To be surprised at being called ‘selfish’ here?

this sounds poor from your psychologist. If one of the risks is a pph, and you’ve had that before, then at the level of anxiety symptoms you describe, I’d want an obstetricians view before taking it honestly.

At 3.5 your child will pick up on a change of behaviour, it's whether they view the change as just a change or something to be concerned about. Only you will know that as ifs child dependent.

Personally I would take the pills, doesn't the heart racing manifest itself in a physical symptom such as increased blood pressure?

Good spot. I mixed the two of them up.

A psychologist isn't medically trained to even make that call, and is completely out of order calling you names.

Just to offer a correction: ssri's are 40-60% effective in moderate to severe depression; not shown to have much effect on mild depression.
Often talk therapy in addition to medication are combined for best outcomes.

Saying you are selfish is an extremely tactless way to phrase it. It must be incredibly stressful for you.

But it does sound as if you are very much minimising the anxiety and the impact of it on your family. As others have pointed out the impact on your existing child is likely to be significant.

I can’t tell you what to do: only you can do that. But I do think you may be overstating the sertraline risk and minimising the effect of your anxiety.

Depends on how it was said. If you said you thought it would be selfish to take it because of the baby, and they replied that it could be just as selfish to your 3.5 year old to not, they may have just been trying to give balance.
I think the word selfish applied to you is inappropriate though, whoever instigates it. You are clearly anything but, as your thoughts are entirely with your children and are trying to make a tough choice that has no guaranteed 'right" answer. The doctor should have said that unfortunately there could be negative effects on others either way, and its your choice which risk to take.
If you have a supportive and present partner, then perhaps the answer is to ask them to monitor you while off the meds with the thought you will go back on if there is an impact on your oldest that can't be compensated for by their support.

I think they think there is more risk to the foetus if the mother is very anxious than the risk of taking sertraline.

I work for a Perinatal Mental Health Service. Firstly, I am so so sorry for your earlier loss.

There is a LOT of misinformation on this thread. The psychologist was unprofessional to use the term selfish to describe your very valid concern about the medication. What they meant was to consider the risks of not treating your anxiety on your child and unborn - there is a lot of research that concludes exposure to a mother with an untreated mental health condition can lead to long term difficulties and higher chance your children will suffer from their own struggles when they grow up. It is a very individual choice. Whilst the majority are wonderful, GPs do not have the specialist knowledge or time to address lots of this properly (not their fault at all btw).

I recommend you ask the psychologist if you can have a consultation with another clinician to discuss medication - hopefully the psychiatrist or pharmacist within the perinatal service you are under can help you weigh up the risks and benefits of each and come to a decision. They are both specialists in the area and will be able to give you all the information to make a decision

Said anxiety mainly manifests as frequent rushes to the bathroom with heart-racing to check for bleeding. I’m not sure that’s really affecting him? do not underestimate the impact of seeing a parent in any kind of distress.

But no, they shouldn't have called you selfish.

Doctors love prescribing SSRIs. It would be great if they actually worked, but studies show they are little better than placebos. I wouldn't want to take them during pregnancy either for that reason alone.

No, she said the doctor gave her it. I think a lot of people think psychologists are doctors so I just wanted to point this out.

Well firstly not all of them are so highly qualified and they vary wildly in approaches , philosophy, ability and quality. This one sounds rubbish.

It’s a completely different skill set and role to a GP and I don’t think calling it counselling devalues it. When done well it is empathetic, spontaneous, skilled and invaluable. Life-changing, life-saving. When done badly it can make things worse.

One thing they are not is a medic and they should not be giving medical advice or be considered as the equivalent of a medical doctor. What psychologists do is not less valuable, but it is different and many people don’t understand that.

@FatOldBitch firstly, I'm really sorry about your previous loss and how hard this pregnancy must be feeling as a result.

I think it's really important to weigh up the risks here. Whilst no-one wants anything to happen to your baby, they also do need to consider your health and the health and wellbeing of your child too and it sounds like they're worried about that.

Parental mental health issues can have lasting impacts on children and your baby in utero so not having treatment isn't without risk either.

I think you need to really weigh up what the risks and benefits are of taking medication in pregnancy. You might need other people to tell you really honestly how you're presenting to them. So partner, friends, family as well as health professionals because when we're in a MH crisis we don't always have a good perspective on this.

Are you under the perinatal MH team? If not, could you ask to be referred? Calling you selfish doesn't sound great but I wonder what the context of the conversation was.

@Helar not they are not psychiatrists but they are also not counsellors and calling them that really devalues their skills and training.
A clinical psychologist will have done at least 7 years of training and have a doctorate level qualification.

I think that’s the confusion op said the psychologist gave her the prescription. So people are assuming it’s actually a psychiatrist

She said psychologist. Psychologists are not doctors. They are counsellors.

Your psychologist is shit. I’d get a new one.

She clearly has no understanding of your thinking patterns and reasoning, and she’s voicing negative judgemental words towards you, so she’s not going to be able to help you.

I think it’s very wise to be extremely conservative about taking anything in pregnancy. I hope you feel better soon OP.

I agree with you Lifeasiknowitisout. A lot depends on the conversation in general, not the specific word.

Like other posters I struggle with the belief that children don't pick up on parental anxiety or the anxiety is just one action. Low level anxiety doesn't tend to involve a psychologist or the doctor has prescribed the medication because they have concluded it's clinically justifiable.

In OP's situation she needs to take on board the advice she's been given by the relevant health professionals and the needs and risks to her unborn baby and her child by each course of action to make a decision.

It really does depend on the whole conversation. Op could have said ‘it is/I feel selfish taking it’

and the reply was ‘but with that thinking you could argue it’s selfish not to’

or op saying ‘I don’t want to take it’ and the reply being ‘that’s just selfish’ which would be awful.

And honestly, people don’t see psychologist or psychiatrist for some occasional low level anxiety. There obviously more at play here. Which is why it may not be helpful to label the person op is talking about as bad or rubbish.

Saying you’re selfish wasn’t appropriate but having an anxious mum can have a major impact on young children, and potentially on your pregnancy and unborn child.

You are not selfish and a psychologist should not have said that. In fact, it is 'bad psychology' to accuse someone of being selfish. Whether you are right or wrong not to take the Sertraline, either decision would not make you 'selfish'.

A psychologist is not a medical doctor who cannot prescribe medication; their role is to give support and try to encourage a patient to make informed decisions and reach their own conclusions. He or she is being judgemental and unprofessional.

Are you under the care of a psychiatrist for your mental health problem or has your GP prescribed the med?

I would say, if you can manage without Sertraline, do so. What happened with your previous pregnancy was awful but the obstetric team will be keeping an eye on you in order to avoid such a thing happening again.

If you find you cannot keep your depression/anxiety under control with relaxation exercises, meditation etc, it is possible to be prescribed a more gentle medication than Sertraline.

Try to keep as physically healthy as you can and take gentle exercise, listen to music, pamper yourself a little. Enlist your partner's help in keeping you and your baby well.

Good luck.

I had dreadful postnatal anxiety with my secondborn child. I didn't take anything for it (the GP actually convinced me not to 🙄), and now I have an anxious 17 year old.
We honestly can't win!

Obviously yiur decision. Your Councillor is right your toddler will pick up on it. Your anxiety will be having a worse affect on your baby then the antidepressant will be.

No one can say here wether you should take it or not.

I think selfish was the wrong word. However, your anxiety isn’t just going to the toilet to check for bleeding then perfectly ok. You are anxious and yes, children pick up on you being generally anxious. Plus as op said, anxiety in pregnancy can impact the unborn baby. You start thinking about whether you are bleeding, your anxiety starts building you go to the toilet and come out temporarily relieved. Your child will pick up on the fact that their mum starts to (for them) randomly become anxious and tense as a regular occurrence. It can make children feel quite anxious themselves.