I’ve had a couple of people reach out to me lately for my advice about having another baby after they’ve experienced a postpartum mood disorder with a previous child. I combed back through Postpartum Progress and realized I didn’t write very much about my pregnancy with my second beautiful child, and what I was thinking at the time. Perhaps I was avoiding writing down how I really felt as I awaited her birth.
Since I knew I was highly likely to experience postpartum OCD again, this time I made sure I had a team around me that I knew would watch me like a hawk. I saw my fabulous psychiatrist at Emory every month (Hi Dr. Newport!), took my meds, talked to my therapist and made my family and friends put on their eagle eyes and their super-sensitive ears to monitor me. I truly felt comfortable that I was doing all I could do to have a better experience the second time around. The absolute hardest part about all of it, though, was the meds. I can still feel twinges of guilt about taking medication while pregnant even to this day. And I’m sure there are plenty of judgmental people out there (like one Mr. Tom Cruise) who would love to tell me what an awful mother I was and am for doing that.
I thought long and hard about it. I prayed about it. I, of all people, know the latest research because it’s my job to inform you about it here at Postpartum Progress. Truly, the risk in general is small, though there are some antidepressants that are more dangerous in utero than others. Yet a risk is a risk. For mothers, even a teensy, less than 1% small risk is really a HUMONGOUS, MAMMOTH-SIZED, JUMBO JET GIGANTO-RISK. The risk that my son or daughter might get pink-eye from one of their friends is enough to give me a headache. My children are like delicate, precious packages of plutonium love as far as I’m concerned. The LAST THING I would ever want to be responsible for is putting them at risk. Yet there I was.
I talked about this with my therapist a lot. I cried about it. But she told me about how the flight attendants on planes warn you that, in case of cabin decompression or oxygen loss or however they put it, you should put the oxygen mask on yourself first before you put one on your child. If you’re out of commission, you can’t help the ones you love. So I decided I wanted to help myself so I could help my family. I know there was risk to taking the medication, and I know there was risk to my child if I hadn’t taken it. Either way there was unavoidable risk. So I bit the bullet. Or the Cymbalta, as it were. I ended up being fine and so did my daughter. That makes me happy. And for those of you who decide not to take meds, find other successful ways to cope, and end up being fine, that makes me happy too.
Just so you know, lots of women take medications while pregnant and are not judged at all. It’s just that society has decided that, while it’s okay for women who have chronic physical illnesses or diseases to remain medicated, mental illness is "optional" so we really don’t have to take that antidepressant stuff if we don’t want to, right? It’s okay if you need something to stop your brain tumor from growing, but if you’re just trying to stop your brain from acting out of control, well that’s different.
Is it?
Your blog on this subject really helped me. I suffered from PPD and MAJOR anxiety after my first born. As I prepare to wean off Cymbalta and discuss another pregnancy, I have discussed the option of going on cymbalta during the end of my next pregnancy to hopefully ward off PPD again. It was a horrible time in my life and I feel like I missed my son's arrival on earth. I just can't go through that again and if meds are a possibilty, although there are risks, I think I'm willing to do so. I mean, aren't there risks in EVERYTHING…even crossing the street? A pregnancy without meds is just as risky!
Katherine –
Thank you so much for sharing your story regarding meds and pregnancy. It is a very common concern and definitely a personal decision that should be made with the utmost care and education. So many women aren't aware that meds are a possibility during pregnancy so I thank you for bringing awareness to the fact that they are indeed an option.
And no – continuing on meds for mental illness is NO different than treating a brain tumor. If mental illness were "optional," I would have checked the opt out box during pregnancy!
Hey–another great post that I can identify with–I medicated on my third and can't imagine what life would have looked like if I hadn't. This post sparked two posts for me over at http://www.lifeafterbaby.wordpress.com. I hope you don't mind sharing!
My son is 7 weeks old, and I was on Lexapro the entire pregnancy. I had asked my doc if Lex was ok during pregnancy in a pre-conception check and was given the ok, only to be scared to death and told to wean off of it at my 9-week pregnancy visit.
Given that pregnancy is an out-of-control time in life, I knew my anxiety would spike if I wasn't medicated. I have a preschooler that I had to stay healthy for too. As it turns out, my dad was diagnosed with melanoma when I was 8 months pregnant, which certainly would have thrown me over the edge had I been sans meds.
Pregnancy and childbirth are risky business, with or without meds. Every one of us with mood disorders does the best we can with the research, knowledge of our condition and faith that are at our disposal.
Great post! I struggled with the decision to stay on Zoloft throughout my pregnancy. The decision alone caused major anxiety. After speaking with my psychiatrist and ob, I decided to continue taking the med. Once I made that decision and got pregnant, I have felt great. Please do not allow others to judge you about your decision, as they have never walked in your shoes!!!
Thank you for sharing that beautifully written story. I feel guilty for having PPD with my second. For have depression while I was pregnant with him. Is that why he was underweight? Did he feel neglected? etc. etc. Either way there is guilt. However, the example of taking care of ourselves and our strength is what we really give to them. I really believe that.
and as for the privilege Mr. Cruise, no amount of green tea and treadmill was going to help me but hating on his smug ways actually did make me smile sometimes…!
This is truly why your voice is so important, so women can have role models instead of stupid sound bites.
Its a relief to stumble upon this site, I have been so anxious about medication while pregnant!! I was recenlty pregnant but had a miscarriage and suffered with anxiety during the pregnancy. I was on a very very low dose of citalopram 2.5mg in fact which wasnt doing anything. Anyway since the miscarriage the anxiety has been intense and i have just upped the dose to 20mg and feel so disappointed with myself I really wanted to be normal and go through a pregnancy meds free… but i just cant do that… and the realisation of that is hitting me hard!! Is there also something you can take to help you sleep thats reasonably safe in pregnancy!! although if im on the citalopram i should manage without that on the higher dose!!Why do we have to suffer with this.? Any info or reassurance would be greatly appreciated!!
I have been going through hell trying to get off of Celexa in anticipation of getting pregant. I have been on it for a couple of years (30 mg) and have been so happy and stable, with my depression and anxiety almost entirely under control. I was so confident that if I tapered off slowly I would be fine, and was determined to do it. It has been 3 months and I've managed to get down to 5 mg, but when I go lower than that I suffer the most crushing, terrifying panic attacks. I've never experienced anything like it. I literally thought I was going to have to check myself into the hospital last night. I think what triggered it was that I started to notice that I was feeling "not quite right," i.e. less happy, more irritable, and it scared me. I decided I just can't handle being off the meds altogether and have been beating myself up over it. I am SO happy to see a site like this with success stories from other women who have taken SSRIs during pregnancy. Although I wish I didn't have to, I now feel that it's "ok" to stay on the meds. Does anyone know whether it makes a difference if you're taking 5 mg or 10 or 15 mg? Once you're taking it, is the risk there no matter the dosage, or is it best to go as low as possible?
I really wouldnt beat youself up about it I am on 20mg as every time i go down past 5mg i get severe anxiety again and bam im back to square one again and my confidence is shot!! I am seeing a pregnancy specialist as i have recurrent miscarriage due to my immune system so I have to take steroids in early pregnancy and citalopram for my anxiety. I had a long conversation with my consultant who happens to be the best in the country for research on pregnancy and medication and he claims citalopram is very safe to use during pregnancy so really be on what you need to!! I just hope I can get to the point of having a baby….good luck!!
I have been on Paxil 30 mg for 4 years. I would love to have another baby as I am thirty three years old but am petrified as all the research states that it can cause heart defects for the baby. The problem is that I tried coming off of it a year and a half ago and ended up falling back into a depression which was bad but not as bad as when I had my daughter four years ago. I've tried Zoloft, Lexapro, and Effexor but they don't help, is there anything else that I could try that would be more safe for pregnancy then Paxil?
Thank you! I've been looking all over the internet about GOOD news about Cymbalta & pregnancy. I've been on Cymbalta for 5 years now for MDD, and just found out that I'm pregnant. Knowing that both you & your daughter are fine relieve my fears. I guess it's a risk no matter what, because even "normal" women have "abnormal" babies. The least I can do is take care of myself, to prepare for baby when he/she gets here, right? Thank you!
First, thank God for this site & all of you women for reaching out & sharif your stories!!
Allison, how are you doing with your pregnancy? I hope everything is well! I have been on 30 mg./day of Cymbalta for almost 5 years. I tried going off it last year as I just got married & thought it was a good idea if I wanted to get pregnant. Horrible mistake. I was back on it after about 6 months after not being able to sleep, eat, or function.
Anyway, I have been told both that I should stop my Cymbalta for the conception through 3 months, & then go back on for the rest of my pregnancy. Does anyone have any thoughts. I'm worried that if I go off again, I might need a stronger dose when I go back on it. Also, does anyone know or have experience with taking Cymbalta up through the labor? Are there any concerns with the Cymbalta & labor process, I.e. c-section or other drugs given during labor? Thank you so much!!
Thank you… your words really helped me ????