Maternal Antidepressant Use Tied to Autism

Justin Karter
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In a major study, published yesterday in JAMA Pediatrics, the use of SSRI antidepressants during pregnancy was found to increase the risk of autism spectrum disorder (ASD) by 87-percent. Previous studies reveal that more than 13-percent of women currently use SSRI antidepressants during pregnancy.

pregnancy“In this large population-based cohort study, maternal use of ADs during the second and/or third trimester was associated with an increased risk of ASD,” the researchers concluded. “Children exposed to SSRIs alone and those exposed to more than 1 class of ADs during the second and/or third trimester had the highest risk. The effect was persistent even after taking into account maternal history of depression.”

Maternal use of SSRI antidepressants during pregnancy have previously been associated with increased risks of spontaneous abortion, malformations, premature birth, low birth weight, neonatal withdrawal symptoms, and pregnancy-induced hypertension. Just last month a study published in the American Journal of Psychiatry found that infants exposed to benzodiazepines or SSRI antidepressants during pregnancy showed delayed neurological functioning in the first month after birth.

Autism spectrum disorder (ASD) is defined a neurodevelopmental syndrome detected in early childhood that is “characterized by alterations in communication, language, and social interaction and by particular patterns of interests and behaviors.” The cause of ASD is still unknown, but the prevalence among US children has risen sharply in the past fifty years and researchers do not think that improved diagnosis and screening entirely explain the increase and that environmental factors are likely at play. One of the risk factors for ASD is depression in the mother, however, so the researchers wanted to undertake a large enough study with sufficient power to adjust for known risk factors to assess the impact of the SSRIs.

For this study, the researchers tracked all full-term infants born between January 1st, 1998 and December 21, 2009, in the province of Québec in Canada. 145,456 newborns were assessed during this period. The researchers tacked whether the mothers were using antidepressants during various stages of their pregnancy, these included selective serotonin reuptake inhibitors (SSRIs), tricyclic ADs, monoamine oxidase inhibitors, and serotonin-norepinephrine reuptake inhibitors (SNRIs).

1,054 or .72% of these infants were diagnosed with ASD with the average age of diagnosis occurring between four and five years of age. Boys were four times more likely than girls to be diagnosed with ASD. Both of these findings are consistent with other studies over the past fifteen years estimating the prevalence of ASD in the general population.

Out of almost 5-thousand women who took antidepressants during pregnancy, more than half (53.6%) continued to take these drugs during the second and third trimester. Of these, 31 out of 2532 infants (1.2%) were diagnosed with ASD.

“This study shows that use of ADs during the second and/or third trimester is associated with an 87% increased risk of ASD, even after taking into account potential confounders; no association was observed between use of ADs during the first trimester and the risk of ASD. This increased risk was observed with the use of SSRIs only, as well as the use of more than 1 class of AD, during the second and/or third trimester. We further found that prenatal exposure to ADs during the second and/or third trimester was associated with an increased risk of ASD in children whose mothers have a history of depression.”

The researchers advance the theory proposed by others that SSRIs can cross the placenta and move from the mother to the infant during pregnancy. The drugs may disrupt several key neurological developmental periods for the child both before and after birth, leading to an atypical synthesis of serotonin in the brains of children with ASD.

“To our knowledge, this is the first cohort study to examine the association between maternal use of ADs and risk of ASD in children according to trimester that takes into account maternal depression, other maternal mental disorders, and comorbidities, such as diabetes and hypertension.”

“What this tells us is that we need to think even more carefully about the prenatal environment. And not just about birth defects you can see at the time of delivery but about longer-term consequences,” Susan Hyman, a former chairperson of the American Academy of Pediatrics committee on autism, told the Washington Post.

Mad In America Continuing Education (MIACE) is currently offering a free online course on “Antidepressants & Pregnancy: The risks and possible harm to normal fetal development and the newborn child” by Dr. Adam Urato, M.D. of Tufts University School of Medicine. Urato reviews unbiased research on the risks vs. benefits of prescribing antidepressant medications to pregnant women and reviews research on alternatives to antidepressants. Click here for more info.

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Boukhris T, Sheehy O, Mottron L, et al. (2015) ANtidepressant use during pregnancy and the risk of autism spectrum disorder in children. JAMA Pediatrics: 1-8. (Abstract)

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Justin Karter
MIA Research News Editor: Justin Karter is a writer, researcher and community organizer with graduate degrees in both journalism and community psychology. He is a doctoral candidate in Counseling Psychology at UMass Boston, an active member of the Society for Humanistic Psychology, and is currently working on several scholarly projects at the intersection of psychology, social theory, and political philosophy.

53 COMMENTS

  1. It shouldn’t be surprising to anyone, especially doctors, that drugs should not be given to a pregnant woman. I have a hairdresser whose been on antidepressants since she was drugged as a young girl, and she’s been trying to convince her psychiatrist to wean her off the drugs since she is hoping to have children some day. Her psychiatrist keeps putting it off.

    Since the antidepressants are no better than placebo, I’m sure this horrific news (except to the psychiatrists, since this will bring them in a lot more business) should be more evidence children, especially young women, should never be prescribed antidepressants.

    It’s staggering how evil all this is.

    • Hi Someone Else,

      You’ve got to be right about drugs and pregnancy. The anti depressants go into the baby’s brain, don’t they?

      I think people take antidepressants because people believe doctors (about ‘mental health’).

      Unhappiness is very normal too (it’s not an illness).

      • Fiachra,

        Well, since other mind altering substances, like alcohol, are known to harm fetuses, it does seem logical that the mind altering psychiatric drugs will also likely harm fetuses. It’s strange to me that a belief system different than this, wouldn’t seem innately illogical to the medical profession.

        I agree, it’s time to stop trusting in doctor’s bizarre, greed inspired beliefs, that “unhappiness,” or other real life concerns, are “mental illnesses.” I’ve personally never met more delusional and insanely disrespectful people than those who work in our current “mental health profession.”

        A “mental health professional,” within my current state, has concluded that it’d be better for me to go back and get my masters in public health, since I’m such a good medical researcher, rather than having my state current state pay me to continue for my former state’s defamation of my character as “bipolar.”

        Thank God I can afford to do so, if I so chose, but what kind of advise is that for someone who cannot afford to do so, which this state’s “mental health professional” had no information regarding? And taking the GRE, at the age of 50, will be tough too. I have forgotten much of the algebra from my childhood that is required on the
        GRE, despite having gotten in the top 95.95% in my math SAT’s as a child.

        Truly, what’s going on in our current society, via the “mental health industry” is disgusting.

        • You might surprise yourself (with your maths).

          On the poisoning of unborn babies: I would wonder how they get away with it – its insanity.

          There are certain basic medical principles that seem to go out the window in psychiatry i.e. that if a substance improves an emotion, it will have to be paid for with interest at a later date.

          • “There are certain basic medical principles that seem to go out the window in psychiatry i.e. that if a substance improves an emotion, it will have to be paid for with interest at a later date.”

            Fiachra, you are absolutely right. Pills for the most part only mask symptoms. They do not cure. The piper always has to be paid down the line, and meanwhile the interest has started accruing two- or three-fold while the drug is being taken if long-term. Rebound/withdrawal can be extremely difficult and can last for months or years.

            We need to stop the mindset that a pill will be a quick answer. Because it’s not a quick answer at all but is rather a very slippery slope. A slow process of damage to the mind and body develops over time. The person taking the pill no longer has control over his/her body.

            Yes, the piper always needs to be paid at some point, and depending on how high of a dose and how long a person took the drug, the cost can be extremely high.

  2. I bet this phenomenon actually has relatively little to do with antidepressants – that is to say, the association is mostly correlational not causal. The key thing in my opinion would be that the subgroup of mothers taking antidepressant are probably less effective mothers with a higher average degree of family problems. These are the moms more likely to be getting drugged in the first place.

    I think the real causal factors are more likely:

    1) The subgroup of moms taking antidepressants are probably on average worse mothers, more likely to be distant, neglectful, and emotionally uninvolved with their babies than those mothers not taking drugs (i.e. those moms who are psychologically healthier). This in turn is a factor making it more likely for the offspring of the drugged/less skilled moms to become distant, emotionally removed, and autistic themselves.

    2) The subgroup of moms taking antidepressants have a higher average family history of trauma, which is passed down epigenetically (as Brian Koehler’s recent article suggested) to the offspring giving them a greater vulnerability to withdrawing in a way that becomes autistic.

    These are speculative associations, but I believe them to be probably more important factors than that the drugs per se are causing the offspring to be autistic… although, the drugs could also be a factor harming the babies in a variety of other ways. As usual with this type of study, there is no exploration of social or psychological factors, especially around the possibility that the mothers’ own “psychopathology” could be partly causing the children’s autism, something which is highly likely in my opinion.

    Frances Tustin wrote an interesting book about psychological approaches to autism, and how refridgerator mothers seem to increase the risk of autistic withdrawal in the child. I bet this is still true, just as it’s undoubtedly true that abusive neglectful parents increase the risk of getting a schizophrenia diagnosis.

    • I am going to give the benefit of the doubt that it was not your intent but, as the mother of a child with autism, I found your comments HIGHLY OFFENSIVE.

      Science does not yet know what causes autism, but idea that it’s caused by bad parenting or “refrigerator moms” was debunked in the 1960s.

      Sometimes kids with autism have unloving or neglectful parents. Sometimes kids with cancer have unloving or neglectful parents, too. That’s just life. Bad parenting does’t cause either of these things.

      • Of course my point wasn’t meant to blame parents. There are definitely cases where “good” or loving/skilled parents still have a child become autistic. Many internal and external factors must be involved in causing autism.

        But given that parenting is crucial to a child’s development, it does stand to reason that poor parenting can increase the risk of extreme withdrawal / abnormal social development, in other words, of conditions including autism. This only applies on a statistical or average level, not to individual parents and children. It’s difficult to discuss this clearly because autism is again a syndrome or continuum, not one illness.

        The approach I am suggesting is actually more hopeful – if relationships can contribute to extreme withdrawal and social nondevelopment, then they could also reverse or ameliorate the process.

        I have worked with autistic children as a teacher myself – and of course, I never blame individual children or their parents for problems the child is having. But I keep in mind that the quality of the relationship with the parents affects the child in many ways, including possibly worsening the child’s autistic withdrawal if the parent does not have a good relationship with the parent. That is different from blaming the parent.

        I can also see with different autistic children I work with that it’s not one illness… there is a great deal of variation in severity between the children, and in the way they relate, and the degree to which they can form any real relationship (if at all).

        Here is the book I was reading – http://www.amazon.com/Protective-Shell-Children-Adults-ebook/dp/B00850IRNO/

        • Nor is it hard to find data linking generational abuse to autism:

          http://blogs.babycenter.com/mom_stories/03272013autism-linked-to-maternal-abuse-in-early-childhood/

          http://www.inquisitr.com/589782/autism-risk-in-offspring-linked-to-childhood-abuse-of-mother/

          What they’re reluctant to say in these studies is that the most abused mothers, who in the studies had the highest rate of autistic children, are also probably some of the worst mothers. That doesn’t mean they’re bad people. They probably just didn’t have good models of a secure loving parent-child relationship with their own parent, and naturally recreate it with their children, increasing that child’s risk of developing autism unintentionally.

          Autism has been linked to many things including pesticides, illegal drugs, poor diet, etc, so why shouldn’t poor parenting be another factor that increases the risk… it probably is.

          • The association between maternal history of child abuse and austism is not necessarily causal. Kids with developmental disorders are also at higher risk for being abused. If autism is genetically inherited and these mothers had were on the spectrum themselves, then there would be a spurious association between maternal exposure to abuse and autism. I think maternal abuse is a bigger contributor to offspring mood disorders, anxiety disorders, and psychosis. with developmental disorders, the more relevant environmental factors are likely things like being born preterm, low birth weight, etc.

          • You’re right; firewoman, associations like this would only be correlational. It’s very hard to prove causal relationships in complex human relationships, especially when the variables include spectrum-like behavioral things like autism.

      • “Sometimes kids with autism have unloving or neglectful parents. Sometimes kids with cancer have unloving or neglectful parents, too. That’s just life. Bad parenting doesn’t cause either of these things.”

        Not only do I agree with this, but I think it’s also a vital statement. Kids come into this world in all sorts of ways with all sorts of differences.

        A nurturing parent will teach by example and presence how to integrate anything with self-compassion in order for the child to grow and evolve along whatever his or her natural path is, with unconditionally loving support all the way (which includes healthy boundaries, I like to always include that, no one should be a doormat) . Not perfection, of course, we’re all human–but at least with that intention and growing in that direction. And certainly letting go of the need to ‘control’…well, eventually in any event. I know that’s a hard one!

        We all discover our balance of this as we go along, and that is how we adjust to the normal rites of passage in life, as we assimilate to whatever it is we face as we go along in life. We are all tested at times in our lives, that’s how we grow and gain wisdom.

        I think problems are most likely to occur when a parent is in fear, judgment, shame, resentment, and/or guilt, and their actions are motivated by these negative and self-recriminating feelings. THAT’S what will get passed along to any child to internalize, if that is the environment in which they develop, and that is never helpful nor healthful, quite the opposite. This can be shifted in present time, though, we all go through learning curves.

        I can’t imagine autism being caused by ‘poor parenting,’ just like I can’t imagine many things being caused by this. But the parent sure does have an influence on how a kid perceives themselves, despite anything. I think that’s always valuable to keep in mind.

        I’ve even heard that autistic children are lumens, guides, and healers, that there is some kind of ‘truth-connection’ here. I can’t speak to this myself, because I have no experience with autism, but I’ve heard this quite a bit and have wondered about it. Something about it rings true to me, not sure why, but it does.

      • jm,

        I wholeheartedly endorse your comments. I view Bettelheim’s ignorant, malevolent and baseless indictment of the parents of autistic children as one of psychiatry’s great embarrassments. I also view this type of thinking as complicit in the disastrous drugging paradigm that followed….Without minimizing the role of Big Pharma and its distribution channel (the drugging shrinks) and their perverse motives and incentives, I believe that the well-founded disgust and rejection of Bettelheim-type thinking helped the druggers. I say this as someone who believes that trauma is foundational to mental illness, but that is quite different from saying, without having any facts to back up one’s opinion, “the parents did it.” The science of epigenetics shows that trauma (physical or emotional) changes one’s biology and those changes are passed on to future generations. So while the importance of good parenting and nurturing cannot be overestimated — the fact that it is out of fashion to emphasize this is another aspect of Bettelheim’s unfortunate legacy — it is also true that good parents can and do have children with autism or mental illness. Good people doing detective-like important work in autism (and mental illness) include William Walsh, PhD, Dr. Natasha Campbell-McBridge and David Perlmutter, M.D.

    • BPD Transformation and JM:
      I want to let both of you know that autistic self-advocates, across the board, are against the framing of autism as something people are at “risk” of – as a varied way of being, it is not a “danger” per se, and autistic people are saying it’s dehumanizing to frame their way-of-being as an “epidemic”. Forcing people to think and act certain ways or face being labeled as defective is the same thing that drives psychiatric violence – so I would hope to find more solidarity from the psychiatric survivor community. If you want to learn more, ASAN’s research is a great place to start.
      Peace,
      Lily C.

      • Lily, this was not quite the attitude of parents of autistic children that I worked with; they clearly wished their children had been “normal”. Also, these kids were quite severely autistic and wouldn’t have been able to advocate for how they wanted to be approached in a conceptual way, at least not yet. It sounds to me like perhaps many of these self-advocating autistic people are on the less severe end of the spectrum of autism.

        I think given that autistic states can cut a person off from being able to have many positive relational experiences, there is some reason to see it as less than desirable and to want to help move their experience closer to a “normal” back and forth relatedness (This is what I tried to do in my coaching of autistic children, with some success. Of course, I never said anything to the autistic children about their being autistic let alone about it being a “bad” thing). A parent or someone like me can have that opinion without being negative toward someone who “has” autism. On the other hand, I do not think that “epidemic” is at all a nice word to use and I would avoid that.

    • When these ‘bad’ mothers are given a mental diagnosis, they are typically drugged with 5-7 different psychiatric drugs. When you begin experiencing psychiatric drug-induced: mania’s, high anxiety, panic attacks, crippling depressions to the point of suicidal attempts, migraines, severe insomnia, chronic fatigue, malaise, homicidality, hallucinations, psychosis & seizures as I have from taking my medicine, it’s Very hard to be a ‘good’ mother when the drugs your taking are making you so mentally unwell that you can’t function. Knowing exactly how they work and have damaged my brain, I have to believe they are damaging the developing brain in the fetus. How can they not be? We didn’t have an epidemic of autism until the early 80’s when Prozac was introduced. We didn’t have school shooting when I went to school either, but then the SSRI weren’t out yet. And the numbers just keep climbing every year.

  3. JM,

    I have to sadly agree with you as one who normally agrees with BPD. In fact, I was greatly taken aback when I read his post.

    I know someone who has a kid with autism and it is definitely not due to bad parenting. This person has done a great job in helping her kid maximize her talents.

    • I, too, am usually impressed with BPD’s research and comments, but was also offended by this one as well. Especially, since I think he knows the doctors are handing the antidepressants out like candy to way too many people, not just bad mothers. And, they’re also handing them out claiming they’re “safe smoking cessation meds,” and denying these drugs are mind altering drugs at all.

      I’m glad this finding has come out, hopefully it will help reduce the number of antidepressants the doctors hand out.

      • My original comment was an observation of a possible social factor (poor parenting) which may be one of the factors increasing risk for and/or leading to autism. It’s not intended to blame mothers (or fathers, whose input is also important) in any way.

        Also, I think we are confusing large-scale research with individual cases. Yes, there are many “good” parents whose children may become autistic. The word “good” (or “bad”) is problematic because it sounds like a value judgment… but it means, in this usage, skilled, effective, reliable, consistent, non-abusive, etc. In other words it tries to describe an objective description of a behavioral reality, not to say certain people are worthy or unworthy.

        I don’t think it should be taboo to say that some parents are horrible parents – some are, through no fault of their own; these are tragic situations when a parent can’t effectively parent – and that some of these horrible parents are increasing their children’s risk for behavioral problems, including not only psychosis but also autism. That doesn’t mean every parent of an autistic child is “bad” or unskilled/neglectful/abusive (again, this means an ineffective, neglectful, or abusive parent, not a bad person).

        I hope this clarifies things a little bit. I also hope that doctors will stop handing out so many antidepressants. On the other hand, I hope more people will be able to educate themselves so they can choose to stop ignorantly taking antidepressants that are likely to harm more than help. It’s not only the doctor’s responsibility; in America a lot of ignorant people just reflexively search for a magic bullet. I don’t think it’s because they’re lazy or stupid; most of them just don’t know any better and are trying to find the best solution they can imagine. Again, being ignorant doesn’t mean you’re a “bad person. Ok, I’ll probably get in trouble for this too 🙂

        • I definitely agree the we need to make the effects of child abuse/”bad” parenting a less taboo subject. That said, I think we need to recognize that many will interpret this as parent blaming and not necessarily use the information in helpful ways. Thus, I do think we should be a little more careful about how this topic is discussed when the data is less than convincing. As I said earlier, the link between “bad parenting” and mood disorders/anxiety/psychosis is pretty clear, but developmental disorders that start very early, not so clear.

          Perhaps we need to be clearer that abuse/ bad parenting is typically a multigenerational problem, that the abuser/bad parent was often subjected to abuse themselves. Maybe that is a way to lessen the preoccupation with shame/blame that always comes up with this topic.

        • Thanks for the clarification, BPD, I appreciate it. And I will concede that since my therapist defamed me to my mom, as a “bad mother,” because I was pointing out the common symptoms of child abuse, but still in denial of the abuse. I may be a bit oversensitive when it comes to defaming mothers.

          Just desserts do seem to exist sometimes, though. My ex-therapist’s child is mentally ill, as is my ex-neurologists, but I have two wonderful children who are doing quite well, since I kept them away from the “mental health” system. Actually, oddly, all the people who screwed me have either dead babies, problems with childbirth, or problems with their children in general. The molesters’ of my child were negligent in the death of their first born, and one of their girls who used to be friends with my son, was arrested at the ripe young age of 18. Leaves one wondering if God does actually bring about justice, sins of the father style, as the Bible claims. Or maybe, some people are just bad parents. I do agree, bad parents do exist.

          Nonetheless, I do agree, people need to educate themselves. However, the AMA and government should stop encouraging people to trust in their doctors, since so many doctors are now claiming to be misled and misinformed by big Pharma. Despite the reality doctors should all actually know the “anti” drugs are known to cause “psychosis,” via anticholinergic toxidrome. And I’m pretty sure, in reality, they all do. Including the psychiatrists, who’ve created a bunch of bogus “serious mental illnesses,” to cover up this reality.

          I also know there are drug seekers, but there are also drug pushing doctors, like my former doctors. And I do admit, I was one who used to believe in the whole, trust your doctor, stupidity. I was “ignorant.” But f-ck me once, shame on you, now I “know more than the doctors,” according to a woman who interviewed me. And I’m “one in a million” according to my most recent doc. Who had me teach one of his students, at my last physical, that we now live in a ‘brave new world’ of healthcare, where sometimes, the patients know, as much as, or more than the doctors. The student was cute, she was so impressed that I could medically explain that my shaky morning ankle was due to tardive dyskinesia.

          And thankfully, not all doctors believe murdering a person to cover up child abuse, with evidence of such written right in one’s child’s own medical records, is moral behavior. Nor is incessantly trying to defame and murder a person to cover up easily recognized iatrogenesis for incompetent and paranoid of a non-existent potential malpractice suit doctors.

          It truly is time for the “dirty little secret of the two original educated professions” to be put to rest. Our society is not actually best served by putting in charge of all of humanity, an industry that exists primarily for the purposes of profit for the pharmaceutical industry, based upon iatrogenic illness creation; cover ups of easily recognized iatrogenesis for the incompetent doctors; and cover ups of child abuse for the mainstream religions. And these are today’s psychiatric industry’s three primary functions, it does seem quite evident, according to the medical evidence.

        • Having read what you have previously posted on here and generally agreeing with it, it was easy to give you the benefit of the doubt that you meant no harm 🙂 But it was still hard for me to let your comment sit.

          I grew with a neglectful and abusive mother. I know that has definitely stamped my psyche. I know the scars of this trauma play a significant role in my patterns of thoughts and behaviors that led me to a diagnosis of “mental illness” (along with some genetic factors, I suspect) – I know this even if science hasn’t fully caught up and told me I’m right.

          But autism is NOT “mental illness” (or trauma or other substitute term). It’s a neurological condition generally thought to develop in children BEFORE birth (though it can manifest later). It is thought to be genetic. In fact, there are several genetic conditions (Fragile X, Rett Syndrome) that are considered to cause autism.

          Autism is pervasive. It impacts all the body’s systems. For some people with autism, some characteristics will look like what we label as mental illness, particularly those who would have received an Asperger Syndrome diagnosis in the past. And some people may have a co-occurring diagnoses.

          But, again, autism is not the same as “mental illness.” It’s not caused by psychological trauma to the mother or to the child. Having spent time with children with autism, you have likely well seen that it’s unlike anything else. It doesn’t “look” like schizophrenia, or bipolar, or any other label.

          Sure, the way my son interacts with the world is impacted by my parenting, but that’s true of all children.And, as someone else (firewoman) noted, people with “autistic traits” or full blown autism may pass that on to their own kids.

          But autism cannot be “cured” by love or good relationships (or crystals – Jenny McCarthy). If that was true, almost every kid I know with autism wouldn’t have it anymore. My son certainly does better when I am at my most nurturing, but he still is non-speaking, he still uses echolia, he still struggles with ADLs, he still is his autistic self .

          As a teacher, you certainly would have had a good understanding of the challenges that autism presents. But you missed the “worst” parts. You missed having to deal with behavioral challenges, possible aggression, lack of communication, and toileting trouble all on just a few hours of sleep. Because when my son with autism doesn’t sleep well (or at all) – which is pretty much every night- neither do I. When a parents are dealing with such a cauldron of symptoms, it’s really not surprising that children with autism are more likely to be abused – NOT acceptable, but not surprising.

          Going back to that “refrigerator mother” theory… Leo Kanner, widely considered the “father” of autism for “discovering” the disorder, he was initially a big proponent if this theory, too. He later reversed position. He came to reasons that when saw what seemed unloving/unaffectionate parents, he was actually seeing the byproduct of the autism. It’s hard to be affectionate to a child (in ways that are seen as typical), if the child won’t let you. It’s hard to interact with a child in ways that are instinctual, if your child doesn’t respond to that. This thinking is what replaced the theory generally in the mainstream medical world.

          If your child is diagnosed with autism before the age of 3, they will likely receive early intervention. This is therapeutic services usually delivered in the house. We had around 20 hours a week, at its height. We then had in-home services from our local school system begging at age 3 (along with full day schooling). We had private speech, OT, and PT therapy, developmental pediatricians, nutritionists, GI docs, neurologists, respite workers, PCA services, on and on. This is pretty typical when you have a child with autism. I do think that, if parents of children with autism as a group were consistently bad/unnurturing/unloving/etc., someone would have noticed by now – someone mainstream.

          And we do know what happens to children who grow up without needed affection or stimulation.This is extremely well studied. They develop attachment disorders (think “Romanian orphans”). This is not the same thing as autism.

          I know many, many parents of children with autism (and the kids themselves). Most are tired and harried, but loving and attentive to their children. As a teacher, I bet many of the parents of your students saw you as the enemy – especially if you worked in public school. We parents of kids with autism have to fight to get the right support for our child (as you probably know). It becomes easy to see your child’s teacher as on the wrong side of the fight. I would be willing to bet that some of what you saw in these parents was actually hostility to you (undeserving I’m sure). This may be my anecdotal thinking, but it certainly isn’t one individual child or parent. And I haven’t seen current any research that fundamentally disagrees with my thinking.

          Just to wrap this up, in case anyone’s wondering…
          I did not antidepressants or benzos (or anything but vitamins) while pregnant. And my son never had a “mercury” vaccine until he was 10, well past when he was diagnosed with autism. We don’t live under power lines or near farmland. I don’t use crystals, chelate, use hyperbaric chambers, or do the DAN diet. I think that ABA is highly overrated. I love my autistic son for his quirks, but do wish that life was a little easier for him.

          • Hi Jm,
            This is a great comment, thanks for putting this all down.

            Yes I have sensed a lot from working with autistic children. I would say I can tell that their state of being or differentness from most people is somehow much more ingrained or more at the core of their being than with a psychosis or depressed state. Over time I came to feel that they are missing some of the basic perceptual abilities that most people have; seeming not to be able to imagine that other people have thoughts or feelings, and to view other people very mechanistically or concretely as functions or things… in this way they reminded me of the description of the “out of contact state” in writing about early developmental problems by Harold Searles. But, there is a difference as you say between psychoses and autistic states. But… if autism is partly psychologically, then its inception predates even psychotic states, occurring even before psychic structures are formed before birth or in the first few months of (preverbal) external life.

            Nevertheless, the autistic children I worked with did gradually form attachments and come to like me, and I to like them.

            I am not a conventional teacher; actually I am a kind of athletic coach. I had great relationships with the few parents of autistic children I came to know. They were happy that their kid was able to get some exercise and be involved in a kind of pseudo-mentoring relationship. The were never hostile to me, but my relationship with their children was different than a conventional schoolteacher. I also have a great empathy and patience with difficult children of all kinds, because I tend to view them as similar to myself when I was a child, and therefore to want to do better for them than my parents did for me.

            I encourage you to check out Frances Tustin’s writing, for the fascination if nothing else. There are accounts there of autistic children being fundamentally changed by good relationships. The book makes the point (as you did) that normal loving or parenting will not work with these autistic children, but that specific preverbal interactions and ways of accessing preverbal fears can succeed where normal relationships cannot. I realize this may sound impossible to you, but in that case I would still encourage you to check out the book. She also has an interesting idea about “psychological black hole states” (states of non-relatedness and non-awareness to external stimuli and human objects and their contribution to autistic states).

            It could be that autism is one illness that is caused by genetic or biological actions, but I think this is not proven yet. I suspect that autistic states are more likely a continuum or spectrum of related conditions with many factors playing into them. It seems to me more likely that genes and biologically faulty development are major factors, because of the more ingrained way of being that we have described. But again, this is an area we do not have enough knowledge about.

            I can see from your writing that you care a lot about your child and have done much research into this, a lot more than me.

          • BPD –

            I can post a reply to my own comment, but not to yours. Hopefully you do see this!

            My son is very affectionate, and has clearly developed bonds with me and other choice individuals (like his great teachers!). My son’s version of bond and affection is just different from “typical” children. No less strong, possibly more strong, but very different.

            It grinds me when people suggest that kids with autism can’t or don’t develop binds (usually purported by organizations like Autism Speaks – autism’s version of NAMI, but worse). So I do truly believe that you were able to form great bonds with your students if you were willing to put in the work – and so many people aren’t.

            It’s funny that you mention being a gym teacher. My son attends a special private school (where teachers are not my enemy!) that weaves activity and fitness throughout their day. It’s a core tenant of their program. He spend several years in a pricey school “world renown” for their execution of ABA, and he stymied. A few short months at this new school, and he’s picking up skills left and right. 3 years in, he’s doing things I never thought he would. I think that the activity/fitness plays a huge role in it. So I hope you can get back into that somehow!

            Anyway, I will definitely read what you suggest, as I do like to read interesting things (even if I don’t agree with them). I’m glad that this discussion played out on here!

  4. Its time for Fathers to step up and tell their baby mommas and these doctors they are not allowed to poison their children with these pills.

    Sorry girl but that’s my baby too and the drugs stop today.

    I could even see lawsuits by fathers against mothers who insist on taking these SSRI pills during pregnancy.

    Its not very nice but if you take SSRIs wile pregnant you are not only depressed you are also stupid and selfish.

      • There are also significant withdrawal symptoms of the antidepressants. They’re called antidepressant discontinuation syndrome.

        https://en.wikipedia.org/wiki/Antidepressant_discontinuation_syndrome

        And it’s sad the mainstream medical community has odd delusions these symptoms are “bipolar.” What a bunch of fools or unethical pieces of garbage the mainstream, greed inspired, medical community of today is.

        Never trust a doctor. We have the internet now, so there is no need. Research everything yourself. And personally, I recommend never taking a drug that’s been on the market less than 8 or so years, since our FDA has such a deplorable tract record.

        • I agree, and if possible never visit a psychiatrist, let alone trust one. There are a few good psychiatrists who function more as therapists, but the chances of getting one of those is not good. Most psychiatrists are acolytes of the diagnose and drug torture model.

          So best to avoid period. This is one of the best things individual people can do to undermine psychiatrists – Opt out of the system. Do not see psychiatrists, do not take psych drugs; if on psych drugs, taper off, and reject diagnosis.

        • Of course, I agree that there is big problem with giving women of childbearing age (well really anyone, but them especially) ADs. However, I think the topic of discontinuation syndrome is especially important for pregnancy. Half of all pregnancies are unplanned, and as many of us have personally experienced, withdrawal can be hell that can go on for months/years and I’m betting that isn’t so great for a fetus either. So there will be women who find themselves pregnant unexpectedly and they may have serious problems with withdrawal, especially if they had been on the ADs for an extended period (and remember, many of them will already be dealing with other pregnancy symptoms). Is coming off the drugs necessarily a better choice? I wonder about this in particular since, as others have pointed, the association between maternal AD use and autism may not necessarily be causal (AD use could be merely a marker for women who were more likely to be on autistic spectrum themselves and there is a fair amount of evidence that autism is genetically inherited). If it were me facing this decision, I’d probably have an abortion, but not everyone would chose that. Just a thought

    • That’s a rather callous comment, don’t you think?

      What about a woman who finds herself pregnant by accident? Birth control does fail.

      What about rape? Incest? Then there’s the whole need to taper slowly off the drugs.

      You would also have these women sued, maybe even arrested, locked up, lose custody too?

      You may want to think about what you’re suggesting here. You are hinting at a whole new type of control over another human being and that’s a little scary.

      • engineer,

        I am perplexed by your comment. It seems firewoman was just suggesting that if a woman is pregnant on an SSRI and experiences withdrawal issues from discontinuing the meds, that could cause harm to the baby then staying on the med.

        She raised an issue I certainly wondered about as I think folks on this board are overlooking the WD issues. Yeah, it is definitely better not to have been placed on the med but once someone is pregnant is on it, what is the best option to cause the least harm to the baby and the mother? It seems callous not to consider that.

        • I think engineer’s comment is actually meant for the_cat. I do at some point hope that we can discuss what a pregnant woman who is already on meds is supposed to do. That I think is the more relevant issue- and I think most here are ignoring that point. Yes, some people may start them during pregnancy, but my impression is that the bigger dilemma is whether to come off them (especially in cases of unplanned pregnancy), given the risks of withdrawal

      • Callous is exposing unborn children to those brain chemical pills. You feed them to my child either inside the womb or outside there is going to be trouble.

        “INTRODUCTION:

        We investigated placental transfer and neurobehavioural effects in neonates exposed to citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine or sertraline (SSRI’s), or to venlafaxine (an SNRI).
        METHODS:

        Women receiving antidepressants during pregnancy and their neonates were studied. Cord and maternal drug concentrations were measured at birth and in the neonates plasma on day 3. Neonates were also assessed using a range of neurobehavioral tests and compared to controls.
        RESULTS:

        Median cord/maternal distribution ratio was 0.7-0.86 (range) for SSRIs, 0.72 for the SNRI venlafaxine and 1.08 for the O-desmethyl metabolite. Neonatal abstinence scores were significantly higher (p<0.05) in exposed infants than controls on day 1. Brazelton scores for habituation, social-interactive, motor and autonomic clusters, and serotonin scores were significantly greater (p<0.05) in exposed infants.
        DISCUSSION:

        Transfer of SSRIs and SNRIs across the placenta was substantial. Neonates developed mild behavioral symptoms in the early perinatal period but these were self-limiting and similar for both SSRIs and the SNRI venlafaxine."

        http://www.ncbi.nlm.nih.gov/pubmed/19452377

        "Transfer of SSRIs and SNRIs across the placenta was substantial"

        That's my child too and you are NOT exposing he or she to those drugs (the very ones that harmed me) so end of story. Its a parents duty and a natural instinct to protect ones children.

        Time for Dads to step up.

        • So, do you think SSRI discontinuation symptoms have no effect on the baby? Things like mom not being able to properly sleep or eat, having elevated blood pressure, etc? That can go on for months and these things ARE associated with significant risks for the baby too- actually it sounds like a good way to get a preterm/ growth restricted baby. I get it, the fetus is exposed to the drugs via the placenta and that obviously carries risk- I’m not disputing that. However, the real question, IMHO, is which risk is worse, and I haven’t seen data addressing that question.

          • How could continued exposure to the drugs not be worse ?

            Most people don’t keep smoking cigarettes and pot or keep drinking or shooting dope or smoking crack wile pregnant because the withdrawal is painful.

  5. To Mad In America moderators and admins:
    While I understand that you’re re-printing a study that was first printed elsewhere, I’d hope to see a bit more discretion in wording/quoting, in line with a human rights-focused site like this. Autistic self-advocates have been very clear, for the past decade, that “epidemic” and “risk” are dehumanizing ways to talk about autistic life. They also challenge the framing of the autism spectrum as a disorder, and for allistic people to throw the “disorder” label onto others involuntarily is definitely uncalled for. And yes, “autistic person” is the preferred term over “person with autism.”

    Since labeling different ways of being as diseases is what drives psychiatric oppression, I would hope that psych survivor authors could have more empathy for the autonomy/liberation movements of other marginalized/disabled groups. (The social model of disability works from an understanding that a disability isn’t a disorder per se. Rather, how social structures treat people are what determines whether or not a certain condition is disabling.) Autisticadvocacy dot org has great collections of writing by autistic people answering back to the “epidemic” language of groups like Aut. $peaks, and maybe some MIA writers would be interested in collaborating on publication with them in the future, if you want to develop a more holistic approach to the whole thing.
    – Lily C.

    • Would something like “chance” be preferable to “risk”? If you have more suggestions about less-problematic wording, I’m sure that Justin would welcome you getting in touch with him via the contact page. We’ve discussed some of the responses to this news item and what efforts we could make to address the concerns. It’s challenging to make everyone happy with word choices, especially when reporting on studies that use diagnostic terminology (as many of them do). And we do need to report on studies like these, because people have a right to know how the drugs they take may affect the fetus they’re carrying.

      • Reporting about things that can impact people’s neurology is important, for sure. But, it’s also just really clear to me at this point, that anti-autistic groups like Autism Speaks use “epidemic” and “danger” language to dehumanize autistic people, even going so far as to defend parents who murder their autistic children. (“Chance” is probably fine.)

        Things that are pushed as alternative or “natural” autism “treatments” are often really dangerous, but mainstream medical approaches like ABA are also abusive as fux. And the idea that autism needs to be cured props up the attitude that autistic people owe society allistic behavior. Invasively demanding that they make eye-contact, stop stimming, and change other harmless personality traits.

        Looked at Justin’s profile page, couldn’t find any email, sent a tweet. 🙂

    • One again, great post firewoman.

      I am not a doctor but it would seem the best thing a woman who is pregnant and on SSRIs could do would be a very slow taper to minimize withdrawal symptoms to her and the baby. That way, her chances of maintaining a good quality of life are alot greater which means she will be in a better position to all the necessary things to ensure a good outcome for her baby.

      • Yep, I agree (I’m not a clinician either, though I am a grad student in Public Health). I think the key concept here is harm reduction- the drugs carry risk, but that has to be balanced with the risks of withdrawal. I don’t think the pregnant women taking the drugs should be vilified- most seem to want the best thing for their baby and many feel guilty about taking medicines during pregnancy. Also, some women who are on high doses or have been on SSRIs for many years may not realistically be able to come completely off without having withdrawal issues (only working with 9 months to taper), so for some a more realistic goal may be reducing exposure (rather than eliminating it).

    • Exposure to toxins is better for the child than if the mother gets a little insomnia and lack of appatite from SSRI withdrawal.

      You will never convince me exposure to toxins is better.

      Say you got to be born again and you are now an unborn child, would you want your mamma to keep popping SSRI pills or not ?

      • Of course the problem is that SSRI withdrawal can be way more horrific than a “bit of insomnia” and “loss of appetite”. There can be agitation, anxiety, increased depression, suicidal thoughts…depending on dosage, years on, taper, etc. so this can be very dangerous.
        These drugs are toxic poisons that should not be prescribed in most cases and if they are, for very short periods of time in extreme cases.
        They are dangerous to start taking, to increase or decrease, and to withdraw from. And, on top of that, studies suggest they are only marginally more effective than placebos!
        This is a horrible position to have put women in.

      • The_cat,

        Just curious, have you been through a bad psychotropic drug withdrawal? There are plenty of accounts of people here and elsewhere about experiences such as not being able to eat consistently and significant weight loss (the opposite of what a pregnant woman needs to do!) or sleep more than 3 hours a night, for months and beyond? Not just a little insomnia or nausea. And remember, we are talking about pregnant women- who often already are dealing with physical issues like morning sickness (really all day sickness, I have heard). Not everyone will experience this and if things aren’t as bad, then yes the risks of continuing on the drugs may be more important . I’m just saying at least some of these women will have problems with the withdrawal- and the risks of withdrawal should be factored in. The way illicit drug withdrawals are handled (via things like methadone maintenance) should be a clue that withdrawal can be a serious issue.

        Also, what happens if the woman becomes suicidal due to the withdrawal and winds up in a psych ward? Then she is likely going be exposed to things like antipsychotics, which I would imagine are even worse for the baby.

        It’s great that you care about the baby (all dads should), but I don’t think you are being very realistic or empathetic towards women here. We are people too (not just a vessel for the baby who can be locked up for 9 months) who may have gotten placed on an SSRI ignorant of the risks involved, just like many others here. As engineer mentioned, birth control can fail ( more often than many people realize), so this is not necessarily intentional reckless. I think these women deserve to be treated with a little more respect for this difficult situation.