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I’m Embarrassed by My Prenatal Depression. Here’s Why I Talk About It Anyway.

If you have persistent symptoms of anxiety and depression during your pregnancy, get help. Untreated anxiety and depression during pregnancy doesn’t just magically resolve when you give birth, said Dr. Meltzer-Brody — it’s a major risk factor for postpartum depression. Prenatal depression during the first trimester is often missed, because the nausea, vomiting and fatigue may make women who are not clinically depressed feel down, Dr. Meltzer-Brody said.

If you are down, moody or anxious for two weeks without relief during any trimester, and it’s a marked change from your baseline, check in with a medical professional, said Dr. Meltzer-Brody. For mild or moderate anxiety and depression during pregnancy, evidence-based psychotherapy is recommended. For moderate or severe anxiety or depression, medication may be needed, said Dr. Meltzer-Brody. If you feel suicidal or have thoughts of self-harm, do not wait two weeks — get medical help immediately. You can call the National Suicide Prevention Lifeline at 1-800-273-8255.

If you have trouble finding a perinatal psychiatrist or if your insurance doesn’t cover visits, you can look for programs like Mothers and Babies or Postpartum Support International, which help women with prenatal depression. You can also find volunteers who provide support to women in every state here.

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  • In February, The New York Times’ Pam Belluck wrote about efforts to bring counseling to women who may be at risk for prenatal and postpartum depression. In 2014, Belluck wrote a pair of articles about perinatal depression and anxiety called “Mother’s Mind,” which are a must-read on the topic.

  • In March, Belluck also reported on brexanolone, the first drug approved by the Food and Drug Administration that is specifically used to treat postpartum depression. (Dr. Meltzer-Brody worked on the clinical trials for the drug.) Brexanolone is given by infusion and works much more rapidly than other antidepressant medication, which can take weeks to kick in, though it comes with a $34,000 price tag.

  • When I was experiencing prenatal depression, the one book that made me feel less alone was “Love Works Like This” by Lauren Slater, a psychologist and writer. Slater’s book combines her personal experience and professional expertise. The one fact I still quote (and quoted in my Slate series) is that during your first trimester, you are getting about 400 birth control pills worth of progesterone a day. No wonder I felt like I was losing my dang mind!

Our toddler hates wearing sunscreen during the day, but loves putting on lotion at night before bed. We started calling sunscreen “outside lotion” and it changed everything — now she’s eager for sun protection.

Jessica Smedley, Melbourne, Australia

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