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How to Talk to Your OBGYN about Depression in Pregnancy

Katlyn Joy |11, November 2013


Some things are harder than others to discuss with your doctor: weird smells, habits or embarrassing lifestyle choices number among those but perhaps nothing could be more vital or tougher to discuss than depression during your pregnancy.

If you have a history of depression you probably realize you may be at an increased risk for depression. If you went off depression medication to conceive, some studies put the odds of a rebound depression in pregnancy around the 70% mark.

Pregnancy is an often romanticized and idealized condition. However, for some pregnant women this may be a new and troubling situation, and one they may even feel guilty for. For women who planned their babies, or those who struggled with infertility issues, the guilt can be sharper about prenatal depression. After all, you wanted this; you planned this; you may have struggled and saw multiple physicians, took fertility medication or had procedures done to have a successful pregnancy. So how could you possibly be depressed?

A landslide of hormones is enough for many women to feel off-kilter, and for an estimated 10 to 15 percent of pregnant women, the result is depression. Have you ever had PMS? That's a droplet compared to a torrential rainstorm of hormones. Plus, if you get PMS, you are at increased risk for prenatal depression.

When and What to Tell Your Doctor About Your Feelings

If you are having severe depression symptoms that are interfering with your normal life, don't wait until your next appointment; make a special appointment as soon as possible. If you are struggling but it's not that severe, just make a solid promise to yourself to broach the subject at your next prenatal visit.

Tell your physician why you are concerned: write down a list prior to your appointment to make sure you leave out nothing important. Explain fully your feelings and symptoms in your own words; you don't want to sound like a brochure on prenatal depression. Detail how the symptoms interfere with your daily schedule or responsibilities. If you have a history of depression or depression runs in your family, share that as well.

If you have darker thoughts that you are afraid to divulge to anyone, especially a doctor please understand the importance of being open. If you have had thoughts of suicide, self-harm or thoughts of death you cannot bear them in silence! Often times, sharing such deep burdens will make a tremendous difference right away. Your doctor will ask you questions to determine whether these are fleeting dark thoughts or a persistent thought pattern. Your physician will ask you if you have progressed to the point of having a plan. It is important to be honest and not hold back out of fear. You need to be candid in order to get the type of help you need. A simple reply of, "Yes, I've had some dark thoughts or imagined death," will not land you in a locked psychiatric ward.

If you don't have suicidal thoughts but are feeling deeply sad, worthless or hopeless, you need not suffer in silence either. There are a number of options such as talk therapy, cognitive therapy, support, and medication to help you.

Questions to Ask Your Doctor about Your Depression

  • Should I restart the medication I took previously for depression?
  • Can you refer me to a counselor in my insurance network?
  • Do you know of any sliding scale counseling in our area?
  • Will this medication cause side effects and what is the history of giving this medication to pregnant women?
  • Can I make any lifestyle changes to help my depression symptoms, such as with my diet, exercise or sleep?
  • Will I need to continue this medication after the baby is born?
  • Is it safe to take while breastfeeding?
  • How soon should I start to feel better?
  • What do I do if I feel much worse or feel like I am in crisis?

Ways to help your doctor and yourself treat pregnancy depression

  • Follow the directions from your physician exactly. If you have questions, get clarification right away by calling him or her.
  • Follow the directions of your medication exactly as written.
  • Let others know you are struggling. Having support from family and friends can make a huge difference.
  • Take it easy on yourself. Don't overload your schedule and stress yourself out.
  • Don't withdraw from people or activities that typically give you pleasure. This will only make things worse.
  • Have hope that things will get better because they will.
  • Exercise is known to produce good feelings. If you haven't already, begin exercising for at least 20 minutes per day – every day.

You do not need to suffer from pregnancy depression. There are treatments available, and with the help of your doctor, you will be on your way to feeling good about yourself soon! Don't give up hope, and get the help you deserve.

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