I Had to Advocate for My Mental Health to My Doctor

Healthcare providers should stop suggesting pregnant women get off their antidepressants

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Deciding to try for a baby was a snap decision for my husband and me. I hadn’t been taking prenatal vitamins or getting my body into a state of pristine health so that I could conceive. The most valuable contribution I was making to my health was taking a daily antidepressant.

As it turned out, that snap decision was a big one. A month later, when I found myself in the women’s center at the hospital in which my mother, brother, and I were born, the OB told me I needed to get off of my daily medicine.

If you are one of those people whose chemistry is so balanced that you’ve never needed help finding your mental equilibrium, you may not know how torturous getting off of a daily antidepressant can be. It feels like what I imagine vertigo to be — but in your eyes. Getting off of a medicine fogs your vision, turns your brain into a heavy, wet sponge, and makes quick movements feel like you’re on unsteady ground.

If quitting antidepressants isn’t a metaphor for anxiety, I can’t tell you what is.

I had been taking Lexapro for a year when I became pregnant. Before that it was Celexa. But I’ve always — always — had a prescription for Xanax. While Lexapro, Celexa, Zoloft, and other Selective serotonin reuptake inhibitors (SSRIs) are daily antidepressants which regulate mental wellbeing via a constant flow of serotonin to the brain, Xanax is for spot anxiety, or moments of panic. On very few occasions have I had to resort to taking it due to panic, but I don’t leave my house without it. Not even for a walk around the block.

Back to the OB. It would be best for the baby if you didn’t take a daily antidepressant, she said.

But what about me?

If you feel you really need to stay on a daily antidepressant, she said, then you should consider switching to Zoloft. But definitely don’t take your Xanax.

One could argue that this drug is no safer than the other SSRIs, but it is the more studied drug, so it’s the one most often suggested for pregnant women.

I asked my doctor which is worse for the baby: exposure to Xanax or the stress that could come from a panic attack. She said the stress would be worse, but still, try not to take the Xanax.

I made the switch to Zoloft that day, and was relieved to find the transition wasn’t as tumultuous as expected. The worst side effect is the one that’s showing up now as I write about it.

Why did I have to advocate for my mental health to my healthcare provider?

I was a pregnant woman. I knew how important it was to care for the baby growing inside of me. But if I didn’t feel balanced, how could I give my unborn child the care and attention it needed?

I eventually switched my care from an OB to a midwife. Just as I expected, the topic of my daily antidepressant came up with my new provider. Would you consider getting off of the drug for the last couple months of your pregnancy? It would be best for the baby, she said.

The last couple months of my pregnancy are the very months in which I will need this medicine, I told her. Being uncomfortable and immobile is scary. Labor and delivery is scary. Having a baby is scary. If the medicine really won’t harm the baby, like scientific research reveals, I would like to stay on my medicine, I said.

Again I found myself in a situation in which I had to advocate for my mental health to my healthcare provider.

The midwife warned me that I might deliver what they call a “Zoloft Baby,” or a child who enters the world slightly sedated due to a small amount of the medicine in their bloodstream. It wouldn’t harm the baby, she said, but it’s not ideal.

Again, I chose to go against the recommendation of my healthcare provider. I chose my own mental wellbeing because I knew myself better than they did. The child growing inside of me deserved a calm, patient mother when she entered the world, and if being born a “Zoloft Baby” wasn’t going to harm her, then I wasn’t going to consider putting my mental stability at risk.

I took Zoloft until the day my daughter was born. And the day after. And I’m still taking it now, 16 months after her birth.

And guess what: she came out kicking and screaming — a perfectly healthy baby. Today she is still breastfeeding, therefore potentially exposed to some of my antidepressant, and she is fine. Thriving, even. She’s passionate and unafraid to share with us her strong opinions and emotions. She is not sedated, nor is she in any way harmed by my decision to remain on a daily medicine. If anything, I think she has benefitted from having a mother who can remain calm under crisis.

I haven’t taken Xanax since before I got pregnant. My mental health is in beautiful shape. I didn’t experience postpartum depression and, though I’ve had some scary motherhood moments like all parents experience, I’ve been strong and stable — exactly the way my daughter needs me to be.

Some people just need antidepressants. Nobody, the least not healthcare providers, should tell an expecting mother that her mental health isn’t important.

Nobody should mess with others’ mental health at all. Period.

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author | reader | mother | kolinacicero.com/book

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