Depression, pregnancy, and nursing: What to do?


I started seeing a psychiatrist at the beginning of 2011. It wasn’t the first time, but it was one of the times I needed it most. I was living in a new place that I didn’t know well and I had no support system. I had parted ways with my job and was itching to occupy myself. I suspected my son was autistic (which was confirmed a few weeks after I started therapy). With all that time on my hands and plenty of misery I was having trouble doing basic tasks. I was anhedonic (unable to take pleasure in anything). And it needed to stop.

Within a few months I was on a comfortable dose of an antidepressant, I’d started a new job and my son was receiving daily therapy. Things were looking up. I was feeling better. Instead of looking up from underneath life, I was able to feel like I was at least level.

Then I found out I was pregnant.

One of the first questions I had was what to do about my meds. I wasn’t on one of the “approved” antidepressants for pregnancy. They’d had side effects I wasn’t comfortable with, including deeper depression. But everyone I knew who’d been in this situation said they’d gone off meds when they got pregnant or when they were trying to conceive.

I took the issue up with my psychiatrist. She’d done her reading and she told me exactly what the research was on my drug. We talked about the pros and cons. We talked about statistics. And then we talked about me. What were the potential dangers of me going off my medication? How would stress affect me in my pregnancy? Would I cause more harm than good?

In the end, I decided to stay on my meds. I was on a low dose. I was stable, but I was just barely stable. It wasn’t a good time to stop. The baby needed me. So did the family I already had. And this seemed like my best shot.

So I stayed on my meds. I told my obstetrician. I kept going to therapy. And then, thankfully, I had a beautiful baby daughter.

But that wasn’t the end of the story. Then came breastfeeding. Some of my antidepressant would probably be transferred to the baby through my milk. I had another conversation with my doctor. And we decided to stay the course.

It’s been over a year now that I’ve been down this road and not once have I heard another mother say she’s doing or has done the same thing. I don’t know if I’m the only one or if they’re just afraid to say so. But here it is: I took antidepressants while pregnant and breastfeeding. And I think it was the right decision for me.

I had only a bit of doubt a few weeks ago when I left my daughter with family while I was out of town for a few days. My pump broke and I didn’t get a chance to set aside as much breast milk as I wanted so they had to supplement with formula. When I called to see how she was, I was told she was happier than ever before, sleeping more than every before, and generally being a delight.

I wondered: was my baby’s tendency to be loud and fussy and a bad sleeper because of my antidepressants? Was I doing this to her? I knew it could be anything: maybe drinking milk or eating spicy foods or too much broccoli. But I thought of my meds first.

I’ve had her back for a couple weeks now and, wouldn’t you know it, she is happier than ever, sleeping more and generally being a delight. It was just a coincidence, one of those baby breakthroughs.

So there it is. I’m on my meds. My daughter is happy. I feel in control of my life. And I’m not ashamed to say so.

******

Have any of you been in Jessica’s situation? What was your decision on meds vs. no meds? How are you and your baby doing? We’d love to hear from all voices out there…

photo credit: -mrsraggle- via photo pin cc

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16 Replies to “Depression, pregnancy, and nursing: What to do?”

  1. Jessica, I think it’s so great that you’ve shared this, and I’m sure there are others out there who have done the same thing, or who will read this when they are struggling to decide and be inspired by your words. Thanks for sharing it.

    I’d also never heard the term “anhedonic” before and will be looking into that one!

    Love to both of you ladies.

    1. Anhedonia trivia: the word “anhedonia” was originally the title of Woody Allen’s ANNIE HALL. I’m glad he changed it.

      But yeah, when we talk about depression and mental health in my house, anhedonia is definitely something we look at to gauge how we’re doing.

  2. Jessica, thank you for sharing your story with us. Through four pregnancies and nursing, I never had any depression – quite the opposite, I was happier than I had ever been. Then, in 2010, my six-year-old son died from brain cancer. Being 40, I thought I was done with babies, but found myself – surprise! – pregnant three months after my son’s death. I was scared to death that something would be wrong with the baby, and felt certain I wouldn’t be able to handle anything so soon after losing my son. I had been on Lexapro throughout my son’s illness and after his death, and my doctor encouraged me to stay on it. I didn’t want to, but she insisted it was safe. I tried to not be on it, but I cried was anxious all the time. Once she convinced me that it would be better for me, the baby, and my family to stay on it, I did. Then, once I was nursing, the same thing – I tried to not be on it, but I was so sad, so I took it – a very low dose. Today, my baby is 14 months old, and happy and sweet and curious and busy. I can’t let myself get wrapped up in the what-ifs about taking or not taking the pills, because in the end I know what I did was best for me, and therefore my family.

    Thanks for sharing. I’ll be checking out your blog (I love JD and I know she has good taste in people ;)).

  3. This is a post so many mothers and fathers should read. The most powerful part was when you said your baby and family needed you. I’m proud of you.

  4. I was on anti-depressants (Wellbutrin, which is usually considered safe for pregnancy) for me whole pregnancy and for the first year and a half of Owl’s life. I sometimes wonder if his extroversion is a result of the dopamine in my meds, but hey – he’s a great and happy little guy so I guess everything worked out for the best.

  5. This is awesome. I did the same thing– took drugs while preggo and nursing with the support of all my docs. Thank you for raising this topic. There’s lots of misinformation out there!

  6. I was diagnosed with depression when I was 28 weeks along in my pregnancy. I started taking Zoloft and joined a support group my psychiatrist ran for pregnant women who were struggling with depression. The medicine worked well while I was pregnant, but I found postpartum it wasn’t doing much so I was put on Pristiq which has been much better.

    L came a little early (36 weeks), and the first night he had what the nurse called a “misty spell”. His skin turned kind of grayish and they were concerned about his oxygen, but when they tested him his oxygen levels were prefect. The next day the doctor did some investigating and said that it was due to the meds, but there was nothing wrong. That is the only side effect that we’ve noticed in him. He’s a happy, alert, bright baby.

    It’s nice to know that other mom’s have gone through similar things. It’s not something I talk about with most people.

  7. Great post. Thanks for talking about this openly. I went on antidepressants (very reluctantly, but it was either that or continually fear that my family would end up as a bloody news story) when my younger child was 6 months old. It really wasn’t clear if I could continue breastfeeding–my doctor said I probably could, but the date wasn’t really there (Celexa, FWIW). So I gave him formula (a HUGE deal for me, as I was totally anti-formula, pro-breastmilk). He got formula all day and nursed at night. I felt better about, but maybe he was still getting meds (probably!). But not as much, right?

    Doesn’t matter. He’s now 2 1/4, I’m feeling much better, he is hale and hearty and still likes his “booby!” at bedtime, and it worked out fine. But WOW it’s really confusing and a hard choice, isn’t it, about antidepressants and pregnancy/breastfeeding?

  8. I have struggled with depression on and off my whole adult life. I felt okay throughout my pregnancy but was on anti-depressants for the 11 months I breastfed my son. It was needed for both of us, and we are both fine!! Bravo to you for sharing your story 🙂

  9. I commend you for your bravery in telling this story. I was terribly depressed throughout my pregnancy (11 yr ago) but too fearful to stay on meds. I cold quit the day I found out I was pregnant (a surprise) and endured 9 months of hell. It’s great that you had a skilled and knowledgable doctor. I didn’t. Maybe if I had, I wouldn’t have had to suffer the way I did during the pregnancy. Thank you for sharing your story.

  10. I’m a little late to the game, but came across this post while searching for info on pregnancy and anti-depressants. Hubs and I are planning to start a family sometime this year and I am terrified of getting off my meds. Thankfully, I have a supportive doctor (along w/ Hubs) that has already started giving me options, suggestions, and information. Thanks for sharing your experiences, all!!

  11. Wow, I love your story, thanks for sharing! I developed terrible PPD requiring Prozac. It devasted me that I needed to make a choice about stopping or continuing breastfeeding. I decided benefits of bf, even with Prozac, outweighed no breastmilk, so I continued both. I too often wondered about the med impacting my baby…fussy, needy, etc.

  12. Just read your blog. I was on meds a month after delivering my first baby and immediately after my second. I suffered from PPD after my fiirst child and wanted to avoid that same feeling of despair. I continued on my medication up until we decided to try for a third. Luckily, I was able to remain med-free through the pregnancy, but began treatment the day after delivery. I thought it was the best option for my children and myself to not suffer as I had the first time around. Why wait for the symptoms of PPD? It was a no-brainier for me. While on Zoloft I nursed my baby and never noticed anything off with her. I know without a doubt, I would have been the one who was off if I had been left untreated.
    People must do what is right for them and not let other’s uninformed judgement influence their decisions. Had I listened to the opinions of many around me, I would never have had my last baby, the best little girl I have ever known.

  13. THANK YOU A MILLION TIMES OVER for this blog post. I don’t know you but I know your struggle as it is also mine. I have had treatment resistant major depression with severe anhedonia and OCD for most of my life. In my teens it manifested as severe anorexia nervosa which almost killed me. I lived in hospitals until I finally began to recover. Then in my 20’s I began self-medicating with alcohol and opiates. This spiraled into a very serious addiction which I, once again, spent years working to overcome. At the root of all my issues was the same dark monster, depression, lurking and waiting for me to slip into self destruction. I could not live that way anymore. I considered suicide at one point – living with the darkness was almost too much for my soul to bear. When I began to get well I was prescribed Prozac and it helped, although the side effects bothered me greatly. I did feel more able to function and less down, anxious, irritable, etc… But eventually it wasn’t as effective and I took it upon myself to find a better option. I began taking Effexor last year and it was a miracle. I got “me” back for the first time in 18 years. It felt incredible. All the sudden I had energy and interests again; I was creative and passionate. I could complete tasks and do simple things (which aren’t so simple for me when depressed) like go out with friends, travel, eat well, paint, play guitar, surf and scuba dive, garden, etc. my OCD got better too. All this and then, unbeknownst to me, a round of antibiotics I was taking for a kidney infection rendered my birth control almost useless and my fiancee and I got pregnant. I was so shocked and scared. Like you, my first thoughts were of the medication. I was already 8 weeks along when we found out and so
    I set out to lower my dose of medication as much as possible and try to taper off. It did end up that I cut the milligrams way down but I could not stop taking it completely without experiencing terrifying panic attacks that left me agoraphobic and depression which had me contemplating running to South America away and never coming back. I thought I was the worst person in the world. I cried for my baby boy and worried all the time but with my therapist and psychiatrist behind me, the decision was made to stay the course and for me to keep doing what was BEST and very NECESSARY for me. Now my son is two months old and I do breast milk supplemented with formula for a latching issue. Otherwise my baby is healthy and fairly happy so far. I’d love to be a “crunchy earth mamma” and do all the organic foods and home birthing and never even take an Advil (wouldn’t we all!) but that’s not in the cards for me and probably never will be. I have to learn to live with it. I can’t beat myself up. I just want to be around for my family and be the best mother I can possibly be to this child. So we are very alike. You aren’t alone. And I read this post with happy tears in my eyes because finally SOMEONE out there understands what I went through in the past year! I feel so much better. THANK YOU AGAIN!!!!!!!!!

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