly can for yourself and your family. Been there