Medication has an important part to play in the treatment of pregnancy & postnatal anxiety and depression. Antidepressants are prescribed due to the evidence that chemicals in the brain that regulate mood and behaviour are believed to be different for those who are experiencing anxiety and depression. It is thought that neurotransmitters, such as Seratonin and Noradrenalin, can become imbalanced and require medication to correct it, with a view to making the individual feel better. However, if mental illness was just because of a chemical imbalance, then medication on its own would resolve the problem.
The fact that it does not, suggests that there are other factors involved in perinatal mental illness. We know from the research that other psychological and social factors are present in problems such as anxiety and depression, and medication alone cannot address these. This is where psychological therapy comes in.
I work with lots of mums who feel that it is the right thing for them to take medication for their mental health during their pregnancy, however I have heard lots of times how mums have been advised to stop their medication due to becoming pregnant, which is not in line with current NICE guidelines. These guidelines advise that should you decide to take medication in your pregnancy, you should be offered the type with the least risk to you and your baby.
I have worked with lots of people who tell me they do not take any medication for their anxiety/depression. This can be due to a variety of reasons; fear of becoming addicted, worry of unwanted side effects, or fear about what others will think of them for taking mediation to manage their mental health. The list goes on.
As a therapist, I will always discuss the current evidence base for the treatment of moderate to severe anxiety and depression, which is psychological treatment and medication combined. Therapy can only do so much, and evidence has shown it may not be as effective without the use of medication alongside it. However, if you are trying to conceive or are currently pregnant, the guidelines state that your doctor should discuss the risk of taking antidepressants with you and together you can weigh up the pros and cons of taking versus not taking antidepressants in your pregnancy. Many mothers can and do take medication whilst pregnant and go on to have healthy babies.
Many people have reported that using medication can take the edge off their symptoms, it can help them to function day to day, it can help them sleep better or rationalise their negative thoughts more effectively. It can also mean they have the headspace to benefit therapeutically from the psychological treatment they are receiving. It is also worth noting that, given that pregnancy can be a time where lots of physical and emotional changes are happening, medication may be something that a mother needs to help her to cope whilst she is pregnant.
The use of anti-anxiety and anti-depressant medication in conjunction with the right psychological treatment can help individuals feel better and more able to cope with life. Medication can also help people to feel better quicker.
The downside is that individuals can and do experience side effects, some can be managed and eventually pass, and some do not. Sometimes people must try different types of medication to work out which is the right one for them. There is also the small risk that taking antidepressants throughout your pregnancy may affect the baby, although again, not taking medication for anxiety and depression in pregnancy also also shown to affect the baby too. Therefore, it’s worth speaking to a GP who ideally has had training in perinatal mental health, so they can advise accordingly.
If you are considering starting medication to treat symptoms or anxiety and/or depression, the first port of call should be your GP. You can advise them what symptoms you are experiencing, what impact those symptoms are having on your life, and whether you are trying to conceive or are currently pregnant. Your GP can then suggest whether they feel medication could help and what specific medication, based on your individual situation.
Taking medication does not make you a failure. If you have diabetes or high blood pressure, and your GP said you needed to take some medication, would you take it? Of course, you would! So, what is the difference with taking medication for symptoms that are related to your mental health? Yes there is a stigma, but the downside of people giving in to this stigma and the worries associated with medication for mental ill-health, means that many people continue to suffer and do not get the full benefit from psychological interventions.
The typical medications used for anxiety and/or depression are not addictive and are meant for use to help with day-to-day symptoms whilst the driver of the symptoms is identified and addressed. This is typically achieved through psychological therapy, which tends to address the root of the problem. When an individual starts to feel better, and with guidance and agreement from their GP, they can and do wean off their medication, which is evidence against the worry that once you start taking it, you are destined to be taking it forever.
Would you take medication for anxiety or depression in your pregnancy? Do you currently take it? How did you feel about taking it? Did you refuse to take it because of any of the worries listed above, or because you were advised to by a Healthcare Professional? I hope this blog will help you to challenge any of your own biases about medication for the treatment of anxiety and depression in pregnancy. The bottom line is – there is no shame in taking medication for your mental health. Do whatever feels right for you and based on the evidence available.