If you are pregnant and depressed, you might hesitate to get help for your depression because of the fear of what others might think of you, and concerns about the effects of any prescribed medication on your baby. However, you should not hesitate since the management of antenatal depression involves looking at:

1. What are the contributing factors
2. Gathering support for you
3. Counselling and other forms of psychological therapy
4. Only when the depression is severe will medication be recommended. And there are certain medications available that are safe for pregnant women and the baby.

The first trimester is often a difficult time with hormonal changes, morning sickness and tiredness. During this time, gathering assistance such as arranging for the family to help with the care of the older child or household chores will give you a much needed break and some rest. Therapy and counselling are often useful too, as they help you to talk about anything that stresses you and work through any difficult emotional conflicts.

In the second trimester, antidepressants may be used if the depression is considered moderately severe, and other methods have not worked to improve the mood. In the last few weeks of pregnancy, it is recommended that antidepressants be gradually tailed off. This is because some medications may cause withdrawal symptoms in the newborn baby.

If you suffer from a pre-existing depressive illness that is severe, and you require long-term use of antidepressants, after taking the risks into consideration, your doctor may recommend that you remain on the medication throughout your pregnancy. The minimal possible dose will be used and you will be kept under close supervision, in addition to receiving other treatment modalities appropriate for you.

Ref: U11