Depression and anxiety during and after pregnancy. Treated, not dismissed.

Before and during pregnancy

"Can I stay on my medication and get pregnant?"

It's the question we hear most. The honest answer is that it depends on the medication, your history, and how you've done off medication before. For many women the answer is yes, sometimes with an adjustment. For some, a switch to a better-studied option before conceiving makes sense. What never makes sense is stopping abruptly on your own because someone said "you can't take that while pregnant." A visit before you start trying gives us time to plan calmly and to coordinate with your OB or midwife.

Depression and anxiety while pregnant

Pregnancy doesn't protect you from mental illness, and "just hormones" isn't a diagnosis. Persistent low mood, worry you can't switch off, panic, trouble sleeping beyond what the pregnancy explains, or intrusive thoughts all deserve real attention. Untreated illness carries risks of its own for you and your baby, which is exactly why "wait until after" is rarely the lower-risk choice. We review the current evidence for each specific medication, weigh both sides honestly, and decide together.

Fertility treatment

The hormonal swings and the emotional weight of IVF and other fertility treatment are often underestimated. If you're struggling through cycles, that counts.

After the baby arrives

Postpartum depression and anxiety are the most common complications of having a baby, and the least talked about. They are not a character flaw, they are not your fault, and they are very treatable.

Postpartum depression

Low mood that doesn't lift, crying for no clear reason, feeling numb or disconnected from your baby, guilt that you're "not doing this right," or a quiet sense that your family would be better off without you. The baby blues fade within about two weeks. Postpartum depression doesn't, and it can begin any time in the first year.

Postpartum anxiety and panic

Worry that never switches off, checking the baby's breathing over and over, a racing heart, dread, and a mind that won't rest even when the baby sleeps. Postpartum anxiety is at least as common as depression and far less often named.

Intrusive thoughts and postpartum OCD

Sudden, unwanted images of something terrible happening to your baby, sometimes with you as the cause, followed by horror and shame. These thoughts are common in postpartum anxiety and OCD. They are the opposite of a wish, and they respond well to treatment. You can say them out loud here without being judged.

Postpartum rage and insomnia

A short fuse you don't recognize. Anger out of proportion. Lying awake wired at 3 a.m. while the baby sleeps. Both are real, under-recognized faces of postpartum depression and anxiety, and both are places where we check thyroid and iron, because they often play a role.

How we help

• A real evaluation, 60 to 90 minutes by video from home or in Clayton, that looks at your history, your labs and your life, not just a screening score.
• Evidence-based medication decisions for pregnancy and breastfeeding, made together, using current data on each specific medication.
• Start low, go slow, with monthly follow-ups while we fine-tune.
• Integrative support: sleep protection, nutrition, supplements, and labs to catch the thyroid or iron problems that mimic or worsen perinatal symptoms.
• Coordination with your OB, midwife, pediatrician, lactation consultant or therapist.
• A postpartum plan made before delivery if you're pregnant now, so you aren't scrambling in week two.