When I learned I was pregnant with my second child, I was overjoyed. My husband and I had been talking about expanding our family for years, but nothing was happening. Things didn’t quite “click,” or line up. But by Father’s Day, I could sense something was different. Something inside me had changed, and so I took a pregnancy test. I got a negative result. Undeterred, I waited a few days. I counted down the hours until I could retest and, when I did, I got the results I already could feel: I was pregnant. But after the excitement wore off, fear set in. I have bipolar disorder and anxiety disorder, and I knew pregnancy meant one thing: I would have to come off my meds. Immediately. Was it even possible to take antidepressants while pregnant, let alone mood stabilizers or benzos?
I was terrified. I called my psychiatrist the following Monday and shared the news. I expressed my concern and asked what my options were, and I quickly learned they were limited; my mood stabilizers were a no-go. So was the Xanax. The only thing I could take during pregnancy was an antidepressant, but my current antidepressant wasn’t even compatible — it was untested in pregnant women.
So what was my best choice? According to my doctor, it was Zoloft, which is a well-researched prescription that has shown little to no impact on a fetus. But I was still afraid. Because studies don’t make a medication reliable; testing doesn’t make it tried-and-true, and research isn’t foolproof. No matter how “safe” a medication may be, it still comes with risks.
According to the National Center for Biotechnology Information, babies exposed to antidepressants in utero face a slightly higher risk of preterm birth, low birth weight, developmental delays, breathing difficulties, pulmonary hypertension and postnatal adaptation syndrome. Plus, my doctor cautioned me that taking an antidepressant — and an antidepressant alone — could cause me to spiral into a manic or hypomanic state. But he also told me my confidence and comfort was key. In fact, many medical practitioners now believe having a mentally stable mother outweighs any/all risks, which is why 13 percent of expectant parents take antidepressant medication during pregnancy.
As for me? I opted for the meds. We started with a low, low dose.
That said, deciding to take antidepressants during pregnancy was (and is) a very personal decision. There is no right or wrong approach. Instead, it’s a choice every mother must make individually — smartly, soundly and with the help of her doctor.
So how does one make a good decision? A wise decision? A thoughtful and safe decision? According to Dr. Pec Indman, a marriage and family therapist and coauthor of Beyond the Blues: Understanding and Treating Prenatal and Postpartum Depression & Anxiety, the key is to do a cost-benefit analysis: “You always have to weigh the risk of medication,” Indman told Parents, “against the risk of illness.” And for me — someone who struggled with severe postpartum depression and has battled mental illness most of her life — avoiding the lows was imperative, as one of the symptoms of my depression is graphic and extreme suicidal thoughts.
Of course, I would be lying if I said everything was perfect on the antidepressants — or if I said that my pregnancy has been entirely depression-free. I have been despondent and emotional. My moods swing frequently, and the exhaustion has been overwhelming. I have been unmotivated: to stand, to shower, to brush my teeth.
One day, I found myself feeling so broken, I just started crying on the bus to work. I called my doctor in a moment of fear, desperation, hopelessness, helplessness and despair. I talked; he listened. Then, together, we decided to adjust my meds.
Because I need help to keep me balanced. To keep my head clear and my moods stable. I am not embarrassed by this fact. I am completely unapologetic and — pregnant or not — I am not ashamed. But I still worry how my decisions may impact my unborn babe.
At eight months, I yearn to hear my little one take his first breath. I can’t wait to see him kick, flail and cry, and I am desperate to count his fingers and toes. I’m still worried at how my medications might have affected him. But I also know I am giving him the best start possible by giving him the healthiest version of me possible. And that is absolutely worth something.
Scratch that: It is worth everything.