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Therapists for Anxiety & Depression during Pregnancy

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24 weeks pregnant and having a lot of anxiety

Aug 2011

Hello BPN community- I'm reaching out because I'm 24 weeks pregnant and really experiencing a lot of anxiety. I'd love to get any advice on dealing with anxiety in pregnancy-- as well as any recommendations for good therapists or psychiatrists in the Berkeley area. I was on 60 mg of prozac before I got pregnant, but went off under the advice of a psychiatrist I trust in New York. I still talk to him weekly on the phone and he maintains that going back on a low dosage of the prozac will only make me more nervous (i.e. because of any potential side effect on the baby). But I'm really not feeling so good and want to make the most informed decision for myself and my baby. Thank you so much for any good advice you can send my way. nervous-mommy-to-be


You may find that eating more protein, necessary to rebuild neurotransmitter stores in the nervous system, could improve how you feel. Both protein and fat can also work to stabilize blood sugar and prevent the sense of anxiety that occurs with hypoglycemia (low blood sugar).

If your doctor can guide you, using 5-HTP, a precursor for the serotonin your SSRI medication was making more effective, might also be of help.

I highly recommend the book SCATTERED by Gabor Mate, MD because he discusses the root causes of anxiety, a major underlying issue with ADD. Nori


I was truly of the mindset that anxiety would do more to my kid than a little prozac. I stayed on my 60 mg my entire pregnancy and it was very low stress, healthy and easy. I totally trusted my amazing NP at Kaiser who has been in the field for 20 years. That being said, I don't know that you want to start back on Prozac this far into your pregnancy. What is your anxiety around? If you are worried about the baby, know that after 20 weeks, the risks of anything going wrong are pretty slim (like less than 1%) and so I always reassured myself by saying things like ''There is more than a 99% chance that my baby will be perfect and healthy''- which in your case is totally true. Tell your doctor, too. low stress mama
Pregnancy can be stressful, so the first thing you should do is try to have compassion for yourself and the changes you are undergoing physically and emotionally. I would also highly recommend a mindfulness based meditation class. There are many hospitals in the area that offer an 8 week course called mindfulness based stress reduction. I took the class at Stanford and there were several people taking it who were doing so to cope with going off antidepressants and antianxiety medications that they had been on for many years. I attended for different health reasons, but found the course life changing. Good luck with everything - you'll make it through. All the best anon
You mention a doctor in New York, but I'm guessing you live in the Bay Area? You didn't say. I had a pretty stressful pregnancy and I found meditation, warm baths, and getting out for long walks very helpful for keeping me calm. I would just sit in a quiet room or my garden in the morning sunshine with a clock and try to just focus on my breathing for 10-30 minutes. My mind would race for the first 5 minutes or so and sometimes I couldn't stand to do it for more than 10 minutes, but I got a lot of benefit out of learning to quiet my mind and just breathe. If you don't think you can do that on your own, there are pre-natal yoga classes with elements of meditation and meditation groups to join. Long walks got me out of my head and connected to my body. I would often go somewhere pretty; it made me feel good that I was bringing my child into such a beautiful world. Even just focusing on taking slow, even, relaxed deep breaths when you are feeling anxious can help. Whatever techniques you can learn now that help you relax and stay calm will be enormously beneficial to you once you are a parent. wishing you more calm & serenity
I know an excellent psychiatrist who is also an excellent psychopharmacologist who ALSO does talk therapy. His name is Gerry Gelbart, near the Orinda Bart Station, (925) 254-3652. An excellent counsellor in Berkeley, on Shattuck, is Johanna Clark 510-549-1336. I have seen both of these at different times, for years. I applaud you for getting the help you need at this time for yourself and planning ahead for when the baby comes, which can be a stressful time, too! Claire
Some good local resources: Lee Safran is an MFT in Kensington. She is very knowledgeable about PPD and perinatal anxiety and depression. She is well-known as a local resource for this. http://www.leesafran.com/ She could see you or she can refer you to someone who can help you.

She referred me to a psychiatrist and an excellent MFT for my PPD. There are a few very good psychiatrists in the area with experience in treating perinatal and post partum depression and anxiety, so you will definitely find someone good through her!

I recommend you also get the book ''Medications and Mother's Milk'' by Hale. It goes into detail about medications and their safety during pregnancy and breastfeeding. I've found it invaluable in researching the medications I've had to take for PPD while breastfeeding. Perinatal and post partum anxiety veteran


There are a gazillion therapists in the Bay Area, as you probably know, but after experiencing several over the years, I finally found one I love: John Conger. He has a particular interest in psychology and the body and would be an excellent resource for someone who has a lot of anxiety (like me). He's very experienced, eclectic in his orientation, and hugely helpful. He's on 851 Regal Road (off Spruce) and can be reached at 510-524-8212. All the best, Happier and More Relaxed in Berkeley
I very highly recommend a Berkeley psychiatrist by the name of Craig Fischer (he is with Bay Psychiatric Associates 2006 Dwight Way Berkeley, CA 94704). He is extremely knowledgeable about using all sorts of psychiatric medications during pregnancy and will surely be a great help to you now and during breastfeeding, if you intend to breastfeed. He is also warm, reassuring and all-around friendly. I wish you the very best with your pregnancy! anonymous new mom
I had severe anxiety during my first pregnancy due to unresolved trauma from a violent rape many years earlier. I cried with joy when my birth teacher, Nancy Bardake, told me about the Berkeley therapist Phyllis Klaus, who specializes in treating pregnant women, particularly those with anxieties due to sexual abuse and assault. I couldn't believe such a therapist existed! Even if that is not your history, I have found her to be a compassionate and wise therapist around all issues surrounding birth anxiety and post-partum anxiety, weaning and couples issues esp. around babies/children.

She has written several books including one on bonding with your newborn, and is one of the founders of the current ''doula'' movement. No doubt, she will suggest to you to hire a doula!

She also uses EMDR to treat PTSD and other issues.

My two births were anxiety-free thanks to her.

Here is a brief bio I found on the Internet followed by her phone number. Good luck!

http://birthpsychology.com/person/phyllis-klaus (510) 559-8000 marie


I understand what it's like to experience anxiety during pregnancy. I want you to know that it will get better. I did take Zoloft for the last two weeks of my pregnancy and while I was breastfeeding and my baby is healthy and beautiful, so I'm not against the very helpful step of taking a low dose of antidepressants to address anxiety. That said, if you can find a way to postpone taking antidepressants as long as possible during your pregnancy, I would. Here are some resources/ideas that you might try:


--Postpartum Depression for Dummies (a great book)
--When Panic Attacks (another helpful book)
--Hypnotherapy (Kathy Woo is a hypnotherapist and her methods are very helpful: www.kathywoo.com)
--Acupuncture (very helpful)
--Exercise, sleep and a healthy diet (low in sugar and high in protein)

Know that whatever decision you make will be the best for you and your baby. Take care of yourself. Been there, worked through it


I feel for your situation. Perhaps my experience might help? I suddenly developed anxiety and panic disorders about week 25 of my first pregnancy. Though I do tend to be anxious at times, I had never had this level of anxiety. I could not fall asleep or if I finally ever did fall asleep I would wake with sudden panic. I consulted my OB, previous therapist, a Cognitive Behavioral therapist and a specialist: Anna Speilvogal MD- a psychiatrist who works with pregnant women at SF General and in her small private practice. After much thinking, consultation and hand wringing, I chose to take a small dose of Zoloft. I realized that my fetus was also being negatively impacted by my panic and anxiety and lack of sleep so I'd risk the medication. I stopped taking it one week before my due date and my daughter (now 11) is totally great! No evidence of having been negatively impacted. I had no panic attacks for 4 years until around week 28 of my 2nd pregnancy! Zoloft once again to the rescue. mom in Berkeley
I took a low dose of Celexa throughout pregnancy and almost 18 months of breastfeeding. My girl is almost 2 now (what?!) and just wonderful. No defects of any sort.

It took me a long time to get over the guilt of taking meds while pregnant. I'm so glad to be completely over it, and knowing that I did the best thing for myself and (indirectly) my baby. Both fetus and baby need a healthy mom! I will continue on my meds through pregnancy #2. This time I will be confident about my choice. I am a mess when off meds, and no fetus should be subjected to that.

My psychiatrist had only general knowledge of the studies on SSRIs in pregnancy, so she referred me to a Women's Wellness Stanford clinic: http://womensneuroscience.stanford.edu/wellness_clinic/. I already knew deep down that I was doing the right thing for the baby by taking meds, but the consultation at the Stanford clinic confirmed what I was feeling. The benefits outweigh the risks. And it really helped for my husband to hear all the doctors had to say. Until that appointment, I was the one doing all the online research, and talking with therapist/psych, etc. Maybe you could ask your psychiatrist for a referral there.

BTW - before/during/after my pregnancy, I saw Dr. Elizabeth Schenk for weekly therapy. I love her. She is a psychologist and does not prescribe meds. For this reason, I also saw Dr. Satoko Miyamoto (psychiatrist) periodically for meds refills and liked her, too. They are both in Oakland.

Feel free to ask the moderator for my email if you want to chat or have any other questions. Good luck and congrats on the pregnancy! -Lauren


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