Mood Disorders While Pregnant

By Meghan Bailey on Oct 29, 2014

An estimated half a million pregnancies every year involve a woman experiencing a mood disorder. We sat down with Dr. Eric Smith, a licensed psychologist, and a board certified OB-GYN, Dr. Jocelyn Ivie, to find out what’s normal, what can be done and who this happens to.

Meghan Bailey – On average, how many patients do you see with a mood disorder?

Dr. Ivie – Every day. The majority of my patients experience depression, anxiety, and grief.

MB – Many people tell women that when they are pregnant hormones are released to protect them from a mood disorder; They receive a period of emotional well-being while they’re pregnant, is this true?

Dr. Ivie – Although some women are blessed with “the perfect pregnancy,” the majority of women have symptoms during pregnancy that include irritability and depressed mood, weight, sleep and appetite changes.

Dr. Smith – That is why it is essential to seek additional care when a woman experiences a serious mood disorder during or prior to her pregnancy.

MB – Is it safe for women who find out they are pregnant to stop medications used to stabilize a mood disorder?

Dr. Smith – It depends on what her diagnosis is, and if the medication is safe for her to stop taking. It is essential for her to call the doctor who prescribed the medications, as well as her OB-GYN.

MB – Pregnancy comes naturally with an influx of hormones, has this ever prompted a woman who has never had a mood disorder to develop one?
“70% of pregnant women have some symptoms of a mood disorder.”

Dr. Ivie – Around 70% of pregnant women have some symptoms of a mood disorder, but only about 10-15% of pregnant women will meet the full criteria for a diagnosis. Women who are taking their medication suffer significantly fewer relapses during pregnancy than women who discontinue their medications.

Dr. Smith – This is a big life change so it can be normal to have depression or anxiety. It doesn’t make a woman a bad mom, in fact, seeking help is a great indicator that she is willing to do anything to keep herself and her baby safe.

MB – What do you look for during your patients’ prenatal appointments that could signal they could be experiencing a mood disorder?

Dr. Ivie – I keep notes throughout the pregnancy on their mood and any evidence of fatigue. Many patients can deal with the symptoms of pregnancy and look forward to the delivery date with anticipation. Lack of interest in the pregnancy and depressed and anxious moods are always triggers to discuss coping skills. Looking out for their support system is critical. If the patient comes to their visits alone every time, I start asking them who is there for them. It comes down to taking the time to notice their behaviors during their prenatal appointments.

MB – What are some effects that a prescribed mood disorder drug has during pregnancy?

Dr. Smith – It all depends on the medication the patient is taking. We will continue to stress how important it is to connect with both doctors. Be open with whoever is scheduling your appointment, tell them you take medication for a mood or mental disorder and ask for an appointment with your OB as soon as possible.

MB – Does an Obstetrician and a Behavioral Health Provider work together to decide on the best course of action, or is this
left to one or the other?

Dr. Ivie – While an Obstetrician is trained to identify the most common mood disorders and can initiate treatment, having the expertise of a Behavioral Health provider is always considered.

Dr. Smith – In the U.S., anxiety disorders (including panic disorder, obsessive-compulsive, post- traumatic stress) occur in the about
18% of the population, depression 17%, bipolar disorder (aka manic-depression) in 5%, and less frequently schizophrenia (1%). Having an OB patient see a mental health doctor allows them much needed time to focus and speak about their disorder. When the obstetrician and the behavioral health specialist work in concert, this ultimately is the best for the patient.

Dr. Ivie – And if the patient is considering becoming pregnant and they are currently taking medication it is important for mother and future baby to have a pre-conception counseling session with their doctor(s).