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When pregnancy and depression happen at the same time

I found out I was pregnant with my third child on a warm August weekend. My two older children tapped on the bathroom door as I quickly peeked at the pregnancy test: Positive. I jumped up in excitement and swung open the bathroom door, scooping up my 2-year-old and 4-year-old in a loving and grateful hugI wanted another baby and had been trying for over a year. What I didn’t realize was that this moment would be the happiest I’d feel for the next nine months.

I expected morning sickness and exhaustion, I’d been to this rodeo twice already, but I didn’t expect to feel overwhelmingly sad, empty inside, restless at night, and even suicidal during particularly dark moments. By the time I was 10 weeks pregnant, I couldn’t hide how much I was struggling anymore—I went to the doctor and talked about all the ways I was feeling. I filled out a patient health questionnaire (PHQ) for depression and was told that I needed to take medication to protect both my life, and my unborn child’s. 

Are antidepressants safe during pregnancy?

“Won’t the medication hurt my baby?” I asked.

My doctor assured me that the medication he was prescribing, a low dosage of Zoloft, was safe for pregnant women and carried very low risks for the baby.

“The risk of not taking the medication is far more concerning at this time,” he said. 

Dr. Amanda Tinkelman, a psychiatrist at Brooklyn Minds says, “Up to 1 in 5 pregnant people will experience clinically significant depression or anxiety during pregnancy. Often the person may lose interest in things they used to enjoy, not be able to look forward to pleasurable things, be tearful very often, feel overwhelmed, have more difficulty coping with stressors, or even have thoughts of worthlessness or self harm.” It’s called perinatal depression, a collective term for the low moods beginning while a mother is expecting, and extending after birth.

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Would antidepressants hurt my child?

One of the biggest fears I had during my pregnancy was that taking antidepressants would lead to health consequences for my child. The few people who knew I took antidepressants were mostly supportive, but some family members shared their concerns with me, which only amped up my anxiety and nervousness.

Rebecca Levy-Gantt, an OB-GYN in Napa, California, says that physicians should take an individualized approach when determining whether a pregnant patient should be prescribed antidepressants.

“We need to look at the balance between taking a medication that may have a small possibility of effect on the baby, versus not taking anything and running the risk that depression or anxiety will get worse—sometimes to the point of suicide, or even just the inability to care for a new baby,” she says. 

Dr. Levy-Gantt also says that antidepressants in the SSRI class (selective serotonin reuptake inhibitors), like Zoloft and Prozac, or in the SNRI class, such as Effexor (selective serotonin and norepinephrine reuptake inhibitor), are the safest to take during pregnancy, which is also in line with what my own doctor told me.

Zoloft and pregnancy

I started taking Zoloft right away, and within a week I noticed a change in my mood. After a month, I was functioning like a typical pregnant woman: still tired, still a bit nauseous, but capable of getting up every morning and caring for my kids, doing a bit of work, and completing household chores—with a lot of support from my husband.

I went on to have a mostly uneventful pregnancy, and gave birth to a healthy baby girl a few days before her due date. I knew that taking antidepressants was the right choice for me because with my moods leveled, I was able to take on the responsibility of caring for my two older children, and when my daughter was born, I was able to be a fully present and loving mother to her, too. I continued taking antidepressants until my daughter turned 1, and I did not experience postpartum depression.

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It’s okay to need help

“Perinatal mood and anxiety disorders are the most common complication of childbearing,” Dr. Tinkelman says. “With stigma reducing, there is more acknowledgment and support available than ever before, albeit still not enough. While you might not feel like yourself, with treatment you can feel better.” 

While I wouldn’t wish my experience on anyone, it’s comforting to know that I wasn’t alone, and with treatment readily accessible and stigma reducing, I hope that others can also go on to have healthy and uneventful pregnancies like I did.