The debate rages on over the safety of psychotropic medications during pregnancy. Those who oppose the use of antidepressants can produce scores of articles and scattered studies illuminating the dangers and challenging the effectiveness of these medications. I think what we have here is a classic case of “splitting,” a psychological term for the inability to recognize that there can be good and bad attributes about a person or object. Many with strong opinions label psychiatric medications either “bad” or “good” and can accept only information that fits in with their view.
The reality is that there ARE incompetent psychiatrists and some who just plain make mistakes. Medications may also be overprescribed or even wrongly prescribed for some. However, there are individuals who benefit greatly from the use of antidepressant and antipsychotic medications. Thus, the need for accurate information about their use in pregnancy and while breastfeeding are crucially important.
Many who oppose antidepressant use advocate instead for natural and holistic alternatives for the treatment of depression and anxiety. I am a believer in holistic medicine. I’ve tried acupuncture, chiropractic, homeopathy, cranio-sacral massage, and herbs at times with good results. However, I would not have survived childhood without life-saving asthma treatment, and I have never found a holistic remedy that cured my asthma. I think we can all agree that the body sometimes has flaws (type 1 diabetes is a good example) where mainstream medical intervention is necessary to maintain health and life.
In my case, many years ago, holistic treatments and psychotherapy did nothing to touch my severe postpartum panic, which caused months of insomnia, dizziness, and nausea, making me incapable of caring for my children or myself. I was hospitalized for major depression when I no longer had the will to live. Within six weeks on an antidepressant, I was functioning again and beginning to benefit from psychotherapy. I know that an antidepressant helped to save my life, and I know many other women who have had similar experiences.
Research is starting to show that there are genetic differences affecting many women who experience perinatal mood and anxiety issues which cause some women to be oversensitive to the impact of changes in estrogen levels. My work with postpartum women has demonstrated to me that women with severe depression, anxiety, and obsessive compulsion that begins in the perinatal period often benefit from antidepressants, along with psychotherapy, improved self-care, good nutrition, sunshine, and moderate exercise.
Some mothers choose not to take medication, and sometimes they do recover with psychotherapy and improved social support and self-care, but sometimes they still end up taking medication later and regretting the time they lost with their baby while they were too depressed or anxious to bond effectively.
The truth is that some new mothers are unable to muster the energy and will to engage fully in therapy and cannot improve self-care adequately to recover from debilitating depression or anxiety without medication. The majority of those women in my experience (and the experience of my experienced colleagues) do improve once they receive the right medication. That is a reality that supersedes intellectual debates about the benefits and risks of medication. Those mothers need balanced information and not scare tactics, shaming, or political agendas. Their lives, and the well-being of their babies, depends on it.
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