The best and most successful course of action is to gather a team of professionals who agree to communicate and work together to support your pregnancy. This team could consist of a family practice doctor and your psychotherapist, or a pediatrician, an obstetrician, and a psychiatrist. Pick one member of the team to coordinate all your efforts and communicate your wishes to the other members.
If your depression is controlled with psychotherapy, make advance arrangements with your therapist to continue your sessions by telephone or the Internet if you cannot leave your home or you are in the hospital. If medications are needed, ask your team what’s best for you and the baby while you search the Internet to discover all the latest information on the pregnancy risks of your antidepressant and potential substitutes. Working with the members of your team, make a chart of every month during your pregnancy that details the risks of medication during each period, and decide in advance what you will do if you become mildly depressed, severely depressed, or disabled by depression. The choices can include increasing your psychotherapy, starting an antidepressant, raising or lowering doses of an antidepressant you are already taking, or changing your medications altogether. Then distribute copies of your chart to each of your team members as a reference for them to consult during your pregnancy. In this way, you will have made the best decisions in advance, and you are unlikely to become overwhelmed if you fall into an episode of unipolar major depression while you are pregnant.