- November 18, 2013

Science Daily/Wolters Kluwer Health: Lippincott Williams & Wilkins

Women with depression in the perinatal period experience a high degree of conflict in deciding whether and how to treat their depression, but strongly prefer treatments other than antidepressant medications, reports a study.

Women with perinatal depression were younger, had lower socioeconomic status, and were more likely to be single than nondepressed participants. Depressed women also had increased levels of anxiety and greater impairment in marital/family relationships -- underscoring the need for treatment.

Although about 70 percent of the depressed women received some form of depression treatment during pregnancy, they often reported conflictual feelings concerning depression treatment decisions during pregnancy. Indeed, one-third experienced a high degree of uncertainty and confusion. Women who were more uncertain about their treatment decisions had higher levels of depression, and were less likely to engage in treatment.

Strong Concerns About Antidepressant Drugs during Pregnancy

Some depressed women expressed positive feelings about treatment. However, as in previous studies, women were more likely to prefer non-drug treatments for depression, such as psychotherapy and alternative therapies.

Many women said they would consider using antidepressant medications during pregnancy only as a "last resort." Concerns included fear of possible adverse effects on the developing baby, including withdrawal symptoms, premature delivery, and childhood learning problems; feelings of shame, guilt, and confusion about using antidepressants during pregnancy; and the potential for the infant becoming dependent on these medications.

All of the women in the study -- regardless of depression status -- were asked about their preferences for treatment if they were to experience an episode of postpartum depression. Most said that they would prefer some form of psychotherapy over medication, expressing concerns about possible effects of antidepressant exposure through breast milk. Again, the women strongly preferred alternative treatments.

Given women's concerns about using antidepressants, it's important to increase awareness regarding effective non-drug treatments for depression during pregnancy, Dr Battle and coauthors believe. They call for further studies of all possible options for treatment of perinatal depression, including medications, specific forms of psychotherapy, and alternative treatments such as yoga, exercise, and light therapy.

http://www.sciencedaily.com/releases/2013/11/131118091416.htm