Depression, Pregnancy, and Psychotherapy

A  study in the journal Human Reproduction recently concluded the following:

Antidepressant use during pregnancy is associated with increased risks of miscarriage, birth defects, preterm birth, newborn behavioral syndrome, persistent pulmonary hypertension of the newborn and possible longer term neurobehavioral effects. There is no evidence of improved pregnancy outcomes with antidepressant use.

This is an important study for several reasons:

  • Pregnant moms who are depressed can be at risk for not taking care of themselves or their unborn baby (not eating well, not taking prenatal vitamins, not going to OB visits).
  • Moms whose depression is not well managed during pregnancy are at a greater risk of developing postpartum depression
  • Moms who are depressed risk other physical and mental health problems
  • As most families know, mom’s mental health and mood has an impact on everyone else in the family

So what do the results of this study really tell us?  Antidepressant use during pregnancy needs to be evaluated carefully.  But to me (as a psychologist, of course) the more important conclusion of this study is this statement right here:

There is some evidence that psychotherapy, including cognitive-behavioral therapy as well as physical exercise, is associated with significant decreases in depressive symptoms in the general population; research indicates that some forms of counseling are effective in treating depressive symptoms in infertile women.

In fact, psychotherapy can be highly effective for many mood disorders, including for depression before, during, after pregnancy.  This is great news because, unlike medication, psychotherapy has few (some would say zero) side effects.  An effective and safe treatment option for moms and their families – now that is an important conclusion.

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