Depression during pregnancy
Up to 20% of pregnant women are thought to be struggling with depression.1 If you have symptoms of depression during pregnancy or are depressed and learn you are pregnant, make a treatment plan with your health professional right away.
If you are being treated for depression and are planning a pregnancy, talk to your health professional ahead of time. You may be able to taper off of antidepressant medication before your pregnancy, to see how you feel during your first trimester. Ideally, it's best to be medication-free, especially during the first trimester. However, if you are severely depressed, your health professional will probably want you to stay on your medication.
Don't ever suddenly stop taking an antidepressant—this can cause difficult emotional and physical symptoms and may also affect your fetus. Your health professional can tell you the best way to taper off of your medication.
Depression treatment choices during pregnancy
If you are not severely depressed, interpersonal counseling or cognitive-behavioral therapy may be all that you need.
- Interpersonal counseling focuses on your relationship and life adjustments, giving you emotional support and help with problem-solving and goal-setting.
- Cognitive-behavioral therapy helps you take charge of the way you think and feel, while giving you a supportive relationship.
If counseling alone isn't enough, or if your symptoms are severe and disabling, talk to your doctor about other possible treatments:
- Light therapy uses regular doses of bright light (not full-spectrum light, which includes ultraviolet light). Typically, a person having light therapy will sit in front of a high-intensity (2,500- to 10,000-lux) fluorescent lamp, slowly building up to 1 to 2 hours each morning. One study has shown that light therapy can help pregnant women with depression, without severe side effects.2 (Possible side effects include eye strain, headache, feeling "wired," and trouble falling asleep when light therapy is used later in the day.)
- Antidepressant medication, most often a selective serotonin reuptake inhibitor (SSRI), such as fluoxetine (Prozac) or sertraline (Zoloft). Fluoxetine is not recommended during breast-feeding because it can pass into breast milk in high levels. It is also linked to side effects in some breast-feeding babies.3 If you are planning to breast-feed and are taking fluoxetine, talk about this with your doctor.
FDA Advisories. The U.S. Food and Drug Administration (FDA) has issued:
- A warning on the antidepressants Paxil and Paxil CR (paroxetine) and birth defects. One new study showed that women who took Paxil during their first 12 weeks of pregnancy had a slightly higher chance of having a baby with birth defects.
- An advisory on antidepressant medicines and the risk of suicide. The FDA does not recommend that people stop using these medicines. Instead, a person taking antidepressants should be watched for warning signs of suicide. This is especially important at the beginning of treatment or when the doses are changed.
Additional measures you can take against depression
Whether you use counseling, medication, light therapy, or a combination, be sure to also get regular exercise, healthy food, fresh air, and time with people who care about you. These are all important parts of preventing and treating depression and having a healthy pregnancy.
For information about depression after childbirth, see the topic Postpartum Depression.
- Koren G (2004). Discontinuation syndrome following late pregnancy exposure to antidepressants. Archives of Pediatrics and Adolescent Medicine, 158(4): 307–308.
- Lam RW, Levitt AJ (1999). Canadian Consensus Guidelines for the Treatment of Seasonal Affective Disorder: A Summary of the Report of the Canadian Consensus Group on SAD. Vancouver, BC: Clinical and Academic Publishers.
- Weissman AM, et al. (2004). Pooled analysis of antidepressant levels in lactating mothers, breast milk, and nursing infants. American Journal of Psychiatry, 161: 1066–1078.
Last Updated: June 24, 2008