TMS is an alternative treatment to medication for Pregnancy Depression

Perhaps another reason to consider transcranial magnetic stimulation, or TMS, therapy for depression in pregnancy, which treats maternal depression but avoids systemic fetal drug exposure:

“Untreated maternal depression was associated with slower rates of fetal body and head growth. Pregnant mothers treated with SSRIs had fewer depressive symptoms and their fetuses had no delay in body growth but had delayed head growth and were at increased risk for preterm birth. Further research on the implications of these findings is needed.”

– Conclusion from Maternal Use of Selective Serotonin Reuptake Inhibitors, Fetal Growth, and Risk of Adverse Birth Outcomes [Original Article] by El Marroun, H., Jaddoe, V. W. V., Hudziak, J. J., Roza, S. J., Steegers, E. A. P., Hofman, A., Verhulst, F. C., White, T. J. H., Stricker, B. H. C., Tiemeier, H.   Published online March 5, 2012. Arch Gen Psychiatry. doi:10.1001/archgenpsychiatry.2011.233.

If you found this post interesting, take a look on another recent post on pregnancy and depression.

Pregnancy Anxiety and How It Affects Women

Having some anxiety during pregnancy is part of the experience. For many women, pregnancy is something they have looked forward to for their entire lives, and there are always uncertainties that may cause a degree of nervousness. When this nervousness becomes pervasive, however, it could be a sign of a more serious issue, such as pregnancy anxiety.

Basis for pregnancy anxiety

There is a biological basis for a good portion of the stress and anxiety that occur during pregnancy. This is primarily due to the hormonal changes that happen as the body prepares itself for pregnancy and birth. In recent years, there has been quite a bit of research done on cortisol, which is associated with stress and pregnancy anxiety. It is normal for cortisol levels to go up some during pregnancy, but excessive elevations could be related to complications.

The key to successfully dealing with pregnancy anxiety is to recognize that it is normal and that it can be managed.

Managing pregnancy anxiety

There are a number of things you can do to better manage pregnancy anxiety, including:

• Communication: The most important tool to managing pregnancy anxiety is to communicate. You’ll need support to get through it, and that support will likely come from family and friends.

• Lighten your load: Many women who are very active prior to being pregnant have trouble adjusting to the limitations that pregnancy often includes. Now is a good time to get rid of the notion that you can do it all. Some simple ways to do this are cutting back on chores or using sick days or vacation time when feeling overloaded or ill. Spending a day”or even an afternoon”resting and/or relaxing can make a big difference in avoiding pregnancy anxiety.

• Focus on health/exercise: Making choices for two can serve as the motivation to make some of those lifestyle changes you have been considering. One of the easiest ways to lessen the effects of pregnancy anxiety are relatively simple changes such as eating a balanced and healthy diet, drinking enough water, getting quality sleep and exercising.

• Limit “information overload”: It is good to be prepared, but everybody seems to have a slightly different opinion about pregnancy, and the amount of information can be overwhelming. Try to find a routine that works for you and stick with that. It’s more important to focus on how you’re feeling and what’s happening to you now. This will aid in preventing pregnancy anxiety.

• Medication: If the anxiety is severe enough or if there is a history of anxiety or depression, it may become necessary to treat pregnancy anxiety with prescription medications. Obviously, this is a discussion to be had with a doctor, but after years of research there is more evidence about these drugs and their effects on the developing fetus. There is a lot to consider when using drugs to ease pregnancy anxiety.

If you feel that you may be experiencing pregnancy anxiety or maternal depression, West Coast TMS Institute in Sherman Oaks, Los Angeles, is available to help you. Contact us at 818-855-1694 if you feel you may be experiencing pregnancy anxiety or depression, and would like to set up a psychiatric consultation.

If you found this post on pregnancy anxiety interesting check out our other posts on behavioral health including one on mood disorders.

Leading Causes of Pregnancy Stress

Pregnancy is equal parts joy and nervous expectation. The rapid changes in hormone levels during the different stages of pregnancy prepare the body to assist in developing the fetus and also affects an expectant mothers mood and ability to deal with lifes everyday stressors. For some, nervous expectation gives way to excessive stress and anxiety, which can be harmful to the health of both the mother and the unborn baby.

An understanding of the causes of pregnancy stress will help in identifying the symptoms of pre-partum stress and anxiety, and allow for early treatment.

Common factors in pregnancy stress

One of the most common causes of pregnancy stress is the fear of an unsuccessful pregnancy.  Some of the risk factors that can contribute to this are advanced age (in these terms, this is defined as older than 35 years) and/or a history of pregnancy complications, including a previous miscarriage or prior problems with getting pregnant.

Another cause of pregnancy stress is being unprepared for the physical demands of pregnancy. Expectant mothers will need to sleep more. Dietary needs generally change, which requires additional time for both planning and preparation. Morning sickness, as well as fatigue, are common side effects of pregnancy and should not be overlooked.

Related to being unprepared is the idea of trying to do too much during pregnancy. Taking a realistic look at ones obligations”whether they are work, family, home or social responsibilities may lead an expectant mother to reduce her activity level. In an age where stories of women working right up to birth or running marathons at 8-9 months are somewhat common, it is easy to get caught up in trying to maintain pre-pregnancy activity levels. This is rarely the best choice for the health of mother and baby, and is a leading cause of pregnancy stress.

Relationship difficulties with family members can also be a significant source of pregnancy stress. Abuse at home or the break-up of a relationship with the father are obviously large sources of pregnancy stress. Death or hardship to other family members can have a dramatic effect on a pregnant mothers state of mind, as well.

Finally, having a personal or family history of depression can be a source of pregnancy stress. Studies have shown that women are more likely to have problems with pregnancy anxiety and depression if there is a family history of these conditions.

Making it through pregnancy stress

It is impossible to go through having a baby without some degree of pregnancy stress or anxiety. It is essential, however, that expecting mothers try to maintain a thoughtful and balanced outlook during this time, as excessive stress and worrying can have real physical consequences.

In recent years there has been a lot of research identifying the role of cortisol, a hormone that is associated with stress. It is normal for cortisol levels to increase some during pregnancy, but excessive elevations could be related to miscarriage. Regular communication with the treating physician, as well as the friends and family that make up an expectant mother’s support network is a key factor to managing anxiety and identifying pregnancy stress before it becomes a health issue for both mother and baby.

Pregnancy stress can take a significant toll on a woman, and can lead to serious issues postpartum, such as depression or an anxiety disorder.   If you are concerned by anxiety or depressive symptoms during pregnancy, consider contacting West Coast TMS Institute in Sherman Oaks, California for a comprehensive psychiatric evaluation.  After reading this post on the causes of pregnancy stress, learn more about women’s mental health issues by reading our post on pregnancy anxiety.

Depression During Pregnancy Can be Treated

Are you Depressed and Pregnant? There’s Likely a Medical Reason

Pregnancy is often regarded as one of the happiest times in a woman’s life. In fact, many years ago it was believed that the hormones associated with pregnancy actually protected a woman from the effects of depression.

It is now known that pregnancy is not protective against depression.  Studies estimate that up to 20 percent of pregnant women will experience some depressive symptoms during their pregnancies, while about 10 percent develop clinical depression requiring medical intervention.

Possible complications of  being depressed and pregnant

One of the most anxiety-inducing aspects of being depressed and pregnant is that it not only causes the mother to suffer, but can also pose health risks to the baby. Women who are depressed and pregnant often lack the energy or motivation to seek proper treatment or maintain regular prenatal care. Also, depressed and pregnant mothers are more at risk of turning to alcohol, cigarettes or drug use, all of which have been linked to negative effects on the developing fetus.  They are more likely to experience preterm birth.

The greater the severity of depressive symptoms, the greater the likelihood of early delivery. It is also important to keep in mind that the biggest risk factor for prenatal depression is a previous history of depression. Above all, we must remember that depression is a medical condition, and is not a normal condition of pregnancy.

Causes, risk factors and treatments for being depressed and pregnant

Depression is linked to a change in the activity of various areas of the brain, as well as the levels of certain chemicals in the brain called neurotransmitters, which control your mood.

In addition to these physiological roots of depression in pregnancy, other factors that increase the risk for depression in pregnancy include:

• Personal or family history of depression
• A high degree of pregnancy stress
• Age at the time of pregnancy (teenage mothers are at a higher risk)
• Pregnancy complications, including a previous miscarriage or pregnancy loss
• Relationship difficulties with family members
• History of emotional, physical or sexual abuse

For mothers who are depressed and pregnant, it is critically important to know that there is hope. It may come down to simple lifestyle changes, including reducing stress, eating well, drinking enough of water, getting quality sleep and exercising. Guidelines published by the Department of Health and Human Services recommend at least 150 minutes of moderate activity per week for both pregnant women and those who have recently delivered.Nevertheless, pregnant women should be careful not to overheat, as it can be problematic for the fetus.

Treatment options for depression during pregnancy include: psychotherapy (particularly,  cognitive behavioral therapy and  in some cases couples therapy), antidepressant medications, transcranial magnetic stimulation (TMS), and in severe cases electroconvulsive therapy (ECT). Although antidepressants pose some risks to fetal well-being, these risks should be weighed against worsening of maternal depression which also poses a risk to fetal well-being.

The most important thing to remember is that an expectant mother need not feel guilty about getting psychiatric help for depression.  Depression is a behavioral manifestation of a very real medical condition, and not a character weakness.

West Coast TMS Institute is a center located in the Sherman Oaks, Los Angeles area that provides complete psychiatric evaluations to fully assess diagnostic and treatment options, including TMS, or transcranial magnetic stimulation, for depression. We make every effort to provide clients and their referring primary providers with objective, expert advice on all appropriate approaches to treatment.

Take a look at our recent post on pregnancy stress if you found our blog Depressed and Pregnant useful and are interested in other aspects of women’s emotional health.

There are many treatment choices for prenatal depression

Prenatal Depression:

What Is It and How Can It Be Treated

Prenatal depression is something that strikes millions of women around the world, and as many as 23% of women who conceive suffer from this type of clinical depression. Whether they enter pregnancy already depressed or they develop prenatal depression, the consequences of pregnancy-related depression can be serious. Not only can the internal functioning of a woman’s body be affected by pregnancy depression, but if the depression continues untreated, the condition of the fetus itself can be negatively affected by prenatal depression.

Women who suffer from prenatal depression tend to have inadequate self-care, difficulties with eating appropriately, and problems gaining enough weight for the wellbeing of the pregnancy.  They often have more than usual pregnancy-related difficulties sleeping, and can be irritable, anxious, and overwhelmed.  Prenatal depression is linked to preterm labor and low birth weight of babies, increased risk of delayed child development and neurobehavioral problems. Women that suffer from prenatal depression often experience postpartum depression as well, which can be the most serious depression a woman can have, at a time when she is most needed by the baby and her family.

Fortunately, there is hope for those suffering from pregnancy related depression, or prenatal depression, with many different treatment choices.

Treatment for Prenatal Depression

Psychotherapy.

There are many treatments that women suffering from prenatal depression can opt for, and psychotherapy is the simplest form of treatment for mild to moderate prenatal depression. These treatments include psychodynamic psychotherapy, interpersonal psychotherapy, supportive psychotherapy, and cognitive behavioral therapy, among others.  Psychotherapy has proven to be effective in helping some women combat their pregnancy depression, but antidepressant medication is often required to handle the more serious forms of prenatal depression or depression that is incompletely responsive to psychotherapy.

Antidepressant Medications.

There are a number of antidepressant medications that can help women counteract their prenatal depression. These include SSRIs, or selective serotonin reuptake inhibitors, and older TCAs, or tricyclic antidepressants.  Lately, over the past several years, however, a growing number of inconsistent studies suggest that the use of medications, especially selective serotonin reuptake inhibitors (SSRI), for pregnancy depression may be riskier than once believed.

Electroconvulsive Therapy (ECT)

While electroconvulsive therapy (ECT) can be used in extreme circumstances to treat severe prenatal depression, and can be quite effective, it does involve the use of electric stimuli to intentionally induce a seizure, which necessitates anesthesia and can cause headaches and memory loss; The memory loss is usually temporary, but sometimes is not.   If it is medically necessary, the benefits of ECT can exceed the risks in severe prenatal depression, when a psychiatrist oversees the ECT, an anesthesiologist carefully supervises the procedure, and when a highly trained obstetrician closely monitors uterine contractions and other parameters during the procedure.  Close external fetal monitoring after the procedure is also important.

Transcranial Magnetic Stimulation – A Novel, Non-Invasive, Non-Drug, FDA-Approved Treatment for Depression

TMS, or transcranial magnetic stimulation, is a breakthrough in the medical and clinical world for the treatment of depression; it is also a viable alternative for the treatment of prenatal depression, or pregnancy depression, because it does not expose the baby or the mother to medications or ionized radiation.  The innovative treatment utilizes a magnetic pulse to stimulate very small parts of the brain that are associated with mood, and the treatment doesn’t call for either medication, anesthesia, or invasive surgery.  Patients remain awake during this office-based procedure.  TMS alone, without medication, can be used for women suffering from pregnancy depression, though for women who have partially responded to an antidepressant, and who continue to have significant symptoms, adding TMS to the medication may be the most prudent next step.

Options Exist for Prenatal depression

The good news is that many treatment options are available for prenatal depression, including psychotherapy, medication, ECT, and now TMS.  Each patient should be individually evaluated by a trained psychiatrist who is able to carefully weigh the risks verses the benefits of each treatment option and provide the most appropriate recommendation for each patient suffering from prenatal depression, or clinical depression during pregnancy.

Important To Treat Prenatal Depression

It is important for women to seek help when dealing with suspected prenatal depression, and doctors and psychiatrists should keep a close eye on pregnant women to determine if they are developing depression. Treating the depression before it develops into something serious is imperative to promote a healthy pregnancy.

Seek professional care if you are suffering from depression during pregnancy;  there are many treatment options available to you.  The risk of a potentially serious postpartum depression and other emotional disorders increases when prenatal depression is left untreated.

If you found this post on prenatal depression interesting, you or a friend of yours may be interested in Depressed and Pregnant .