Category Archives: Pregnancy

Enough Evidence for SSRI-autism Risk in Pregnancy to Warrant Stopping their Use…so says a new study with a large sample size

Pregnant-woman-window-3Things just got much tougher for pregnant women on (SSRI) antidepressants. Another study, as discussed in today’s NYT, this one with a large sample size (4000+)  has made it impossible to discount the evidence linking a mother’s use of SSRI antidepressants during pregnancy with a higher risk for autism in her child. I’ve posted the link below. Pregnant women dealing with severe, moderate or even mild depression face a much more complicated choice with this knowledge in hand. If, as seems advisable, you opt to stop using a SSRI during your pregnancy, please be sure to substitute alternative treatment (psychotherapy, an exercise regimen, a strong support system) and lifestyle changes that help with depression rather than simply opting out without replacing your antidepressants. I mention mildly depressed above because it is commonplace for mild depression to become more severe during and after pregnancy due to hormonal changes and related stresses.

Motherlode - Adventures in Parenting

April 22, 2013, 11:57 am 119 Comments

Study Links Autism With Antidepressant Use During Pregnancy

By KJ DELL’ANTONIA

A cautiously worded study based on data collected in Sweden has found that “in utero exposure to both selective serotonin reuptake inhibitors (S.S.R.I.’s) and nonselective monoamine reuptake inhibitors (tricyclic antidepressants) was associated with an increased risk of autism spectrum disorders, particularly without intellectual disability.”

Read the New York Times article here:

The Swedish study in BMJ

“A Mind in Danger” Wins 2013 ASJA June Roth Best Medical Journalism Award

a-mind-in-danger_1 (1)I’m thrilled to share today’s news from the American Society of Journalists and Authors (ASJA) that my 2012 article in Scientific American MIND, “A Mind in Danger,” is the 2013 winner of the June Roth Prize for Medical Journalism.

The article is drawn from my book, A LETHAL INHERITANCE, A Mother Uncovers the Science Behind Three Generations of Mental Illness published in 2012 by Prometheus Books. It goes into the extraordinary research now available showing the subtle and not so subtle early signs of mental illness in children as young as five and twelve years of age.

I’m excited and honored to be recognized by my journalist peers with this prestigious award. Here’s the lede from the article — Thanks to the folks at Scientific American for making it free access for this occasion:

Cover Image: March 2012 Scientific American Magazine

A Mind in Danger

Signs of incipient psychosis show up early in life. Reading them is key to rescuing kids from the abyss of a serious mental illness

By Victoria Costello

In Brief

  • Signs of a mind in danger—including social deficits, impaired body sensations and reduced tolerance to stress—may show up anywhere from two months to 35 years before schizophrenia strikes.
  • The prevalence of schizophrenia is 1.1 percent, but if a parent has the disorder, the child has a 10 to 12 percent increased risk and a 17.1 percent chance of developing a related personality disorder.
  • Physical abuse, bullying by peers and ingesting cannabis can push a genetically vulnerable child toward psychosis.

From the moment he was handed to me in the delivery room, Alex, my firstborn, seemed not happy to be here. His eyes were bottomless, his expression grave. He spent his first three months writhing and screaming inconsolably, the word “colic” wholly insufficient to describe our collective suffering. It wasn’t until his brother, Sammy, arrived that I realized just how different Alex was compared with other babies. Sammy cried only when he was hungry or wet. He made easy eye contact and loved to be stroked, hugged and kissed—all the things Alex recoiled from as an infant.

Later, when I took Alex to playgroups, he crawled away from the other toddlers to do his own thing, so we quit going. It wasn’t that Alex appeared unhappy. He would sometimes sit and smile with satisfaction for no apparent reason. At age two and three, Alex attended a Montessori preschool. Although he enjoyed the hands-on activities, his teachers often commented that he usually ignored them as well as the other children. His first grade teacher thought he must be hard of hearing because he routinely ignored her directions, especially the daily reading and writing drills she assigned. In one of the first studies ever done with families afflicted with schizophrenia, the Edinburgh High Risk Study, Scottish mothers commonly described children who went on to develop the disorder as occupying a world of their own.

I had so often thought of Alex the same way.

Alex first began to manifest the so-called negative symptoms of schizophrenia in puberty. These included a loss of motivation, social and emotional withdrawal, a disinterest in hygiene and dress, and trouble sleeping. The term “positive symptoms” refers to the more obvious behaviors we think of as “crazy”—hearing or seeing someone who is not there, for example, or holding fixed, illogical beliefs—and they would unfortunately come, too, a little later, as they are known to, right before the first psychotic break.

Knowledge of schizophrenia as a long-term disease process has existed since the early 20th century. The initial signs of this process—the impaired body sensations, reduced tolerance to stress, increased emotional reactivity and, especially, social deficits—“can appear more or less continuously between two months and 35 years prior to their progression to the first psychiatric symptoms,” wrote German researcher Joachim Klosterkötter of the University of Cologne in a 2001 essay.

Although much of the profession still focuses on the debilitating full-blown illness, paying attention to its origins and early stages provides the greatest chance of altering its course. In particular, adjusting a child’s environment is one important way of minimizing the impact of this serious mental illness. Parenting does not cause schizophrenia, at least not on its own, but that does not mean that parents and other adults are powerless to protect children from it.

Weighing the Chances
In an 1896 treatise German physician Emil Kraepelin observed that many of the children of his schizophrenic patients, especially those who would go on to develop the disease themselves, were “a little different in character and behavior from their peers—beginning in early childhood.” The accumulating evidence now backs up Kraepelin’s observation that a significant number of individuals later diagnosed with schizophrenia display some common and often peculiar traits and experiences as children or adolescents.

Here’s the full article link:

http://www.scientificamerican.com/article.cfm?id=a-mind-in-danger

Considering Medication When You’re Pregnant And Depressed | CommonHealth

Highly recommended article weighing the pro’s and con’s for women making this difficult decision. Here’s an excerpt but definitely read it all.

Untreated depression and anxiety disorders are not risk free during pregnancy and may negatively affect the mother, her baby or both. These disorders may:

1. Affect the mother’s feelings and behavior by increasig anxiety about OB visits or diminish energy levels to the point that prenatal care suffers. Poor appetite or fear of gaining weight may lead to poor nutrition. Depression or intense preoccupation may affect the mother’s ability to bond with her baby.
2. Lead to overuse of harmful substances (like alcohol, nicotine, excessive coffee intake, to name a few) to manage distressing symptoms.
3. Increase the risk of problems like nausea and vomiting, pre-term labor, low birth weight, lower Apgar scores (a measure of the baby’s health immediately after birth), enduring emotional and cognitive changes in the baby and post-partum depression.

• Treatment with antidepressants during pregnancy has also been associated with potential risks. Some are simply side effects of the medications which could be problematic during pregnancy (e.g. excessive weight gain or loss), some (like pre-term labor) are similar to the risks of no treatment. Yet others include an increased risk of miscarriage.

Commentary: Considering Medication When You’re Pregnant And Depressed | CommonHealth.

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Jennifer: On Having A Baby, Postpartum Psychosis And Bipolar Disorder

One of the most poignant, important letters among my fellow mom writers in the Mother’s Day Rally for Moms’ Mental Health. A cautionary tale about untreated depression, in this case bipolar, and pregnancy. Please read it. Jennifer: On Having A … Continue reading

My Mother’s Day Rally Letter: On Why Postpartum Depression Treatment Is Important

To Every Mom and Mom-to-be on Mother’s Day:  My story is not unusual. My message is not complicated. You have to take care of yourself so you can be there for your children. What’s not simple is how someone who’s in the depths of postpartum depression, and enduring sleepless nights for months on end, can lift herself up far enough and for long enough to understand what must be done to get out of this place. I share my story because I waited far too long to get help.

Start with mine and check out each of the 24 letters being published hourly today to reach out to new mothers who are struggling with depression.

via Victoria Costello: On Why Postpartum Depression Treatment Is Important.

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4 Facts About Anxiety During Pregnancy & How to Find Help | World of Psychology

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By Margarita Tartakovsky, M.S. I  trust what Margarita Tartakovsky writes and highly recommend this new article of hers on Psych Central. As she points out, anxiety is actually as or more common during pregnancy than depression. When severe, neither is … Continue reading

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Diabetes or Obesity in Pregnancy Tied to Developmental Delays – NYTimes.com

Of course we’re not surprised to hear this finding, but it puts more attention on the health and mental health of the mother before, during and after pregnancy….A mother’s diabetes, hypertension or obesity during pregnancy may increase her child’s risk … Continue reading

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The Bad Daddy Factor – For all those who question whether father’s health/mental health and lifestyle matters

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The gist: drinking, smoking, taking prescription meds or failing to eat a balanced diet can influence the health of men’s future children. This is a comprehensive article by Emily Anthes (from 2010 but still way ahead of conventional wisdom) that … Continue reading

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Oh no…Cell phone use in pregnancy linked to ADHD, mouse study suggests

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I’m sure I’m not the only one whose jaw dropped on reading this headline. In fact, I’ve waited a couple of days to post about the Yale study behind it because I find its implications so potentially huge, and I … Continue reading

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Margaret Spinelli, M.D.: Antidepressant Treatment During Pregnancy

A balanced, informed perspective if you’re searching for some sanity on this issue….There is considerable evidence that the decision not to prescribe antidepressants to a woman who is depressed (or likely to have a recurrence of a depression) during pregnancy … Continue reading