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29 Jan 2009

Anti-depressants TTC
My baby daughter died in July last year. Two months later I was diagnosed with cervical cancer and underwent radical surgery. Fortunately I am still theoretically able to have children, although my fertility, and chances of carrying to term, are substantially impaired. We are currently trying to conceive.

I know that sadness after loss is not considered to be depression as such. At what stage should I consider anti-depressants, if I am still struggling to function normally? Is it safe to take them while I' m trying to conceive?
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Expert
CyberShrink
cybershrink

01 Jan 0001

Sadness, and many opther features of grief and bereavement, are natural after major loss, and probably need to be experienced and worked through. And facing a threat of death or disability oneself, also usually provokes a grief response. Grief and depression can co-exist, too. Antidepressants (ADs ) clearly help Depression ; whether they are useful in grief is debated and not at all proven. A proper assessment by a psychiatrist or psychologist may distinguish the two or at least clarify what might be most helpful. I generally find the threshold for treatement needs to relate to whether the burden of symptoms is interfering with our capacity to function normally, and counselling, especially of the CBT form, helps both Depression and grief --- and has the advantage, of course, of no concerns about pregnancy.
The psychiatrist could also advise, if ADs are indicated, about choosing some most likely to be safe during pregnancy. If one is highly stressed and depressed, one might be less likely to conceive, so dealing with the Depression first might be best all round.
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