Posts Tagged ‘depression’

Feeling depressed when you breastfeed?

Monday, August 15th, 2016

Contemplative woman with babySome women experience feelings of depression during milk letdown and the beginning of breastfeeding. This experience is called Dysphoric Milk Ejection Reflex or D-MER and is caused by a drop in dopamine, a hormone that is released in the brain. Dopamine affects your mood, behavior, and the way you think and process information.

A mom with D-MER may experience a range of feelings such as sadness, depression, anxiety, irritability, anger or restlessness. Anything that causes a milk release, whether it is breastfeeding, manual milk expression, a breast pump, thinking about your baby or just having full breasts, can generate the negative feelings associated with D-MER.

D-MER is a reflex, which means the feelings cannot be controlled and symptoms can vary from mild to severe. Symptoms may decrease over a period of months or they may continue throughout the breastfeeding experience. D-MER is not the same as postpartum depression and is not associated with breastfeeding aversion, a severe lack of interest in breastfeeding.

D-MER is a newly diagnosed condition – receiving its name in 2008; more research needs to be done to learn about it. If you think you may be suffering from D-MER, speak with your health care provider. You can also visit Share Your Story, where you may connect with other moms, and perhaps start a conversation forum.

Help to bring postpartum depression out of the shadows

Friday, May 20th, 2016

Contemplative womanDid you know that 1 in 7 mothers experience postpartum depression but only 15% receive care? The March of Dimes is working to urge Congress to pass a bill that will bring postpartum depression out of the shadows to ensure that mothers get the proper mental health care they need. This very important legislation will make it easier for women to get the screening and treatment they need for postpartum depression.

Postpartum depression (PPD) is the most common health problem for new mothers. In fact, between 9-16% of moms experience PPD in the first year after the birth of their baby.

We’re not sure what causes PPD but it can happen to any woman after she’s given birth. It’s possible that PPD may be due to changing hormone levels after pregnancy. Also, PPD can happen any time after childbirth. But it most often starts within 1 to 3 weeks of having a baby.

While we don’t know the exact cause of PPD, we do know that there are some things that may make you more likely than other women to have PPD:

  • You’re younger than 20.
  • You’ve had PPD, major depression or other mood disorders in the past. You may have been treated for these conditions. Or you may have had signs of them, but never saw a health care provider for treatment.
  • You have a family history of depression. This means that one or more people in your family has had depression.
  • You’ve recently had stressful events in your life.

If you think you may have PPD, see a health care provider right away. PPD is a medical condition that needs treatment to get better. The vast majority (90%) of mothers with PPD can be treated successfully. But first, PPD needs to be diagnosed. Getting treatment early can help both you and your baby.

Please contact your members of Congress and ask them to support legislation to increase access to PPD screening and ensure all affected women get the treatment they need. Help us to help moms suffering in silence.

Antidepressant use and what it means for pregnant women

Tuesday, February 2nd, 2016

Doctor with womanMore than 15% of reproductive-aged women have filled a prescription for an antidepressant medication during the years 2008-2013 according to a new analysis released by the Centers for Disease Control and Prevention (CDC).

An antidepressant is a medication used to treat depression. Some commonly used antidepressants are sertraline (Zoloft), bupropion (Wellbutrin, Zyban), and citalopram (Celexa).

Why is this important?

There is conflicting evidence about the potential link between some antidepressants and certain birth defects.  Antidepressant medication use during pregnancy has been increasing in the U.S. Given that 50% of all pregnancies are unplanned, antidepressant use may  occur during the first weeks of pregnancy, a critical time for fetal development.

Further research on antidepressant safety during pregnancy is needed so that health care providers can advise women about the potential risks and benefits of using certain antidepressants before, during and between pregnancies.

What is being done?

The CDC’s initiative, Treating for Two: Safer Medication Use in Pregnancy, provides women and their health care providers with reliable and accessible information on common medication used during pregnancy. The CDC aims to expand and accelerate research on prescription antidepressant use during pregnancy so that women have up-to-date information and providers can make informed treatment decisions and prescribe the safest medications.

What can you do?

If you are thinking about pregnancy or are  pregnant, speak with your prenatal care provider about any medications you are taking.

If you’re taking an antidepressant and find out you’re pregnant, don’t stop taking the medicine without talking to your provider first. Not taking your medicine may be harmful to your baby, and it may make your depression come back.

Bottom line

Talk with all of your providers about the benefits and risks of taking an antidepressant during pregnancy and decide together on your treatment plan.

Antidepressant use and the risk of ASD

Friday, December 18th, 2015

medication bottlesA new study suggests that the use of antidepressants during pregnancy, specifically in the second and third trimesters, may increase the risk of autism spectrum disorder (ASD) in children.

While these findings help to add to our understanding of autism, it is important to recognize that this study does not prove that antidepressant use causes autism. It is difficult to determine whether the increased risk of ASD is the result of antidepressants or the result of the underlying depression.

Researchers looked at data from more than 145,000 births between 1998-2009. They found that when mothers took antidepressants during the second and third trimesters, the chance that the child would develop ASD was higher when compared to children whose mothers did not take antidepressants. Keep in mind that the overall risk of having a child with autism is 1%. This study suggests that the risk increases to 1.87% if a woman is taking certain antidepressants.

The increase was seen with a specific type of antidepressants called selective serotonin reuptake inhibitors (SSRIs). SSRIs are the most commonly prescribed antidepressant medicines and include medications like citalopram (Celexa®), escitalopram (Lexapro®), fluoxetine (Prozac®), paroxetine (Paxil®) and sertraline (Zoloft®).

There are a number of causes of ASD but we don’t know all of them. More research is needed. However, there are some factors that we know increase the chance of ASD:

  • Having pregnancy complications. Some research shows that there may be a link between ASD and pregnancy complications that lead to low birthweight, premature birth or cesarean birth.
  • Taking certain prescription medicines, like valproic acid or thalidomide, during pregnancy. Taking these medicines during pregnancy has been linked with a higher risk of having a child with ASD.
  • Having an older parent. Babies born to older parents are more likely to have ASD.
  • Having genes linked to ASD. Researchers are studying a number of genes that may be linked to ASD. Children who have a brother or sister with ASD are more likely to have ASD themselves.
  • Having a genetic or chromosomal condition. ASD happens more often in children who also have certain genetic or chromosomal conditions, like fragile X syndrome or tuberous sclerosis.

Important:  If you are pregnant or thinking about getting pregnant and are taking antidepressants, you should not stop taking them until you talk to your health care provider. Together you can look at the possible risks of these drugs on your baby as well as the risk of having your depression come back if you stop taking your medicine. Learn as much as you can about the medicines so you can make the best choice for you and your baby.

Have questions? Email us at AskUs@marchofdimes.org.

Postpartum depression

Friday, October 30th, 2015

contemplative woman facePostpartum depression (PPD) is the most common health problem for new mothers. For most women, having a baby brings joy and happiness but about 1 out of every 8 women experience postpartum depression. It is the most common complication for new moms. Recently actresses Hayden Panettierre and Drew Barrymore publicly discussed their struggles with PPD.

Postpartum depression is different than the baby blues. The baby blues are caused by the sudden change in hormones after childbirth. This leaves many women feeling sad or moody and is very common. The baby blues usually peak about 3-5 days after delivery. Postpartum depression is more severe and long-lasting. PPD is strong feelings of sadness that last for a long time. These feelings can sometimes make it difficult for you to care for your baby. PPD can happen any time after childbirth, although it usually starts during the first three months. PPD is not your fault. It is a medical condition and it requires medical treatment.

Causes of postpartum depression

We’re not sure what exactly causes PPD but it can happen to any woman after having a baby. We do know that certain risk factors increase your chances to have PPD:

  • You’re younger than 20.
  • You’ve had PPD, major depression or other mood disorders in the past.
  • You have a family history of depression.
  • You’ve recently had stressful events in your life.

Warning signs

You may have PPD if you have five or more of the signs below and they last longer than 2 weeks.

Changes in your feelings

  • Feeling depressed most of the day every day
  • Feeling shame, guilt or like a failure
  • Feeling panicky or scared a lot of the time
  • Having severe mood swings

Changes in your everyday life

  • Having little interest in things you normally like to do
  • Feeling tired all the time
  • Eating a lot more or a lot less than is normal for you

Gaining or losing weight

  • Having trouble sleeping or sleeping too much
  • Having trouble concentrating or making decisions
  • Changes in how you think about yourself or your baby
  • Having trouble bonding with your baby
  • Thinking about hurting yourself or your baby
  • Thinking about killing yourself

If you’re worried about hurting yourself or your baby, call emergency services at 911 right away.

Treatment

If you think you may have PPD, call your health care provider. Your provider may suggest certain treatments such as counseling, support groups, and medicines. Medicines to treat PPD include antidepressants and estrogen (estrogen is a hormone. Hormones are chemicals in your body).  If you’re taking medicine for PPD don’t stop without your provider’s OK. It’s important that you take all your medicine for as long as your provider prescribes it.

PPD is not your fault. It is a medical condition that can get better with treatment so it is very important to tell your doctor or another health care provider if you have any signs. The earlier you get treatment, the sooner you can feel better and start to enjoy being a mom.

Have questions? Text or email us at AskUs@marchofdimes.org.

Depression: symptoms and treatment options

Friday, October 9th, 2015

contemplative woman faceDepression is more than just feeling sad. It is a medical condition that affects your thoughts, feelings, and even causes changes to your body. You may have depression if you have any of these signs that last for more than 2 weeks:

Changes in your feelings 

  • Feeling sad, hopeless or overwhelmed
  • Feeling restless or moody
  • Crying a lot
  • Feeling worthless or guilty

Changes in your everyday life 

  • Eating more or less than you usually do
  • Having trouble remembering things, concentrating or making decisions
  • Not being able to sleep or sleeping too much
  • Withdrawing from friends and family
  • Losing interest in things you usually like to do

Changes in your body 

  • Having no energy and feeling tired all the time
  • Having headaches, stomach problems or other aches and pains that don’t go away

If you have any of these symptoms, talk to your health care provider.

Depression during pregnancy

If you’ve had depression before, you’re more likely than other women to experience depression during pregnancy. If left untreated, depression during pregnancy can affect your baby. If you’re pregnant and have depression that’s not treated, you’re more likely to have:

  • Premature birth (before 37 weeks of pregnancy).
  • A low-birthweight baby (a baby weighing less than 5 pounds, 8 ounces).
  • A baby who is more irritable, less active, less attentive and has fewer facial expressions than babies born to moms who don’t have depression during pregnancy.

It’s best if a team of providers treats your depression during pregnancy. These providers can work together to make sure you and your baby get the best care. They may include your prenatal care provider and a professional who treats your depression (such as a psychiatrist, psychologist, therapist, or counselor).

There are several treatment options available for depression during pregnancy including talk therapy, support groups and medicine, such as antidepressants.

Some research shows that taking an antidepressant during pregnancy may put your baby at risk for certain health conditions. But if you’ve been taking an antidepressant, it may be harmful to you to stop taking it. So talk with your provider about the benefits and risks of taking an antidepressant while you’re pregnant. Together you can then decide what you want your treatment to be. If you’re taking an antidepressant and find out you’re pregnant, don’t stop taking the medicine without talking to your provider first. Not taking your medicine may be harmful to your baby, and it may make your depression come back.

If you’re pregnant and you have any signs of depression, talk to your health care provider. There are things you and your provider can do to help you feel better.

Have questions? Text or email us at Askus@marchofdimes.org.

NICU parents can develop PTSD due to stress and trauma

Wednesday, October 7th, 2015

parents in the NICUParents of NICU babies have been found to be at risk for developing stress disorders, according to research. It is very scary for parents to see their infant hooked up to monitors or undergoing serious medical procedures. Every parent’s reaction to the NICU journey is different and what is overwhelming or traumatic for one person might not be for another. But for some parents, it is possible for feelings of fear, grief, helplessness and continued anxiety to result in a stress disorder.

What is a stress disorder?

Stress disorders include ASD (acute stress disorder) or PTSD (post traumatic stress disorder). These can develop in anyone who has seen or lived through a crisis or terrible event. You may have heard about PTSD in the news – many military veterans returning from active duty have developed it. The prolonged stress of deployment or the witnessing of traumatic events can trigger debilitating symptoms. But, PTSD can occur in anyone who has gone through a traumatizing event, including a NICU experience.

Every parent comes to the NICU with varying coping mechanisms, and react or handle the situation in their own, unique way. According to Stanford University researcher Dr. Richard Shaw, the NICU experience can be so traumatic that almost 60% of NICU parents were found to be at risk for PTSD. In some cases, the stress disorder continues for years after the baby’s birth.

It might seem logical that the longer a baby stays in the NICU, the more traumatic the experience may be for the parents. However, research shows that the impact of a shorter NICU stay, even less than two weeks, can lead to a parent developing ASD or PTSD. A stress disorder can occur along with postpartum depression (PPD), too.

How do ASD and PTSD differ?

ASD and PTSD share many of the same symptoms. The biggest difference between the two is when a parent’s symptoms begin.

  • ASD refers to symptoms that begin during the period from 2 days following an event up to 4 weeks post trauma. (The “trauma” in this case is the baby’s experiences in the NICU.) Symptoms usually start to occur while the baby is still in the NICU. ASD is a good indicator that the parent may later develop symptoms of PTSD.
  • PTSD symptoms occur later than ASD, starting from at least 4 weeks post trauma, and can last for years.

Both ASD and PTSD include symptoms such as trouble sleeping or staying awake, avoiding reminders of the event, and experiencing flashbacks, dreams/nightmares.

Additional symptoms of ASD include a lack of emotional responsiveness – you feel numb and like you’re in a fog.

Other symptoms of PTSD symptoms include physical responses (like a racing heartbeat or sweating) when reminded of the event, a depressed mood, persistent and exaggerated negative beliefs about yourself, little interest in activities, irritability, difficulty concentrating, hyper vigilance and startling easily.

What can lessen the likelihood of developing a stress disorder?

Researchers have found that NICU parents cope better when they:

  • feel involved with their baby’s care, such as reading to their baby, practicing kangaroo care (skin to skin bonding), decorating the isolette, taking the baby’s temperature, etc.
  • feel heard – they feel free to ask questions and fully understand what is happening to their baby in the NICU.
  • take care of themselves.
  • reach out and receive support from other NICU parent graduates who have been in their situation. March of Dimes offers an online community, Share Your Story, which is specifically designed to provide support and comfort to parents of babies in the NICU.
  • understand that the feelings of fear, anxiety, sleep interruption or loss of appetite might pop up unexpectedly once they go home.

Bottom line

The NICU experience can be difficult and even traumatizing. If you or someone you know has a baby in the NICU, please share this post with them so that they get the help they need. Parents suffering from ASD or PTSD can receive treatment from a healthcare provider who is trained in stress disorders (such as a social worker, psychologist or psychiatrist).

Have questions? Text or email them to AskUs@marchofdimes.org.

See other posts on how to help your child including how to transition from the NICU to Early Intervention services.

New study looks at link between antidepressants and birth defects

Friday, July 10th, 2015

pregnant woman with MDThe use of certain antidepressants during pregnancy is associated with a higher risk of birth defects, according to a new study. But other antidepressants do not carry the same risk.

The study looked at a specific group of antidepressants called selective serotonin reuptake inhibitors (SSRIs). SSRIs are medications used to treat depression and other mental health conditions. Previous studies gave conflicting evidence about potential links between the use of SSRIs during pregnancy and certain birth defects.

In this study, researchers from the CDC analyzed data from 17,952 mothers of infants with birth defects and 9,857 mothers of infants without birth defects, born between 1997 and 2009.

The researchers found that some birth defects occur about two or three times more frequently among babies born to women who took certain SSRI medications, like Prozac (fluoxetine) and Paxil (paroxetine) early in pregnancy. It is important to note that the actual risk for a birth defect among babies born to women taking Prozac or Paxil is still very low. For example, the risks for a specific heart defect could increase from 10 per 10,000 births to about 24 per 10,000 births among babies of women who are treated with Paxil early in pregnancy. Since these specific types of birth defects are rare, even doubling the risk still results in a low overall chance.

Researchers did not find a link between birth defects and other SSRIs such as Zoloft (sertraline).

“A pregnant woman should be reassured that she can choose a safe drug to treat her depression and not have to go off her medication because she is afraid her baby may develop a birth defect,” Dr. Edward McCabe, Chief Medical Officer of the March of Dimes said. “Not treating depression can be unhealthy for both the mom and her baby. It can cause stress, and stress during pregnancy is associated with early births and low-birthweight babies.”

If you are currently taking an antidepressant and are concerned, do not stop taking the medication until you talk to your health care provider. And if you are planning to become pregnant and are taking an antidepressant, schedule a preconception checkup and discuss what medications may be best for you.

Staying positive in the NICU

Wednesday, November 12th, 2014

Passing the time while your baby is in the NICUHaving a baby in the NICU is stressful. Very stressful. When a baby is born prematurely, the roller coaster ride of the NICU experience is emotionally, physically and mentally taxing for parents.

Premature birth is the birth of a baby before 37 weeks of pregnancy. One in 10 babies is born prematurely, or 15 million babies globally! Of these babies, one million will die. Babies who survive often have lifelong health problems such as cerebral palsy, vision and hearing loss, intellectual disabilities and learning problems. Just knowing these statistics provokes anxiety and worry in parents. If you are a parent with a baby in the NICU, observing the ups and downs of your baby’s progress day to day can be heart wrenching and particularly wearing.

Depression more common in the NICU

Studies have shown that “in the month after delivery, parents of preemies are significantly more depressed and anxious than parents of term babies,” according to Linden, Paroli and Doron MD in the book Preemies – The Essential Guide for Parents of Premature Babies, 2nd Edition. The authors report that “Besides depression and anxiety, they (parents) were more apt to feel hostile, guilty, and incompetent at parenting and to isolate themselves socially…An early delivery is itself so scary that even many parents of healthy preemies react with shock and anxiety.” Given the stress associated with seeing your baby in the hospital, and the ups and downs of slow progress – it is not hard to imagine that depression is seen more often in parents of preemies than in parents of children born at term.

Baby blues and postpartum depression

Many new mothers experience the “postpartum blues” or the “baby blues.” Baby blues are feelings of sadness you may have three to five days after having a baby. These feelings most likely are caused by all the hormones in your body right after pregnancy. You may feel sad or cranky, and you may cry a lot. By about 10 days after the baby’s birth, the baby blues should go away. If they don’t, tell your health care provider who will determine if you may have postpartum depression (PPD), which lasts longer and is more serious than baby blues.

Signs of PPD include feeling tired all the time, having no interest in your usual activities, gaining or losing weight, changing your eating habits, having trouble sleeping or concentrating, and thinking about suicide or death. If you have five or more of these signs and they last for two weeks or longer, you may have PPD. Sometimes mothers of preemies develop postpartum depression as a result of the severe stress and anxiety experienced by having a premature baby. Even fathers of preemies can become depressed.

What can help?

There are many ways to feel better. Treatments for depression may include all or some of the following: healthy eating, regular sleep and exercise, talking with friends, family or a professional counselor/therapist, lowering your stress by taking time to relax and avoiding alcohol. In addition, your health care provider may give you medication specifically designed to help with depression.

Talking to other parents who have gone through the NICU journey can be very helpful. The parents on the March of Dimes’ online community, Share Your Story, “talk” to one another and share their experiences. It is a comforting and supportive community, where all NICU families are welcomed.

When will you feel better?

The length of time a parent feels down, anxious or depressed can vary, and may depend on the health of your baby, and the length of NICU stay. But usually, parents of preemies begin to feel more balanced as their baby grows, and “by the end of the baby’s first year, their psychological distress, on average, has been found to be similar to those of mothers of term babies” according to the Preemies book. But, each baby and NICU stay is unique, so each parent’s journey to feeling better is unique.

Bottom line

Having a baby in the NICU is extraordinarily stressful and difficult. You need to take care of yourself in order to be able to take care of your baby. It is important to be aware of the signs or symptoms of depression and to speak with your health care provider if you have any concerns at all.

The sooner you seek help, the sooner you will feel better.

 

Note: This post is part of the weekly series Delays and disabilities – how to get help for your child. It was started in January 2013 and appears every Wednesday. While on News Moms Need, select “Help for your child” on the menu on the right side to view all of the blog posts to date. You can also view the Table of Contents of prior posts.

Feel free to ask questions. Send them to AskUs@marchofdimes.org.

Updated October 2015.

Depression during pregnancy: what you need to know

Tuesday, August 12th, 2014

sad woman with coffee mugDepression is a serious medical condition. It is an illness that involves the body, mood and thought. It affects the way a person feels about themselves and the way they think about their life. So many people were shocked and saddened by the news about Robin Williams. But unfortunately, depression is far more common than many of us realize. And regrettably, many people still feel that depression is a sign of weakness and do not recognize it as the biological illness that it is.

As many as 1 out of 5 women have symptoms of depression during pregnancy. For some women, these symptoms are severe. Women who have been depressed before they conceive are at a higher risk of experiencing depression during pregnancy than other women.

Signs of depression
Depression is more than just feeling sad or “blue.” There are physical signs as well. Other symptoms include:
• Trouble sleeping
• Sleeping too much
• Lack of interest
• Feelings of guilt
• Loss of energy
• Difficulty concentrating
• Changes in appetite
• Restlessness, agitation or slowed movement
• Thoughts or ideas about suicide

It may be hard to diagnose depression during pregnancy. Some of its symptoms are similar to those normally found in pregnancy. For instance, changes in appetite and trouble sleeping are common when you are pregnant. Other medical conditions have symptoms similar to those of depression. A woman who has anemia or a thyroid problem may lack energy but not be depressed. If you have any of the symptoms listed, talk to your health care provider.

Treatment options
Since depression is a serious medical condition, it poses risks for you and your baby. But a range of treatments are available. These include therapy, support groups and medications.

It is usually best to work with a team of health care professionals including:
• Your prenatal care provide
• A mental health professional, such as a social worker, psychotherapist or psychiatrist
• The provider who will take care of your baby after birth

Together, you and your medical team can decide what is best for you and your baby.

If you are on medication and thinking about getting pregnant, talk to your doctor. You will need to discuss whether you should keep taking the medication, change the medication, gradually reduce the dose or stop taking it altogether.

If you are taking an antidepressant and find that you are pregnant, do not stop taking your medication without first talking to your health care provider. Call him or her as soon as you discover that you are expecting. It may be unhealthy to stop taking an antidepressant suddenly.

If you or someone you know is experiencing any signs of depression, please talk to your health care provider or someone you trust. Help is available and you can feel better.

Click here to read more News Moms Need blog posts on: pregnancy, pre-pregnancy, infant and child care, help for your child with delays or disabilities, and other hot topics.