Need advice for a friend

[4midablemama]

She's actually a friend of my cousins'...around three months pregnant, seriously depressed, cries constantly. The doctors are telling her to take Zoloft, but she's terrified to because of the effects it can have on the baby. Are there any btdt moms here who can recommend any natural/herbal remedies that might help this woman? If this is the wrong place for this post, I have no objections to having it moved. TIA, ladies!!

[LilyTiger]

I had serious depression in college, and while I did go on Zoloft for a while, I eventually went off it.  I was fine for a while and then had a backslide.  At that time I spoke with my dad who is a clinical psychologist and told him I REALLY did not want to go back on antidepressants.  He recommended my eating half a can of red salmon 2x per day along with brown rice.  Also, increasing exercise and access to sunlight.  In less than two weeks, my symptoms were totally under control. 

Your friend probably can't do as much salmon as that, but she can take extra fish oil and do salmon maybe every other day.   Exercise is really really important for fighting depression.  Studies have shown it is as or more effective than anti-depressants.  See if she can start with brisk walks and then ramp it up a little bit. Contrary to popular belief, starting an exercise regimen during pregnancy is actually not a problem.

Finally, see if she can get a light box if access to sunlight is not possible (which it's not in my region this time of year). 

[BroodyWoodsgal]

I have to second everything the mama above me said....this girl needs to see someone she can talk with and start a diet and exercise habit the is supportive of getting depression under control.

My understanding, which could be limited, is that Zoloft is super, duper not safe during pregnancy. That's just what my doctor said to me, once upon a time...but he is SUPER crunchy and WAY  into diet and supplements before medications.

I would never take it during pregnancy, especially during early pregnancy, for the fact that the whole point of the drug is to enter your brain like a ninja and tinker with things. People say that SSRIs are safer because they are "more straight forward"....but the way I see it, we don't know a LOT about exactly what we're doing to brains when we meddle with how things are balanced, reuptake of serotonin, etc...and the VERY last time in my life, where I would feel comfortable putting something that meddles with the brain into my body, would be while I was GROWING A PERSON with a brain, that is trying to form and program itself for doing all of these things that we need it to do. What traces amounts of this junk are going to pass through the placenta? How is the forming brain going to be impacted, by the presence of a drug that is meant to tamper with brain function? I don't have the answers to these questions...and that is enough for me to know that it's not for ME while growing a human, who has to live with the consequences of my actions while pregnant, for the rest of his/her life.

I'm not unsympathetic at all. Depression runs in my family and is something I dealt with for many, many years. I understand that darkness and I can relate to being willing to do anything....but until I tried absolutely EVERYTHING else, I could never make that choice. Too many unknowns, too much hanging in the balance.

Zoloft(sertraline) is a Category C drug, during pregnancy....for more on what that means: http://en.wikipedia.org/wiki/Pregnancy_category

Something I found on the web:

The results of a cohort study indicate that 30% of neonates who had prolonged exposure to SSRIs in utero experience symptoms, in a dose- response manner, of a neonatal abstinence syndrome (e.g., tremor, gastrointestinal or sleep disturbances, hypertonicity, high- pitched cry) after birth. The authors suggest that infants exposed to SSRIs should be closely monitored for a minimum of 48 hours after birth. The effect of sertraline on labor and delivery in humans is unknown.

Sertraline has been assigned to pregnancy category C by the FDA. Animal studies have failed to reveal evidence of teratogenicity, but have revealed decreased pup survival related to in utero sertraline exposure in doses up to 4 times the maximum human recommended dose. There are no controlled data in human pregnancy. Neonates exposed to sertraline late in the third trimester have developed complications requiring prolonged hospitalization, respiratory support, and tube feeding. Complications can arise immediately upon delivery. Reported clinical findings have included respiratory distress, cyanosis, apnea, seizures, temperature instability, feeding difficulty, vomiting, hypoglycemia, hypotonia, hypertonia, hyperreflexia, tremor, jitteriness, irritability, and constant crying. These symptoms are consistent with either a direct toxic effect of SSRIs, a drug discontinuation syndrome, or possible serotonin syndrome. Infants exposed to SSRIs in late pregnancy may have an increased risk for persistent pulmonary hypertension of the newborn (PPHN). This condition has been associated with substantial neonatal morbidity and mortality. It has not been determined if all SSRIs pose a similar level of PPHN risk. Sertraline is only recommended for use during pregnancy when benefit outweighs risk.

[NicoleT]

She may need a complete evaluation from a qualified healthcare practitioner to find out and address the root cause of the upset or depression.  I recommend flower essences to my clients.  They are highly effective, non-toxic herbal preparations that address core issues of emotional upsets, such as depression, fear, worry, anger, resentment, insecurity, disempowerment, and so on. The essences are used internally or topically to balance everyone, including maternity and pediatrics, emotional health.  She may find this option supportive.  Consult with a certified flower essence practitioner for proper usage.

All best,

Nicole

[LilyTiger]

As an addendum to my last post and the other great responses, she really does need to see a mental health specialist who can help her sort of where these feelings are coming from.  If it's a hormonal imbalance, exercise and diet can work wonders.  But if she's in an unsafe environment or doesn't have the financial and emotional support of family, for example, she really needs to work with someone who can help her improve her situation before her mental state improves.  Definitely start with diet and exercise, but she needs to see a professional ASAP.  If she doesn't like the first counselor/psychologist she sees, try again.  It takes a little while to form a connection with someone, but it's really important that she do so.

Good luck to her!

[Monkey's Mum]

1000 mg (1 g) of  omega 3 fatty acids / day is recommended by my midwives for depression. (fish, walnut, flaxseed oil) as well as b-complex vitamins. There is some good information on fighting depression without meds in the PPD section of this forum. 

[BabyFireFly]

Since I have no idea of her mental or physical health history, I am not going to even try to "prescribe" anything herbal or homeopathic over the internet....that should come directly from someone who knows this woman's complete history and is dealing with her on a one to one basis.

However, Zoloft is a BIG no no....good rule of thumb, if there are lawyer commercials on TV that say "if you were pregnant, and were prescribed XYZ, and your baby was born with this or that defect....call us"....it's a bad idea.

If the lady in question is "terrified" of the advice given to her by her current health providers, then my suggestion for her is to seek alternative care. Personally, I knew after my first OB/GYN visit with my first child, I was terrified, actually horrified at the information I was given. I knew at that point that they were not the kind of providers I needed. Instead I turned to a midwife...who didn't just put me in a paper gown and sit me on a table, talk to me with a checklist in hand for 5 minutes and send me on my way.

I was ridiculously upbeat during my first pregnancy....I mean, I was sweet as pie. Things couldn't have been better....but, then I got pregnant again, and I turned into the troll under the bridge. I was depressed, I sobbed over everything and anything, I was a terror to be around and I started to hate myself. Luckily, I had my midwife. I could call her anytime, go to her house whenever I needed to....and just talk. That's really all I needed. During those long talks she would go over all sorts of herbal, homeopathic, nutritional and meditative things for me to try. Some worked, some didn't....but at no time did I ever feel worried about the health and safety of my unborn child or myself.

So, that's the best advice I can give. Have her seek out help from a professional who is "on her level." When it comes to depression, you need a good support system, not some white coat with a prescription pad.

[csekywithlove]

http://www.zoloftlawsuitbirthdefects.com/

The link above is for the lawsuit that Zoloft is up against right now. Birth defects such as heart, cranial, abdominal birth defects, etc are covered in this suit. Paxil and Prozac are other medications listed in the suit as well. 

I was on Zoloft when I miscarried in 2010. I would not start an anti depressant during pregnancy. Therapy might be very helpful and a strong family/friend support system will always make a difference.