Deciding whether or not to treat depression in pregnant women
By Dr. Anthony Policastro
Whenever a physician prescribes medication, there is a need to balance the effects of the medication against the possible side effects. In most cases, the effects far outweigh the side effects so it is not a problem. In others, the decision is more difficult. One of the situations in which this is an important consideration is treating depression during pregnancy. We know that depression symptoms are common during pregnancy. It is estimated that about 10-20% of pregnant women have some symptoms of depression. We know that maternal depression during pregnancy affects the levels of a chemical in the brain called serotonin. These effects occur in the brain of the infant as well as the mother. The medications we use to treat depression are called SSRI (selective serotonin reuptake inhibitors) medications. The medication will affect the levels of serotonin in the brain of both mother and infant. There is a suggestion that altered levels of serotonin in the developing fetus can cause a variety of issues with the developing infant. The issue is that these problems can be caused by the changes in serotonin due to the depression. They can also be caused by the changes in serotonin due to SSRI treatment. Thus the physician is faced with a dilemma as to whether to treat the depressed mother or not. Both maternal depression and the use of SSRI's can cause behavioral problems in children. However, the effects are different. Mothers with untreated depression might see their three-year-old child be more aggressive than other children. Mothers who took SSRI's might see their three-year-old child with more anxiety and depression than other children. Now that we are studying the human genome in more detail, we are finding that the specific effects that occur might vary with the genes that the infant carries. There appears to be one set of genes that is more affected by maternal depression. Another set is affected more by SSRI's. The issues that can occur with the use of SSRI's during pregnancy can also involve the newborn period. Some newborns can have mild breathing problems related to the medication. The likelihood of this occurring also seems to be affected by the infant's genes. The result is the possibility that in the future we might be able to decide more easily which approach is better when we see a pregnant woman who has some depression. It is also likely that we will find other disorders that will predict a response to medication based upon the genes that a person carries. Thus this information suggests that a more defined approach for selecting the correct medication will be available to physicians. Unfortunately, this will likely take years to develop the kind of medication/genetic maps that are necessary. However, the promise of making decisions more easily remains.
Caregiver training rescheduled The Alzheimer's Association Delaware Valley Chapter sponsors The Family Caregiver Education Series several times a year in each of Delaware's three counties. LifeCare at Lofland Park in Seaford will host a training session on Tuesday, Feb. 22 from 8:30 a.m. to 4:30 p.m. This session was previously scheduled for Jan. 19 and had to be rescheduled due to several conflicts. The training session includes a medical overview, legal and financial issues, challenging symptoms, daily care issues and information on getting the help you need. This training for family caregivers is free and lunch will be provided by LifeCare. Pre-registration is required by Feb. 16. For more information or to register, call Jamie Magee, branch office coordinator, at 854-9788 or 1-800-272-3900.
Cancer Support Group The Wellness Community-Delaware offers a General Cancer support group for people affected by cancer and their loved ones at Nanticoke Memorial Hospital in Seaford. The monthly support group meets in the first floor resource library of the Cancer Care Center on the third Monday of each month. For the winter months the group will meet from 3:30 to 5 p.m. The next meeting takes place on Jan. 24 at 3:30 p.m., due to the Martin Luther King holiday. The Wellness Community, an affiliate of the Cancer Support Community, is dedicated to helping people affected by cancer enhance their health and well-being through participation in a professional program of emotional support and hope. All facilitators are trained mental health professionals with a master's degree or more. Call 645-9150 for information or to register for this program. All support groups offered at The Wellness Community are free of charge. This program is made possible by the support of Nanticoke Memorial Hospital. For more information about The Wellness Community, visit www.wellnessdelaware.org.
Stroke Support Group Nanticoke Memorial Hospital's next Stroke Support Group meeting is Tuesday, Jan. 18, 1:30 p.m., at Nanticoke Memorial Hospital's Mears Rehabilitation Center, 300 Health Services Dr., Seaford. The support group is designed for individuals who have survived a stroke as well as their families and caregivers. The two-hour support group meetings consist of guest speakers and breakaway sessions, in which caregivers and stroke survivors meet in groups to discuss concerns, provide support and allow for networking.Refreshments will be provided. Pre-registration is not required for this free support group. For more information, contact Nanticoke Memorial Hospital at 629-6611, ext. 8626.
NMH offers CPR classes Nanticoke Memorial Hospital will offer community CPR classes to anyone interested in learning CPR at the Nanticoke Training Center located on Water Street in Seaford.
Participants will learn how to perform the basic skills of CPR on adults, children, and infants and how to help an adult, child or infant who is choking. This classroom-based, video and instructor-led CPR course offers families, friendsand community members the opportunity to learn CPR and need a course completion card. Classes are open to participants ages 12 and up. This program is specifically designed for those who prefer to learn in a group environment with feedback from an instructor. The target audience is those who have a duty to respond to a cardiac emergency because of job responsibilities or regulatory requirements. Cost is $30. Payment and registration is required by no later than five business days prior to the class. Late registrations (if seating is available) will be an additional $5 fee. To register and to obtain a listing of class dates/times, contact the Nanticoke Memorial Hospital's Training Center office at 629-6611, ext. 8919. Pre-registration is required.
Hospice offers support group Delaware Hospice's Bereavement Counselor, Midge DiNatale, will lead an eight-week support group for adults on "Grieving the Loss of a Loved One," Jan. 19 through March 9, from 2 to 3:30 p.m., at the Easter Seals Conference Room, 22317 DuPont Highway, Rt. 113, Georgetown. Any adult who would like to give and receive support from others experiencing a loss are invited to attend. Many people find that sharing reduces the loneliness and heartaches of grief.Topics discussed are what to expect when grieving, mistaken ideas about grieving, managing and coping with grief, family interactions, spiritual issues, how to handle special days and holidays and ways to find a renewed sense of purpose. There is no fee for this service which is provided as a community outreach by Delaware Hospice. Registration is requested by calling Midge DiNatale, at 302-416-0581 or 302-856-7717, or by emailing, firstname.lastname@example.org.
Family Caregiver Training offered The Alzheimer's Association Delaware Valley Chapter sponsors The Family Caregiver Education Series several times a year in each of Delaware's three counties. LifeCare at Lofland Park in Seaford will host the training on Wednesday, Jan. 19, from 8:30 to 4:30 p.m. This program includes a medical overview, legal and financial issues, challenging symptoms, daily care issues and information on getting the help you need. This training for family caregivers is free and lunch will be provided by LifeCare. Pre-registration is required by Jan. 14. For more information or to register, call Jamie Magee, branch office coordinator, at 854-9788 or 1-800-272-3900.
Heart and Stroke Gala The 2011 Southern Delaware Heart and Stroke Gala, "An Evening in Oz," will be held on Saturday, March 19, 2011, at the Sheraton Dover Hotel. The annual event benefits the American Heart Association and the American Stroke Association. Volunteers are actively planning the gala. Volunteers work on committees, including sponsorship, publicity, auction, hospitality, multimedia, website, entertainment, casino, photography and decorating. To find out more about sponsorship or to volunteer, contact Karen Gritton, special events director at email@example.com or 286-5705. You may also contact the American Heart Association and American Stroke Association's Delaware office toll free at 877-750-4276.
Bereavement luncheons Delaware Hospice's "New Beginnings" bereavement luncheons are an informal way to meet and talk with others, who have had similar loss experiences. Lunch begins at noon and is followed by a brief program.The location rotates each week of the month according to the following schedule:
"New Beginnings" luncheons are open to the public. Registration is not required. There is no fee except the cost of your lunch. For more information, call Carol Dobson or Paul Ganster at 856-7717.
- 1st Thursday: Grottos Pizza, Rt. 26, Bethany Beach;
- 2nd Thursday: Georgia House, 300 Delaware Ave., Laurel;
- 3rd Thursday: Millsboro Pizza Palace, Rt. 113-southbound lane, Millsboro;
- 4th Thursday: Blue Ocean Grill (formerly Milton House), 200 Broadkill Rd., Milton;
- 5th Thursday (when applicable): Texas Grill (formerly Ocean Point Grill), 26089 Long Neck Rd., Millsboro.
Breast cancer support group Delaware Breast Cancer Coalition, Inc. (DBCC) has expanded its Beginning Your Pink Ribbon Journey, a program for women newly-diagnosed with breast cancer, by partnering with Nanticoke Memorial Hospital Cancer Center in Seaford. The free, monthly program is offered at the Cancer Center located at 801 Middleford Road, Seaford, the third Thursday of each month from 3 to 4 p.m. Of particular value to newly-diagnosed women is DBCC's Peer Mentor Program through which they are paired with a long-term survivor for one-on-one support. To learn more about the journey at Nanticoke Memorial Hospital Cancer Center, call Lois Wilkinson at 672-6435. Registration is required and light refreshments and small gifts are provided. Of particular value to newly-diagnosed women is DBCC's Peer Mentor Program through which they are paired with a long-term survivor for one-on-one support. To learn more about Beginning Your Pink Ribbon Journey at Nanticoke Memorial Hospital Cancer Center, call Lois Wilkinson at 672-6435. Registration is required and light refreshments and small gifts are provided.