> I have a friend who is 7 + months prego. is diagnosed with Bipolar but can't take anything while she is pregnant.

Inanna:

That’s a pretty key statement!

I don’t know much about treating anxiety/depression DURING pregnancy, but I do know some things about treating depression without drugs. Since your friend is not comfortable taking atavan, my initial suggestion would be for her to see if she can find a local counselor who practices Cognitive Behavior Therapy.

CBT has been shown to help people with a variety of presenting problems (if you want to call them that) including: coping with panic, anxiety, ending depression, worry control, getting mobilized, stopping unwanted thoughts, changing habits, anger management, overcoming phobias, problem solving, changing limited thinking, testing core beliefs, healing ones past, and stress inoculation.

The basic premise of CBT states that events in themselves have no emotional content. But immediately after an event occurs we will have a thought about the event, and a nano-second later we experience an emotion. It goes like this…

Event ---> Thought ---> Emotion

Therefore every emotion experienced is appropriate to the thought that immediately proceeded it. So if a person changes their thoughts their emotions will change too.

Sometimes thoughts become set patterns and limit a person’s way of thinking. When that happens they become automatic (and subconscious.) The key is to begin tracking one’s thoughts, so that one can become aware of how emotions are intimately connected to what they think. We can change these patterns, but must first become conscious of what we are thinking, then test the validity our thoughts.

If your friend cannot afford counseling, then I highly…and I mean HIGHLY…suggest purchasing a copy of a book titled "Thoughts & Feelings." It’s a workbook that lays out a specific course to follow, and your friend herself will create an outline for self-treatment when she reads the first chapter.

If she doesn’t feel she’ll have enough focus to follow-through, maybe you can read along with her and team-up in a “buddy system,” so that motivation stays high. Email, chat on the phone, meet once a week to do “homework,”…or do whatever else it may take to really work it. Only four chapters are needed (more or less) to deal with depression; add another one, maybe two, for anxiety. Results can be seen as quickly as one to two weeks...ask me how I know :)

You can look inside the book here to see if it has any appeal…
tinyurl.com/2sdlz

And here, for a better price…
tinyurl.com/33yo35

If you decide to purchase, be sure to get the third edition (2007,) because it’s the most up to date…

Warmest regards,
Darth

my understanding is that St John's wort is considered to be minimally risky in pregnancy. the compendium with evidence on herbal therapies for pregnancy that i access, categorizes this remedy as a "low risk with strong supporting evidence" herb. i recommend it to many of my clients and am interesting in knowing more about whether i should discontinue this. best of luck to those navigating pregnancy with challenging mental health concerns...