I wish that I had spoken to my therapist about my fears of medication and pregnancy and seen a psychiatrist specializing in my condition sooner. I wish that I hadn’t put myself in the path of such terrible, useless suffering.
I wanted to get pregnant so I decided to wean off my antidepressant.
I didn’t make the decision lightly. I knew that antidepressants could cause problems with lung development and potentially affect the brain. The BRAIN of my child! I had read stories on the Internet of babies that could not be comforted, moms who deeply regretted staying on their medication. I believed that the best thing I could do for my baby was to provide a medication-free womb.
Ironically, I had been through this before with my first baby. I had weaned off my meds, conceived, gotten horribly depressed, tried Zoloft, hated it, and got back on Lexapro halfway through my pregnancy.
But this time was going to be different. I was doing great. I was meditating nightly, doing yoga, going for walks, and seeing friends who had dealt with my issues. I had support.
I didn’t make the decision in a vacuum. My then-doctor suggested I wean off for pregnancy reasons before I was even thinking about getting pregnant. I had many conversations with friends about medication and depression. Some said things like “medication gets in the way of your spiritual development” and “medication is a crutch that keeps people from dealing with their real problems.” I saw articles and comments about how common it was to prescribe antidepressants, implying that most people didn’t need them. From the hippie/spiritual/earthy/crunchy worlds in which I traveled to the mainstream media, I heard messages that antidepressants were unnecessary, harmful, and a sign of weakness.
And honestly, I didn’t want to be dependent on medication. Dependency is bad (or so says our culture). I want to be independent. Strong. In control. Mind over brain! Did I really have to take medication my entire life just to be normal?
I weaned off oh-so-slowly on my own, at first shaving slivers off each 20 milligram pill with a knife. I didn’t tell my therapist I was weaning off my meds. I knew that was a red flag, but I ignored it and left therapy with my therapist’s stamp of approval (knowing she didn’t know what I was doing). I took fish oil supplements, exercised, spent my lunch hour in the sun, and ate healthily. It took me about six months to wean off completely.
In that time, I quit my job and started working part-time for a friend. I was truly miserable at my old job—though I have to wonder if I would have been quite so unhappy if I hadn’t been going off my meds. I was thrilled to be working for my friend, even though it paid much less and didn’t come with benefits.
On the day that I went to zero on my meds, my friend laid me off, with no notice.
I crashed.
I don’t know how to describe it from a position of sanity because the key thing about depression is that you are no longer rational. I felt like everything was ruined forever, that I had made a terrible choice in leaving my job, that I had no options, that everything was, in fact, fucked.
I didn’t think this so much as a I felt it—as a grey tide that sucked me down, down, down to the ocean floor, an irresistible gravitational force. I didn’t have the energy to move. I wanted to pull the covers over my head and disappear from the world forever. Sometimes I cried, but mostly I was paralyzed by unfathomable emotional pain. I wanted to exit the world, but I knew that wasn’t fair to my son and husband. I was trapped between wanting to die and feeling like that would be the most horrible thing to do to my son.
I have incredible frustration and compassion for myself at that time. In retrospect, it seems so simple, so easy to solve: go back on your medication! But at the time, I was sunk so deep that I couldn’t think my way out of a paper bag. And feeling that way seemed inevitable.
I somehow managed to get pregnant—one try was all it took. You might think that feeling so bad might preclude the activities necessary to conceive, and you’d be right 98 percent of the time.
My period was late, and I took a pregnancy test. Positive. I was stunned—I hadn’t expected it to be happen so quickly. Now I was actually pregnant instead of preparing for a future, hypothetical pregnancy.
I knew I was in a bad place—and I knew because I had been there before, and I had gotten out with the help of medication. I reached out for support, which was really hard to do. I took the easiest possible tack—I sent a facebook message to my friend Amber, a mental health champion. I asked her about her thoughts on antidepressant use and pregnancy. Amber told me, “You don’t have to suffer.” She sent me articles about new research and recommended attending the local postpartum support group, even though I was still pregnant.
Being unemployed, I had time to go to the group, though I didn’t make it until the next month. It was a small group, just two other women. We shared deeply, revealing the painful experiences usually elided in everyday conversation. I was shocked that others had suffered so much as well and relieved that I wasn’t the only one. I knew the stats on postpartum depression—1 in 5 or 6—but knowing was different than hearing the meat of women’s stories. Even though my story was different, it made sense there.
At the end of the meeting, the organizer asked us what our next steps were. I said, I guess I should see a psychiatrist…but who? The organizer gave me several names and gently encouraged me to call.
The first couple of names were a miss—they’d moved on or their practice was full. I felt like giving up. But I had gotten the name of a psychiatrist who specialized in pregnancy and postpartum in the course of making calls. I called, got an appointment, and went to see her two weeks later.
After the painful intake (review every difficult circumstance in your life and your current suffering in response to a series of questions), my new psychiatrist leveled with me. “The best thing you can do for yourself and your baby is to go on medication. Right now, your system is in a state of depression and anxiety. Depression can cause low birth weight and pre-term delivery.”
I asked her if I should continue to wean up. “No,” she said. “Go back on the full dose immediately.”
And I did. Knowing that medication was the best choice not just for me but for my baby made a huge difference. I stopped feeling guilty about my “failings”—my tendency to depression, my inability to stay afloat without medication, my desire to get back on medication—and felt good that I was choosing to take care of myself and create the best environment for my growing fetus.
The medication started making a difference in a week, and in a month, I was close to normal. The overwhelming pain and fear just…receded.
Life is still plenty stressful, and I still have ups and downs—but the difference is that the rollercoaster isn’t pointed permanently down and the slope isn’t as steep. I don’t feel numbed to my emotions, or that I’m wearing rosy glasses. I feel more like myself and able to engage with the world. Now I can once again partake of those activities—walking, seeing friends, meditating—that were unthinkable in the throes of depression.
I wish that I had spoken to my therapist about my fears of medication and pregnancy and seen a psychiatrist specializing in my condition sooner. I wish that I hadn’t put myself in the path of such terrible, useless suffering.
There’s a great deal of fear of and misinformation about antidepressants. Just last month, my midwife told me that my medication could cause neural tube defects, and it was already too late to do anything about it. My psychiatrist explained that this was untrue—my particular medication does not have those side effects. I can imagine how upset I would have been if I didn’t have a psychiatrist (the actual expert in the field) to explain the differences between medications. I would have felt terrible, irresponsible, and horribly afraid…because my health care provider was giving me bad information.
I’m so grateful that I have the expert’s endorsement to take my antidepressant—because I don’t see how I could get through pregnancy (or any other life condition) without it. I’ve accepted that I do need medication to function normally. For me, it’s not a crutch, something you use until your leg heals. It’s more like glasses—a corrective to a biological condition. And just like wearing glasses (or contacts), taking an antidepressant shouldn’t be seen as a personal failure or weakness.
You don’t have to suffer.
Yael D. Sherman has a PhD in Women’s Studies and is gestating her second child.
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