The debate rages on over the safety of psychotropic medications during pregnancy (NYT Health Blog, September 1). Those who oppose antidepressants can produce scores of articles and scattered studies illuminating the dangers and challenging the effectiveness of these medications. I think what we have here is a classic case of splitting. Medications are “all bad” or “all good” and some of us can only accept information that fits in with our view.
The truth is that there ARE incompetent psychiatrists and that psychotropic medications CAN be overprescribed and misprescribed, AND there are clients who benefit greatly from medication.
I am a believer in holistic medicine. I’ve tried acupuncture, chiropractic, homeopathy, cranio-sacral massage and herbs at times with good results. However, I would not have survived childhood without life-saving asthma treatment and I have never found a holistic remedy that cured my asthma. I think we can all agree that the body sometimes has flaws (Type 1 diabetes is a good example) where mainstream medical intervention is necessary to maintain health and life.
In my case, holistic treatments and psychotherapy did nothing to touch my severe postpartum panic disorder, which caused months of insomnia, dizziness and nausea, making me incapable of caring for my children or myself. I was hospitalized for major depression when I no longer had the will to live. Within six weeks on Paxil, I was functioning again and beginning to benefit from psychotherapy. I know that an SSRI saved my life and I know many other women that have had similar experiences.
Research is starting to show that there are genetic differences affecting many women who experience Perinatal Mood and Anxiety Disorders which cause some women to be oversensitive to the impact of changes in estrogen levels. My work with postpartum women has demonstrated to me that women with severe depression, anxiety and OCD that begins in the perinatal period often benefit from antidepressants, along with psychotherapy, improved self-care, good nutrition, sunshine and moderate exercise. Some mothers with mild to moderate symptoms choose not to take medication, and often they do recover with psychotherapy and improved social support and self-care, but sometimes they still end up taking medication later on and regretting the time they lost with their baby while they were too depressed or anxious to bond properly.
The reality is that some new mothers are unable to muster the energy and will to engage fully in therapy and cannot improve self-care adequately to recover from debilitating depression or anxiety without medication. The majority of those women in my experience (and the experience of my much more experienced colleagues at Postpartum Support International) do improve once they receive the right medication. That is a reality that supercedes intellectual debates about the benefits and risks of medication. Those mothers need balanced information and not scare tactics, shaming or political agendas. Their lives and the well-being of their babies depends upon it.
