Medicated Motherhood
In the peak of my postpartum depression, I had two therapy sessions a week, check-ins with my psychiatric care team every other week, and a weekly support group with other moms experiencing a postpartum mood and/or anxiety disorder. While this may seem like an abundance of support, it wasn’t enough. Medication, specifically antidepressants, saved my life.
My primary care manager signed off on my use of Prozac during pregnancy without any discussion of potential adverse side-effects. Fast forward a few months to when I began to really struggle with prenatal depression. We were in yet another wave of COVID, I suffered a major loss in my family, and I was moving across the country again without my partner. My depression brain told me that I should take myself off my meds because that would “fix” things. All I could see was that, for some reason, I felt off-kilter and as if I was teetering on the edge. I couldn’t control my emotions, what was happening in the world around me, or even what city I called home. I so badly needed to exert control over even one inch of my life that I chose to control what I put into my body, which is a remnant of my lifelong battle with an eating disorder. The decision to entirely stop taking my medication was devoid of all logic and was fueled by the desperate hope that if I changed the one thing I could control, the things I couldn’t control would stop spinning. Unsurprisingly, depression brain won this argument and of course made my anxiety and depression much worse. Unfortunately, when you are in the place where your anxiety and depression are dictating your choices, there is nothing to do but spiral. With the help of my therapist, I managed to get myself back into a routine of taking my medication as prescribed for the final eight weeks of my pregnancy.
After W’s birth, the nurses in the hospital continued to bring me my medication, as prescribed, while simultaneously bullying me to breastfeed. I didn’t think twice and continued to believe that taking Prozac postpartum would be a non-issue, especially after I was discharged and sent home with a refill of the prescription. However, at our first pediatrician appointment, both the doctor and nurse raised a flag when I said I was taking Prozac.
“Has anyone discussed the potential side-effects of Prozac on breastfeeding?”
“Why aren’t you taking Zoloft? That is often prescribed first to pregnant and postpartum women as it has fewer side-effects and is considered to be the ‘safest’ option.”
At five days post-c-section birth, I was being crushed by the onslaught of information, questions, and choices. Suddenly, my non-issue Prozac was an issue and I had to make a decision. It felt as if I had to choose between helping myself or helping my child - taking medication or feeding him how I was “supposed” to feed him. I was completely paralyzed. Luckily, our pediatrician saw this and immediately assumed the role that I was not yet capable of filling for myself - that of the problem solver. She told me, “Your mental health is just as important, if not more important, than the baby’s health. You cannot take care of him if you are not taken care of.” These words resonated so deeply that I went home, immediately took my Prozac, and vowed to not skip doses again.
This is a vow I struggled not to break. With all the changes my body had gone through after the birth of my child, the Prozac didn’t seem to work anymore. I didn’t just feel a small dip in my mental state, what is typically referred to as the baby blues. I felt myself plummeting. The times where I’ve most needed my meds, like this free fall I was experiencing, have been the times when I was most likely to give up hope and stop taking my meds all together. Logically, I knew that I needed to continue to take my Prozac until a psychiatrist could see me for an assessment, but I barely had the strength to breathe let alone take medication that felt as if it was doing nothing for my pain.
Three torturously long weeks after I sat down with my partner and told him I didn’t want to be alive anymore, I was seen by a reproductive mental health psychiatrist. They immediately changed my medication regimen in the hope that it would improve my symptoms, Unfortunately, however, a “happy pill” does not exist. Antidepressants or anti-anxiety medications are not a quick fix. It takes time to literally rebalance the chemicals in your brain. Over the next several weeks, we tried multiple doses of multiple medications before landing on a routine that, if nothing else, helped me achieve some semblance of balance in my mental health.
To be honest, this routine still felt like someone had thrown me a set of baby swimmies as I was drowning in the middle of the Pacific Ocean being circled by the genius sharks from Deep Blue Sea (1999). Because of this, my psychiatrist has continued to adjust my medications as needed. Trying new meds, making endless trips to the pharmacy, cutting tiny pills in half in order to cross-taper between the old med and the new med - the process seems never ending. But I have to do it because if I don’t, I will yet again find myself in a state of free fall.
I firmly believe that every newborn’s love language is Acts of Service. Think about it - all they need from us in the beginning is to be fed, cleaned, and rocked to sleep. These are all tangible acts that express our intangible love. By taking care of myself before I did anything else, I spoke my son’s language. I showed him that I loved him, even before I was able to say or even feel it. Taking medication doesn’t make me weak. It doesn’t make me a failure. It supports me as I work to be the best Kirstin I can be, which in turn makes me the best mom I can be. Please, if you remember nothing else from what I have written, remember this: taking care of yourself before you do anything else is a profound and beautiful expression of love for your child. And even if that expression includes medication, know that I’m here to cheer you on.
Resources
LactMed: Drugs and Lactation Database
Psychology Today: Find a Psychiatrist
Psychology Today: Find a Therapist
Postpartum Support International
Edited by Rae Fagin