Tag Archives: anxiety disorder

Mental Illness and Pregnancy: To Medicate or Not to Medicate? That is the Question. (…that I do not have the answer to. I’m not a doctor. But here’s my experience.)

**Disclaimer (in case the title wasn’t disclaim-y enough for you): Like literally everything else on this CLEARLY non-medical blog, the following is based on MY personal experience. It is not intended to serve as definitive medical advice for my fellow mental health sufferers. I am not telling you to go off your meds, and I’m not telling you to stay on them. I am suggesting that you thoroughly consider your options, under the close care of a doctor who knows you well, and that you advocate for yourself before making a rash, fear-based decision. Mostly I am just letting you know that no matter what you decide or what you are going through, try to go easy on yourself. You’re doing the best you can. You are not alone. And you got this.**

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A lot of people have asked me if I’m still on my depression/anxiety meds while pregnant. This is a totally fair and welcomed question, mainly because most of you have asked in a matter-of-fact, non-judgmental, just-curious way, like, “Oh, hey, what’d you end up deciding about that?” But some of you have asked in more of an accusatory “You’re not still on your meds, are you!?” way that implies some sort of moral wrongness should I be on them– and even though I know (most of) you people come from a well-meaning place, it still makes me want to light your face on fire.

So allow me to try to explain a few things. Knowdlege is power and faces are generally better not aflame.

The answer is no, I am not on my meds. But let me be VERY clear about this– I am not off them because I have some kind of holier-than-thou judgement about staying on meds while pregnant. I have absolutely NO judgement about that, and in fact encourage women to stay on them if that’s what works best for their health and situation. Obviously. I am the queen of mental health triage– you do what you gotta fucking do to keep your marbles, sista! #sanityfirst

The drug I was on, Prozac (an SSRI), is actually known to be safe for pregnancy, and I know plenty of women who have been on this drug or others like it and have given birth to perfectly healthy children. And in fact, countless medical studies show that having a depressive episode or being acutely anxious while pregnant is far more harmful to a fetus than taking medication that will effectively treat these conditions (these MEDICAL conditions, in case you needed a reminder that this shit isn’t made up hocus pocus, they are legitimate illnesses). But yes, it is true that some mental health meds are unsafe for pregnancy. As long as you are discussing family planning with your therapist ahead of time, though, he/she should be steering you clear of those particular meds while pregnant.

Soooo after reading the above regurgitation of all the fun medical facts I’ve learned during my family planning journey,  you’re probably wondering, “Ok, so if all of that is true, why DID you stop taking your meds?”

Well, in a shocking turn of events, it was for no good reason at all, really. Basically, my therapist presented it to me like this: “The optimal, ideal situation is that you are off all medications and feeling fine, aka not depressed or anxious. Should you go off them and feel anxious or depressed, then the next best situation is for you to go back on them and stay on them for pregnancy. The least optimal scenario is that you have an acute depressive episode or debilitating anxiety while pregnant.”

Ok, so obviously all I heard there was, “The optimal, most ideal situation is that you are off meds….” and then I sort of stopped listening and everything else just became giphy. After all, it was my first time getting pregnant, I had no fucking clue what to expect or what the process TRULY entailed, so yeah, I wanted to do the thing I was told is “optimal.” No-brainer here. Do the “optimal, ideal” thing, because those are strong words that sound good. And I’m gonna be a good mom, damnit!

I’m not saying that line of thinking made sense, I’m just saying it’s the line of thinking I had when I quickly declared, “Ok, off the meds we go!” with far more confidence than any medication-dependent person with a lifelong mood disorder should have. lets-do-this

This decision was made back in July, and we weren’t planning to try to get pregnant until December, so I still had some time to wean off and be completely med-free for a bit before inviting a fetus into this  shitshow of an experiment delicate situation.

A few things to note.

  1. For the previous year before going off it, I had been on a very low dose of Prozac. That was part of why I felt I could probably be ok stopping it. Had I been on a high dose, it would have been a much more difficult and lengthy weaning process and likely wouldn’t have been worth it in my mind. Going off a low dose seemed easy and low risk.
  2. That being said, the last time I was med-free (age 26), I lost my goddamn mind. Like, completely incapacitated, lost 25 pounds, moved back in with my parents, played lots of senior-living type board games and took copious lukewarm baths just to pass the interminable minutes. I was extremely sick, and it was terrifying.
  3. THAT being said, I was younger then, far more naive, and had no idea what was happening to me. I had no reliable therapist, coping skills, or treatment plan for dealing with my illness. I didn’t even remotely UNDERSTAND it as an illness, so I certainly had no way of managing it (and no faith that it would ever end). Since then, I’ve done a ton of work on myself and have learned how to manage things (to the extent that I’m able) when life gets dark.
  4. THAAAAAAT being said, I’ve always had the medication to help me.

The conclusion I made based on these four somewhat unhelpful and conflicting points? If I go off the meds and things get bad, they probably won’t get as bad as that really bad time, because things are different now, and I’m more prepared.

But let’s be real, given I’ve had the consistent help of meds for 9 years, there’s just no possible fucking way to know that.

So I took the gamble, because gambling is fun when you’re drunk in Vegas so it’ll probably also be fun when you’re sober and housing a fetus, thought no one logical ever.

And at first it was fine. The weaning went smoothly. By the time I was completely off the meds, it was late October, aka my non-optimal time of year thanks to colder, darker weather setting in, and a general life-long refusal to understand why summer ends. So I didn’t feel GREAT* (*not really my M.O. regardless) but I certainly wasn’t depressed. Plus we had the 2-week, warm-weather honeymoon to look forward to, so that kept me going.

But the second I got pregnant in early December, shit hit the fan. I alluded to a lot of this in my post In a Shocking Turn of Events, I Am No Glowing Goddess, but shied away from some of the grimmer details because a) it was my first post about the pregnancy so I didn’t want to come out Depression guns a blazin’ and b) I was genuinely excited to finally share the news. But I do now feel the responsiblity, as a mental health advocate and general blogger of honesty, to let it be known that I was NOT ok that first trimester. I was hesitant to use the word “depressed” while I was in it, because I really didn’t want to admit to needing meds, and I felt like I should “stick it out” until the second trimester. Plus, recognizing you’re depressed WHILE you’re depressed isn’t always easy– it’s part of the mind-fuck of the illness. The very symptoms of depression (self loathing, worthlessness, hopelessness) prevent you from assessing the situation as “This is medical. I am ill,” and instead twist it to “I am the worst, I am being a little bitch, and I need to grow a pair.” (but alas, you cannot grow a pair– and the harder you try, the more you hate yourself for failing. Tricky little devils, these mood disorders).

I convinced myself it was all normal first trimester stuff. And some of it definitely was. Constant nausea and exhaustion will make anyone feel like shit. But some of it was really fucking dark, and I’m not so certain that’s normal.

I cried every single day. I stared blankly a lot. I couldn’t write, and could barely read. I felt absolutely no attachment to the pregnancy, and had no ability to see how anything was going to get better, or how I was supposed to love or care for a child. I was stuck in a thought loop of “You’re going to be a terrible mom, what were you thinking? This was a huge mistake.” I could barely get out of bed and I felt horribly, utterly lonely– the kind of lonely that can’t be cured by another person comforting you, because that ironically just makes you feel all the more alone (on that note, God bless Eric. No, literally, God, PLEASE bless him with a bevy of Corgi puppies upon his eventual arrival in heaven). That self-hating loneliness was the only feeling I had– about anything else, I felt absolutely nothing at all. It was 3 long months of toggling between complete isolated self-loathing and absolute, utter detachment. I’m not sure which I prefered. Both were pretty fucking non-optimal.

But it got better, eventually. Very recently. Do I feel great now? No. But I’m not depressed, and I’m able to feel excited at times. I have some energy back. I feel more motivation to get up and go. I open the blinds. I listen to music. I’m doing my job, not just suffering through it. I walk on the treadmill. Food tastes like food again.

But please note, the second after this baby is born: tenor-1 (<— definitely what post-labor looks like, no?) I will be right back on that Prozac. That was always the plan– my risk for postpartum depression is high, and we’re not taking any chances. And when it comes to the next pregnancy, should I be lucky enough to have that happen, I will likely stay on the meds. Those 3 months were horrible, and I see no reason to make an experience that is so hard on even the average, emotionally stable woman even harder. 

So, this is just to say, if you are one of those pregnancy newbies out there, and you are presented with your options in the same way I was, please know that it’s ok to not choose the “optimal, ideal” scenario if it’s not going to work for you. It’s not optimal or ideal if you feel like a self-loathing garbage truck for three months. It doesn’t make you selfish– it makes you reasonable and responsible. There is no wrong moral choice here, and you shouldn’t feel bullied* into making a decision that might not make sense for you (*to be fair, I really wasn’t bullied by my doctor. I still completely trust her. While I wish she had worded it slightly differently, what she said was perfectly reasonable– but I heard what I chose to hear and then I proceeded to bully myself, because that’s what we depressives do best).

But how should I respond when told it’s best to try to go off the meds, even if I don’t feel that’s the best option for me, you ask?

Well, next time, I’m probably going to say this, so feel free to borrow it: “Nope nope nope! No thanks, Doctor Person Who Isn’t Me, but I am me and because of that, I know myself farily well by now, and I sure do enjoy being sane! Seems the risks of the meds are pretty low, and the risks of me losing my shit are pretty high, so I’m going to keep doing that thing where I’m lucid and functional and seeing the point in showering, because, even though I don’t know much about babies yet, I DO know it’s easier to care for them when your mind is firmly planted in reality and you don’t wake up wondering why you have to exist. Right? Babies like moms who care about living and eating and clothing themselves? I feel like I read that somewhere and it sounded accurate.”

Or something similar. There’s probably a less condescending way, I don’t know.

Bottom line, do what works for YOU. I am not advocating for either option– every mental health situation, and every person, is different. I am simply advocating for you to advocate for yourself (under the care of a doctor you trust, of course. I really hope that goes without saying), and to really think through what will work best– again, for YOU.

Did going off meds work for ME? Meh. Hard to say at this point, because now that I’m out of the darkest darkness (I hope), it’s like “Ok, I survived that and no one died or anything, so that’s good.” But should that be the standard? No one died? Probably not. I feel like it was a lot of unnecessary suffering and potential risk, and I can’t imagine ever willingly going through that again. Plus, I can only hope and pray that my struggle didn’t harm the baby. So far everything looks good in there, the heartbeat is rapid and strong (doc says “Sounds great!,” I say “Sounds like anxiety!”), and I have no tangible reason to think she’s not thriving. But who really knows. And whether on or off meds, I’d have that “who really knows” feeling regardless. So next pregnancy, pretty sure it’s gonna be tenor.

And if you’re not ok with that? That’s cool. Just express your judgement to someone else, not me. I can’t go lighting faces on fire once I’m a mom, but I can definitely teach my kid to spit in your eye and claim it’s an accident.

Reaching

Therapist: “So it seems like all those travel anxieties you had leading up to your Africa trip were, as usual, in vain, because none of them happened.”

Me: “Ummm….were you listening? I got a violent stomach bug,  vomited across two separate countries/airports/airplanes, spent the whole last leg of the trip exhausted and achy– and I in fact STILL don’t feel like myself.”

Therapist: “Right but your fear is always that you’ll feel sick for no real reason. This was an actual REASON.”

Oh you are really fucking reaching today lady.

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But I Pay You to Be an Infallible Robot

Me: “I did what you suggested, but I think it made me feel worse.”
Therapist: “Ok, well. That is information.”
Me: img_1179-7
Therapist: “I apologize if it made you feel worse. Sometimes my advice is wrong.”
Me: “What?”
Therapist: “I make mistakes.”
Me: “WHAT?!”
Therapist: “I am only human.”
Me: “YOU ARE?!”

Literally The One Thing

Therapist: “I’m starting to notice this about you– you tend to start things from a place of assumed failure. You approach new things, even new conversations, or small tasks, as something you’re going to screw up. And immediately starting from this assumption puts you in a space of feeling defensive, like you constantly have to prove yourself. And that’s why it’s so hard for you to get started with things. And, quite frankly, why you’re so exhausted.”

Me: <stunned silence>

Therapist: “Big ‘Aha!’ moment for you?”

Me: “It took you 7 years to notice this about me?!”

It’s literally the one thing I was born knowing about myself

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I Am Miserable In This Photo

I want to apologize.

Last weekend I went to a Phish show and posted this photo on Facebook, for all of you to see:

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In it, I am fucking miserable.

Surprised? I’ll bet. Nothing says “My life is so happy and fun, guys!” like an open-mouthed, wahoo yell-smile, indoor sunglasses, bright lights, and background spirit fingers.

(For the record, Eric is exactly as happy as he looks. If he had a tail, it’d be wagging. Which is why he is the absolute necessary img_7492 to my img_1179-5.)

The second after that photo was snapped, my face fell back into its previous anxious contortion. That entire afternoon and night, I just couldn’t calm down. I didn’t feel present. Everyone around me was excited, and I couldn’t get on board, not matter how hard I tried. I felt disassociated, stuck in my bell jar, uncomfortable in my body. I was trying to move to the music but just….couldn’t. Everything about me felt awkward, disconnected, and out of place. And so, the self-defeating but all-too-predicatable marathon of thoughts began swirling through my brain, a loop so familiar that I carry a VIP pass to this particular ferris wheel ride of misery: “Why can’t you just relax, Emily? Why can’t you just have fun like everyone else here? Why do you have to be such a goddamn downer? JUST ENJOY YOURSELF FOR CHRIST’S SAKE, THIS IS SUPPOSED TO BE FUN! STOP BEING THE ABSOLUTE FUCKING WORST!”

(It’s weird how this strategy never works.)

Those sunglasses? Not a cute, bright-lights-at-Phish gimmick.

They were necessary to hide my tears.

Now brief side clarification– my misery that night had NOTHING to do with Phish. Phish critics might think, “Of course you were miserable at Phish, it’s a crowded shitshow.” And yeah, it sure is! But truth be told, I actually like Phish. A lot. Ok, not nearly as much as the die-hard, 100-shows-and-counting phanatics I’m usually with, but I do have an appreciation for the music, the people, and the scene. In fact, I had been to a Phish show 8 days before this one and had a genuine blast. My mood was stable that day, and the music and crowd were in sync with my dopamine levels. I got lucky. I should have posted a photo from THAT show. At least it would have been authentic.

So why did I choose to post a “joyful” photo when I felt shattered inside? I’m sure there are a million different answers to that, all of which I will analyze to death with my therapist next week, so she better buy at least 3 hats, 2 helmets, and hold the fuck on. But I’m in touch with myself enough to know that the main reason is this:

That photo represented how I wanted to feel.  And maybe if that was the image I projected to the world, it would, in some way, become the reality.

 

But shame on me. I know better.

I know that when I’m down, a filtered, look-at-me-having-fun photo feels good for one moment and one moment only. Then I’m just part of the problem, a problem that I’ve always been so conscious and critical of.

It’s no secret that social media can be harmful to self-esteem. I’m not making any groundbreaking statements in that regard. The constant comparison to other people’s happiness and success, which is generally the majority of what gets posted, makes us feel badly about our own less-than-perfect lives. We’ve all experienced this. It’s insane how we can scroll through a news feed and, even when we KNOW, intellectually, that what we see is not capturing the true, more nuanced reality of our peers’ lives, we still, on some level, process it as such. Our visual perception, paired with our own insecurities, trumps our rational mind every time.

That is why I am so disappointed in myself for posting a photo that projects fun and joy, when inside I was torn to pieces.

This helps no one.

Especially not myself.

I know better than to communicate an inauthentic truth. I know what it does to my mental health when I try to put forth a version of me that isn’t real, and the possible damage it can do to others who struggle. It’s the main reason I have this no-clear-theme-and-sort-of-all-over-the-place mess of a blog– a mix of stories that highlight my imperfections, struggles, and staggered journey. Yes, some of my expereinces are joyful, and I’m always thrilled when I get to share that. And I will continue to share that, as we all should– when it’s genuine.

But a lot of the journey is hard. And awkward. And sad. Anxiety-and-guilt-ridden, scary, uncomfortable, confusing and head-in-hands frustrating. So I try my best to capture that, too. Not push it down and cover it up with a camera-ready smile. Because if I’m doing that, if I’m masking the struggles, I’m just another “Look how great my life is ALL THE TIME!” social media monster. We have enough Kardashians out there eating us alive, ass-first.

The thing is, my life really IS great, guys.

It’s also a category F5 shitnado.

I promise an online presence that continues to project both these realities.

Forgive me?

 

 

 

Stigma

Went to see my general practitioner for my yearly check-up today.

Doctor: “Are you still taking Prozac for depression and anxiety?”

Me: “Yes, 30mg.”

Doctor: “Hmmmm. That’s more than you were taking last year.”

Me: “Yes…”

Doctor: “But you just got married?”

Me: “Yes.”

Doctor: “Well that’s a happy event! That didn’t help the depression?”

Me: “It was a happy event. I’m not sure what that has to do with my mental illness.”

Doctor: “I would just think the wedding would boost your spirits, no?”

Me: “It did. It also boosted my husband’s spirits– and yet, wouldn’t you know it, he still has diabetes!”

 

Yeah, so. I need a new doctor.

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