But I also see how significantly it frustrates science. Other studies are retrospective.
If you take, for example, all children with a particular cardiac defect, check how many of their mothers took antidepressants and find a rate higher than in the general population, you might suspect that the antidepressants are causing it. But the real culprit may be maternal depression itself, or the erratic and self-destructive behaviors that often accompany it. What physicians refer to as the confounders are huge.
To separate out the consequences of a depressive life from the physiological consequences of the long-term illness and from the effects of medication is nearly impossible. Recalling the Hippocratic oath, doctors who encourage depressed pregnant women to white-knuckle it without medications for the benefit of the fetus set out to do no harm. But there can be harm not only in writing prescriptions but also in withholding them. Depression itself comes with its own host of problems and consequences. Learning about them, I felt hints of the despair that afflicts both doctors and patients: I was still bereft of ready answers.
Those with depression may be in trouble whether they medicate or not. Untreated depression or anxiety during pregnancy have been linked in multiple studies to miscarriage, pre-eclampsia, preterm birth, neonatal complications and smaller newborns. Antenatal depression is often accompanied by anxiety and obsessive-compulsive symptoms, and sometimes by psychosis. Cortisol, the stress hormone that is pumped up in women with anxiety and depression, crosses the placental barrier and can reach the fetus.
Anxiety in pregnant women is associated with impaired blood flow in the uterine artery, which feeds the placenta. In one study, children whose mothers were highly anxious when they were 19 weeks pregnant showed reduced gray matter at ages 6 to 9. Children of mothers who had untreated anxiety during pregnancy, other studies have found, have a higher incidence of anxiety at 4 years old, and of raised cortisol levels in adolescence.
The problems are not only biological. Women experiencing antenatal depression are more likely to engage in damaging behaviors such as drinking, smoking, drug abuse and lack of exercise. They are more likely to be obese.
You can beat depression
They often cease functioning at work, which can be financially catastrophic. They are less likely to sleep regularly or take prenatal vitamins, and they often miss obstetric appointments. Depression during pregnancy also puts an enormous strain on marriages, possibly creating a poor environment for the child. What really struck me in listening to the physicians who treat suffering pregnant women is that while most depression is essentially private, this depression is understood to be public because it implicitly threatens others.
The greatest fear among the women I met was that their depression might hurt their children. Many discounted their own suffering, even though their suffering is also part of the story. The discussion is always about risk. Mom is suffering terribly. Fitelson considers, with each woman, how severe her depression has been in the past, whether she has previously tried going off medication, what other treatments have been helpful, what other measures she can try besides medication that might enable her to at least lower the dose.
Fitelson also considers whether the woman has ever had an eating disorder, has a history of substance abuse, is in an abusive relationship or seems to be at risk of suicide. She asks whether the woman has other children for whom she needs to care. Fitelson has had patients with catastrophic depression who went off their medication and then were unable to cope, to the point of terminating their pregnancies; she has also had patients whose children have deficiencies for which the mothers blame the medications they took.
They all live in a penumbra of regret and guilt. Margaret is petite and dynamic, with an air of competent efficiency typical of many people who work in financial services. I'm using a nickname to protect her identity, as well as nicknames for her children. Her grandmother committed suicide before Margaret was born; when Margaret was 10, her mother jumped in front of a New York City subway train and killed herself.
She was working in the financial district in Lower Manhattan on Sept. She went to see a psychiatrist who prescribed Paxil, an S. Then she and her husband decided to have a child.
- How to cope with a depressive episode!
- Jérôme K. Jérôme Bloche – tome 21 - Déni de fuite (French Edition);
Complete loss of energy or desire to do anything. She initially found it difficult to bond with Katie. Her husband was supportive but bewildered, and Margaret worried that her short temper and disengagement would damage their marriage. When Katie was 3 months old, Margaret went on Wellbutrin and Zoloft, and within six months, she began to feel better and undertook, belatedly, the process of bonding with her child.
As Katie grew older, she was closer to her father. When Katie was about 10 years old, she developed anxiety after an upsetting experience with food, refused to eat for a year and was nearly hospitalized for emaciation. Margaret told Katie that she herself had been afraid to leave the house after Sept. That is what happened.
Margaret has worked hard to build the relationship with patient love, step by painful step.
We Need to Talk About Post-Graduation Depression | Top Universities
Her first pregnancy and its aftermath were so traumatic that she waited the better part of a decade before trying to have a second child. Under his guidance, Margaret modified her antidepressant regimen. When she explained that plan to her obstetrician, the doctor was skeptical; it is not unusual for an obstetrician, who is focused on the fetus, and a psychiatrist, who is focused on the mother, to reach different conclusions. I enjoyed every moment. Another mother I interviewed took S.
Margaret had felt guilt about being on medication during her second pregnancy, but now, she said, she felt guiltier about being off medication for the first one. Growing up in the shadow of two generations of family members having ended their own lives had made Margaret afraid that she might one day follow their example. She wants to protect her children from the presumption of suicide that has inflected her own episodes of mental illness.
- fearizuobufurawaborutuu (Japanese Edition)?
- Out With the Bad, In With the Good.
We know too little, and none of the options are uncomplicated. But understanding some of the complexities might help millions of women who confront this condition feel less alone and make more informed decisions. I was deeply moved by my conversations with the women whose experiences I drew on in this article, most of whom felt that their struggles had not been validated. They thought their despondent pregnancies were bizarre, outlying experiences. Some had been too ashamed to tell their husbands, their doctors, their mothers — and many of them spoke to me with evident pain when recalling what they had been through.
Free time with my partner was normally over dinner after which I could barely stay awake to watch one television show. Despite this, I think my academic experience was one of the better ones—my supervisors were not evil tyrants. They had high expectations of their students but were themselves under a lot of pressure to succeed, being young investigators. By the end of my studies, I seemed to be an accomplished student, having published well and graduating summa cum laude.
I felt guilty about everything. I felt like I was not performing high enough, not achieving better results, not working long enough. My self-worth was at an all-time low and that thirst for knowledge that motivated me to do my PhD was drying up. For two years during my PhD, I sought psychotherapy and was taking medication for depression. Numerous studies including one published by the Guardian , reported that two-thirds of academics suffer mental health problems which they believe are attributed to their work situation. In the months leading up to end of my PhD career, I began to feel overwhelmed with fear and anxiety.
Most students I knew in my position were searching for potential post-doc positions and were filled with excitement now that the light at the end of the tunnel was becoming brighter.
30 Best Self-Improvement Books for Those Battling Depression
I did not apply for any positions and my PhD ended and I was unemployed. I relocated to the UK and quickly realized that, for one, I am not the type of person that enjoyed all the spare time associated with being unemployed. I was climbing the walls and driving my husband crazy. I also knew that if I was going to wait for the world to give me a handout, I was going to be waiting an awfully long time. I had a PhD.
- The Link Between Alcohol Abuse and Depression?
- How to Overcome Depression: 5 Things You Can Do NOW to Make a Meaningful Impact.
- Tina (Universale economica) (Italian Edition).
- Seven Tips for Writers Living With Depression.
- Dafidi and Abdul: Beyond Friends.
No one felt sorry for me. Everyone expected me to be successful. The only things preventing me from succeeding were my own limiting beliefs and not any other external factor. After I defended my thesis, that moment arrived.