Women who come into my office seeking help with feelings of postpartum depression or anxiety usually feel they are at their wits end. Their symptoms are so intrusive in their lives that they know they need help. One of the biggest questions I hear is whether trying a medication is the right thing to do. They wonder whether an antidepressant would be detrimental to their unborn or nursing child. Many also have fears around taking medications, wondering whether their symptoms are really that bad enough as well as the short and long-term ramifications of doing so.
Trying a medication is a very personal decision so I want to educate you on how to make the decision. I’ll be referring to the term medications throughout this article but what I’m really referring to is psychotropic medications, those medications that are specifically used to treat mental health.
You’ll know it’s time to consider trying a medication if you have symptoms such as crying, lack of motivation, loss of interest, disconnection from baby, irritability, panic, intense feelings of anxiety and other overwhelming emotions or even suicidal ideation. We all go through times of intense emotions but they usually resolve within a few hours and we can return to our normal functioning. If your symptoms seem to stick around too long, happen too often or don’t seem normal for you, consult your doctor, whether that’s your primary doctor, your midwife or OB/GYN or even a psychiatrist to ask about medication and/or supportive counseling.
A few things to know about medications. Many medications have side effects and not all classes of medications work in the same way. Therefore, finding the right fit for you, the one that is going to address your symptoms properly, is going to be trial and error. Some medications don’t work well for some people and each one has its own mechanism for treating the brain. What works for you will depend on multiple factors such as your personal history, family history, your gender, weight and severity and type of symptoms.
A few things to know about what type of doctor to consult. There benefits of considering a psychiatrist over a primary doctor or OB/GYN and vice versa. A primary doctor or OB/GYN may know you better. They may have more history with you, know your sensitivities and you might feel more comfortable with them. You may be already seeing your OB/GYN or another doctor so it’s a natural fit and easier than going to a psychiatrist. However, not all OB/GYN and primary care doctors have the same knowledge. Some chose to get continuing education which gives them more expertise, however, most don’t specialize in those psychotropic medications we’ve been discussing. A psychiatrist is a specialist in mental health issues, and sometimes it’s best to see a specialist. I wouldn’t go to my primary doctor to deliver my baby and wouldn’t go to my OB/GYN for a skin issue. While it can be scary to think of seeing a psychiatrist, they do have the most knowledge about how to treat mental health issues.
Should you just try therapy alone without taking medication? Many of my clients try that approach and it can be very effective. Therapy is most effective when clients learn to manage the symptoms and use the tactics the therapist is giving them. However, if the symptoms aren’t resolving with best efforts on your part or if therapy doesn’t seem to be working well enough or fast enough, sometimes mediation can allow symptoms to lessen enough, enabling you to cope better.
I want to leave you with this: There is no wrong decision. You are deciding only for this season in your life and while that decision may be different in the future, you’re making the best decision you can and it won’t be the wrong one. Make sure you are asking for guidance by asking a therapist or a doctor.
Here are some trusted sources you can consider whether taking medication is right for you and if it’s safe during pregnancy and breastfeeding:
Massachusetts General Hospital www.womensmentalhealth.org
Jennifer Estrada is a Licensed Psychotherapist who helps women find their joy again, whether in motherhood or after a traumatic experience. She enjoys helping women heal from their past and find hope for their future. She practices in Palm Springs and can be reached at