Medication for PMADs
Reviewed by Chris Raines
You might not be sure whether you need medication to treat your symptoms for depression or anxiety. Perhaps therapy might help. Good people to consult with include your OB-GYN or general practitioner, and an ideal choice is a perinatal mental-health provider.
Having to go on antidepressants may not be what you expected when you became a mother, but it doesn’t equal weakness or failure. It means that you are taking care of your health, which is a sign of strength.
Jen Schwartz
Founder, Motherhood UnderstoodHow do antidepressants work?
Antidepressants work by balancing the chemicals in your brain that affect mood and emotions. When you’re depressed or anxious, the parts of your brain responsible for planning and problem solving don’t work well because they are overpowered by tons of intensified emotion. That’s why it’s impossible to think your way out of it.
Antidepressants help bring down the level of intense emotion you feel so your problem-solving brain can do its job–you’re able to think clearly and make decisions without jumping to “worst-case scenarios,” says Chris Raines, a perinatal psychiatric nurse practitioner. When this happens, it becomes easier to perform everyday tasks.
Antidepressants can set off a positive feedback loop. Consider the following potential sequence:
- While taking antidepressants, you might have more energy to participate in therapy sessions or attend a support group. Therapy might help reduce your anxiety.
- With reduced anxiety, you might become more likely to answer a friend’s phone call or go out on a walk.
- When you are out walking, you might be able to think more clearly and communicate your needs more effectively.
- Communicating your needs more effectively might result in getting more help—and sleep.
- Feeling better supported and rested might make you feel more confident in the choices you are making.
All of the above changes will help improve your mental health and facilitate your recovery.
If you’re new to mood disorders
If your mood feels unstable, your physician may prescribe medication for you. If you’re new to the concept of medication to help manage your mood, the very topic can be fraught with stigma. You may be worried that you’ll become dependent (you won’t) or scared that it will negatively impact your baby (not likely). Or perhaps the very thought of taking medication makes you feel as though you’ve failed as a parent.
It’s OK. You’re not a bad parent; you’re taking responsibility for yourself, which will enable you to be present with your baby.
Taking an antidepressant will change your personality.
If you have a mood disorder history
If you’ve been on medication for a mood disorder, this road isn’t completely unfamiliar, but it can feel different because you have a baby’s well-being to consider in addition to your own. It may feel more complicated or confusing, and that’s understandable. But you may already know that medication can make a world of difference, if that’s what you and your provider decide is best for you.
If you’re worried about taking medication
Medical research1 about SSRIs (selective serotonin reuptake inhibitors), a widely prescribed class of antidepressants, suggests that it's important to talk to your perinatally trained provider about your own risks and benefits. Your provider can help you determine the best course for you.
“It is not a one-size-fits-all,” Raines says. “It is important to consider the risks of taking medication and the risk of untreated perinatal mood disorders to you and your baby,” she says. If you and your provider decide it’s right for you, know that they have a role to play in your healing.
If you’re currently on medication
If you’re on an SSRI, the current medical advice is to continue taking it, but if you are at all concerned, don’t stop any of it until you’ve talked to your trained provider.
Once you go on an antidepressant, you’ll need it forever to feel good.
Pair medication with therapy
Multiple types of therapy, such as psychoeducation, support therapy, cognitive behavioral therapy (CBT), and interpersonal therapy (IPT), along with acceptance and commitment therapy (ACT), can help you find tools that work for you. Mental-health providers trained in perinatal mood disorders can help support you in your journey. PMADs are different from general depression and anxiety. They require treatment from providers who truly understand these differences.
References
1 https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2769190#yoi200049r67
Additional resources
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