Depression is a very common disorder and is seen frequently during pregnancy and in the postpartum period. Feelings of depression such as loss of hope, interests, inability to concentrate and emotional instability should be discussed with your health care provider and considerations for treatment weighed. Any patient who feels she wants to harm herself or her baby should immediately contact her health care provider or report immediately to the emergency room. This can be treated.
It is appropriate to treat depression medically during pregnancy. As is the case with any medication, the risk of taking the medication must be weighed against the risk of not taking the medicine and the potential benefits. SSRIs are the class of drugs most often employed to treat depression and there is some controversy regarding their safety during pregnancy. Though they are thought to be associated with preterm birth, decreased birth weight, and neonatal syndrome, they have not been associated with major congenital defects or long term developmental deficits in childhood. There may be a small association with persistent pulmonary hypertension in the newborn. The absolute risk is very small and PPHN would be found in less than 1% of babies born to mothers taking SSRIs in the third trimester. Thus, the benefits of taking an SSRI during pregnancy will typically outweigh the risk. That being said, there are many options for treatment of depression and that treatment should be individualized.