Pregnancy and anti-depressants – a subject rarely spoken about

Looking back over my previous blog entries, I realise it’s 8 months since I’ve written anything on here. One of the main events to happen in this time is I gave birth to a beautiful baby girl on 3rd September. She is now 10 weeks old and a happy, healthy little girl. Even if she did arrive 5 weeks early! I think she was just so determined and impatient to get out into the world. I’d had a strong feeling for a while beforehand that she was going to make an early. appearance. I suppose you’d call it maternal instinct. I’ve always trusted my gut instincts about things, and so far they’ve never let me down.

I’d had a bit of a scare very early on in the pregnancy. At 5 weeks there’d been some spotting and very bad cramps, but when they did a scan of my tiny little baby, all was good. I felt instinctively that it was a girl, but in those early weeks of pregnancy, I really wasn’t sure if I was doing the right thing.

After 12 months and counting on Prozac, I switched to 75mg of Anafranil in August 2014. I’d had several discussions with either my Psychiatrist or one of his team about this drug and its safety during pregnancy. Anafranil was one of the first anti-depressants to come onto the market in 1963. So there has been lots of research done on any possible side effects on the developing foetus or any long term coginitive/behavioural problems with the child. It’s one of the older Tricyclic anti-depressants, whereas Prozac and Lexapro are SSRIs (Selective Serotonin Re-uptake Inhibitors) They all do more or less the same thing, but as previously stated, there has been a lot more research on Anaranil because it’s around longer. Prozac was considered safe to take in pregnancy until recent years, when it was discovered there is a small percentage chance of the foetus developing a heart defect.

I was a bit anxious about switching meds but I trusted my Psych and the other doctors and knew I was in safe hands. however, I was still unsure whether or not I should get pregnant because of my fear of a relapse. The last bout I’d had, had definitely been the worst and scariest and I just didn’t want to throw pregnancy into that mix. Then in January of 2015 the decision was completely taken out of my hands. I fell pregnant unexpectedly, it was a complete surprise. To be honest I felt like despite all the darkness that had gone before, I’d been given a gift. Someone up there somewhere believed I deserved it.

I was delighted, here I was pregnant at 39 years of age and it was all fantastic for a couple of days. Then doubts began to surface. Yes I was pregnant, but I was also on anti-depressants. So I started Googling ‘Anafranil and Pregnancy’. Online, the news wasn’t good, ‘USE IS NOT RECOMMENDED’ ‘HAVE CAUSED OR MAY BE SUSPECTED OF CAUSING, HARMFUL EFFECTS ON THE HUMAN FOETUS’   So there it was, and there I was, in the early stages of pregnancy and extremely anxious to protect the precious little life inside of me.

I phoned the psychiatric clinic I attended and spoke to one of several psychiatric nurses I knew there. I have to say they are all fantastic, supportive and warm; just so easy to talk to and be yourself around. I knew this particular nurse quite well and she told me to stop Googling, which I did, and go through things with my Psych at my next appointment. So I really grilled him on the meds. To be honest I felt bad and apologised, but he was so patient and understanding. He assured me that he had treated many pregnant women on Anafranil and none of them had had any problems during or after their pregnancies. So I asked him were any of them open about it, and if so was there any women I could discuss this with? He said he didn’t know of anyone because they wouldn’t discuss it. It just wouldn’t happen. I was stunned. There was no-one I could share my fears with. It was hard to take because one of the lovely things about being pregnant is the support you get from other women. From the physical ailments we’ve all experienced, like morning sickness, to the jokes about cravings. Yet for something like this is not spoken about. I didn’t have any friends who’d been through a similar experience.Some of them had had Post-Natal Depression, so I bounced my thoughts off them, and they were very supportive. Still I felt very much alone and I couldn’t blame women for not being open, because I wasn’t even open about it at that stage myself. Yet I wanted to be, just with those who had gone through what I was going through. The fact that I didn’t know of anyone else in my situation, made me even more reluctant to open up to everyone, as I had a real fear of being judged.

So what could I do? I decided to contact a well known Irish pregnancy and mother website asking them to post up my question: had any other mums taken anti-depressants during pregnancy and if so, what had been their experiences during and after. Unfortunately, only one woman responded to say she had taken anti-depressants for her last pregnancy and there had been no side effects. It was so great to hear from someone, but I just couldn’t believe that was the only feedback I’d received. I’m very familiar with this website, and there are always tons of comments on pregnancy – everything from colic to baby names; but not this. I felt like a freak to put it mildly. I started wondering was I in a minority. And yet, as a good friend pointed out, there were some women who smoked, drank or took illegal drugs during their pregnancies. And I was taking a medication that I very much needed, the alternative being a possible relapse during pregnancy or a severer bout of Post Natal Depression. So what was the shame in that? There was no shame, but there were still those other two factors which had obviously affected many women before me. Fear and stigma. I had been fully open about my experiences of depression two weeks before my 40th birthday in May of this year for Green Ribbon Month, but I hadn’t disclosed the fact that I was taking anti-depressants during my pregnancy openly, because brave and all as I’d been, I just wanted to protect myself and my baby until some time after she was born.

I did thankfully get over my worries, but I didn’t do it alone. The girl who’d posted up a comment for me suggested I contact Nurture http://www.nurturecharity.org . Nurture is a fantastic charity which provides counselling and support around conception, pregnancy and childbirth maternal mental health illnesses. I spoke to its CEO, Irene Lowry, telling her how I felt like a bit of a freak, and very much on my own at the time. Was I doing the right thing for me and my baby? Would I be better off not taking anti-depressants, as I didn’t know of anyone else really with experience of this. Why weren’t women open about it? Would I be judged? Irene was fantastically encouragingand got rid of any doubts I’d had. I really felt so much better after that phone call.

Another kind doctor on my Psychs team who I saw regularly during my pregnancy,suggested I speak to the midwives at my pregnancy check-ups. This was one of the best things I did. The midwives I dealt with were very anxious to know how my mood was going and it was so easy to open up to them and tell them of my worries. They reassured me that there were always some women going through the pregnancy unit being treated for some form of mental illness. Their main concerns were the women putting on a brave front. They said these women were the best actresses, and normally waited until the last moment to disclose the fact that they were having difficulties. These are the women we need to watch out for.

I think when you go through an illness like depression, news of someone dying from it is never lost on you. Because you have a good idea of how they were feeling as they fought and struggled hard to hold onto their lives. The mind is a very complex place; it’s only when it starts to slide severely off course that you realise just how overwhelmingly powerful it can be. I always think of a well persons mind like a calm quiet sea, but depression turns it into a turbulent storm; where your mind brings you through the worst places in that storm you can imagine, as you try so hard to fight your way back.

One tragic story that comes to mind is that of Charlotte Bevan, who, just days after giving birth in late December 2014 threw herself and her baby girl into the Avon Gorge in Bristol. It is thought that Charlotte may have stopped taking anti-depressants in order to breastfeed. I breastfed my daughter for a month, but anafranil is perfectly safe to take for breastfeeding mothers also. That is why I think the internet can be so so dangerous. All the information I came across was completely negative. I think some websites really need to be mindful of the number of pregnant women, who like me, will look up this information, but may not, like me disclose these worries and get the support they so badly need.

That is why I write these posts. In the hope that it will reach someone who’s lost or having difficulty somewhere, be it in a storm going through their brain, the isolation of their own room, or a worried and concerned pregnant woman. Because when you’re sick with depression every kind deed, no matter how small helps. Every single person who is brave enough to reach out to you will make a difference, offering you a small step on the road back to yourself. So if you have a feeling, maybe a gut feeling that someone is not well, please ask them. I know it’s difficult to take that extra step, but these are the little things that could help someone open up and take hold of a lifeline, because every single step brings them a little closer to the shore.

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Should you be open about your mental illness?

After every post I write here, I say to myself ‘ok, you’re done baring your soul now. You’ve gotten it out there to hopefully help someone. So let’s leave it at that ok?’ Then of course I get the urge to write again, and on it goes.

In the last while I’ve been thinking about people who are open about their mental illness, and those who prefer to keep it a secret. There’s pros and cons to both, I think we all know that.

At the moment a lot of courageous individuals and celebrities have come forward to tell of their own battles with mental illness. This type of openness has been badly needed in this country for a long time. But we still have a long, long way to go.

I suppose the problem is fear and stigma. So I can completely understand why many people don’t come forward. Because there is still a strong perception out there that depression is a weakness. And it only happens to weak, sensitive people. Of course I know that’s not true. But it is perceived that way by a huge number in society. I think a lot of sufferers are understandably fearful about opening up because we all know, that there are those who will use it as a stick to beat you with. And who needs that kind of grief? No-one. Least of all someone suffering from depression. So people protect themselves, and who could blame them? Because one of the worst feelings in the world is someone slapping it to you about your mental health. And there are many subtle and not so subtle ways it’s done. So why leave yourself wide open?

I think the truth is you have to be at a stage where you are in complete acceptance of your illness. For me, I simply now feel that it’s the way my brain is wired. However, it took me ten years to get to that stage. So I can totally empathise with those who keep their illness to themselves. The other important point about being open is it’s a way of letting everyone know that you are not ashamed of your illness. It’s one of the many parts that make up you.

I’m not saying I’ve told every single person I know that ‘hey I have depression’, because of course I haven’t done that. It’s not something you just drop into the conversation. It’s a sensitive issue and deserves to be treated with sensitivity. So I didn’t blatantly shout it from the rafters. But my blog was a big starting point. And in the last year or so, I’ve spoken about it when opportunities have presented themselves. Because of this, a lot more people know about me now, than ever before. Of course I knew by starting a blog I would be leaving myself open to possible criticism. But I was at the point where I simply didn’t care about that anymore.

When I started to recover from my last severe bout of depression in December 2013, I had an overwhelming urge to help other sufferers. And even if that meant making a difference to just one other person, I would cope with any negativity that came my way. And since I’ve started this blog, there hasn’t been any negativity. People have been supportive in their own way. And whilst most have never said it directly to me, I’ve always felt their support. This has meant a great deal to me. At the end of the day, there is no right or wrong way to be for sufferers. All any of us really want  is to get well, so we can have the peace of mind that everyone deserves.

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A Good Year

I suppose like everyone else, I gave a little thought to 2014 and what kind of year it’s been for me. Well it’s been pretty good to be honest.

I haven’t had a bout of depression for 14 months. And mentally I feel better and stronger than I have done in quite a while. I’m still on anti-depressants but the dosage is very small. And it’s been working very well for me. So I’m lucky. Very lucky.

I’m amazed at how many times I still say that to myself. And always when I least expect it. Like when I’m doing some menial thing like peeling potatoes or putting away the laundry. I’ll suddenly hear myself humming happily and realise again that my mind is at peace. The volume has turned itself down, and there’s no deafening static anymore.

In October last I waited for, and expected the depression to return. Because October of the previous year had welcomed in the most overwhelmingly terrifying bout of depression I’ve ever had. So I was nervous that the shorter days and long dark nights, might signal a severe dip in my mood. But this hasn’t been the case. It’s hard to even write the words in case I tempt fate!

Meditation has been a big factor in my wellness too. I can’t say enough good things about it. I was advised by my counsellor to do it for a long time before I actually gave it a go. It was only on the advice of my Psychiatrist last year, who told me in no uncertain terms I had no choice but to do it. That I knew he meant business. And whereas I’d always been sceptical of meditation. For once I shut up and didn’t question him. (I’d say he feels like diving under his desk when he sees me coming, the poor man barely gets a word in with me sometimes.) And thank God I didn’t, because it has helped me no end.

He explained that the mind is like a saucepan of water. When we’re stressed it starts to simmer. And if we do nothing to reduce the simmering, our minds can boil over. Meditation calms down the mind. And that simple example convinced me. I downloaded some 20 minute meditation apps onto my phone, put on the earphones and listened to one when I woke up. And again before I went to sleep. (I normally nodded off before it finished!) I did this religiously for about two months, until in conjunction with the medication I started to feel better. Now I do it a couple of times a week if I’m feeling a bit stressed.

My Psychiatrist also explained that if I meditated regularly, there would come a time when I could literally click my mind into that relaxed place. And that is exactly what happened. If I’m in a stressful situation, I just take some deep breaths, and it’s like I’m back on that sandy beach, with turquoise water and Palm trees. And who wouldn’t want that 😀☀️🌴🌴🌴🐬

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Southern Comfort – On The Rocks

With Ginger Ale. That was my drink of choice about ten years ago. When I was a party girl. I was just out of a long term relationship and a fun filled Summer stretched ahead of me. A friend suggested I try Southern Comfort with Ginger Ale on a night out, and I was hooked. I loved the buzz it gave and my free spirit danced wildly to its tune. Of course there were blanks the next day, but I didn’t give a toss because I was having FUN. And as for depression?

That was a distant memory I’d well and truly buried. It hadn’t reared its ugly head in nearly ten years at that stage. And I felt pretty invincible. No, depression was not something that even entered my pretty peroxide blonde head. But I was in for a shock, because it was coming after me, and I didn’t have a bloody clue. I lived for the weekend, going out, buying clothes. I was enjoying my new found freedom and independence and NOTHING could stop me.

But it came back with a Bang. As I’ve since learned, that’s the way it pulls the ground from under me. Then shoves me onto autopilot, and plants a nice big black cloud down on top of my head. Oh yeah, and throw in a lot of hellishly scary thoughts just for good measure. All I knew was that one week, I was happily trying a new hairstyle. And within days I was seriously wondering what was the point of it all. It was that quick. I tried to shrug it off, but dark thoughts were coming thick and fast, and I was very very scared. Everytime someone spoke to me I’d wonder why they were bothering, because we were all going to die anyway, so really, what was the point?

I wished I could confide in one of my friends, but how could I? When all along I was the one who cracked the funniest jokes, and was generally the life and soul of every party. All I knew was that I wanted oblivion, to escape my own head, because it was killing me. I kept wishing it was two months before when I was normal, when I was partying. I’d look at my friends for any sign that they were suffering too, but they weren’t. They were young and carefree, the way I used to be.

Then I thought that if I just went out and got rat arsed, it would kick my depression into submission. I distinctly remember getting ready to go out one Saturday night, putting on my favourite tune ‘A Rollerskating Jam named Saturdays’ by De La Soul. But it didn’t make any difference. I couldn’t get the Southern Comfort down my throat fast enough, and way hey, I was having a great time…Until the next day. My mood plummeted. I just didn’t want to be around anymore. My friend phoned, and as we giggled and laughed I remember wondering how she couldn’t see it was all an act with me.

That same day a couple of us went to some Outlet store up the country for the afternoon. I sat in the back of the car, cracking all the jokes, making everyone laugh. And I knew none of them suspected. But I felt like a robot, everything was very dark. I was so far removed from them all I couldn’t think who to turn to. I wasn’t living at home, and my flatmates had their own lives. I didn’t want to see a doctor in case I was admitted to hospital. So I lay in bed and prayed it all just go away by morning.

When I awoke I knew I had to phone the doctor. I was completely overhwhelmed and sinking fast, my thoughts were pummeling me to death. It was terrifying. I’ll never forget it. I cried and cried at the doctors. He told me it was depression. I just could not believe it had come back. Because there was no reason in the world for me to be depressed. Of course hindsight is a great thing isn’t it? The doctor referred me to a councellor and prescribed 20mg Prozac. He told me to start it straight away. I did, and it scared the life out of me. It made me feel very strange. And my head was flying along in a way I didn’t like. Not in a fun way like Southern Comfort, no. This was a completely different ball game. I could not keep up with it. I felt like my voice was slurred too. I phoned the doctor and told him it wasn’t agreeing with me. He advised me to stick with it, and give my body a chance to get used to it. After a couple of days I went cold turkey against his advice. It was a mistake. Everything seemed strange and alien for a day or so, I don’t actually know how I managed to function or go into work.

I went back to the doctor and he put me on 10mg of Lexapro. He also gave me a talking to, and told me I HAD to stick with the medication. I did. But it was very hard. My head was absolutely flying again for a couple of weeks, whilst I tried to act normal in work and with my friends. I started making excuses not to go out, which they must have found odd. I had my first session with my counsellor. I told her that I missed going out, and couldn’t possibly tell my friends I couldn’t drink anymore. Wasn’t taking the mediation enough to get me better? She got really annoyed with me then. And said I had to start taking my illness seriously in order to get better. And under no circumstances was I to start drinking. It was devastating for me, but I was so sick I just wanted to get better.

I thought long and hard after that session with my counsellor. I knew she was right. I just didn’t know how to break the news to my friends. I decided I couldn’t tell all of them, just one or two. Over the phone was easier, they’d been asking and asking me why I wasn’t going out. So I told them I couldn’t go out because I was suffering from depression, and couldn’t drink because I was on anti-depressants. I was mortified. I just wanted to go and bury myself in my bed. I don’t think they knew how to react. After all, this was ten years ago, before mental illness and depression were as widely discussed as they are today. And even so, stigma is not a thing of the past.

So on a sunny Sunday morning, when I normally would have been nursing a hangover, I put on my tracksuit and went for a walk. It was early, about 10 o clock. I felt so sorry for myself as I walked along. Thinking of other people my age who were probably still asleep, or doing the walk of shame somewhere. It was hard. I wondered was I being punished somehow. I couldn’t stop thinking of all the people I’d met on my nights out that Summer, and all the laughs I’d had. What would they think if they could see me now? It wasn’t fair, I thought to myself. It just wasn’t bloody fair.

I did a six month course of anti-depressants, stayed away from partying, and focused on getting myself back on track, which I did. All those quiet weekends gave me a lot of time to think. And I began to realise that taking a break from partying hadn’t really been a bad thing. My bout of depression was a terrible kick in the back side. But it had forced me to grow up too, and after that, I never took my mental health for granted again. I wasn’t open about it however. Back then, I believed I’d kicked it for good, but it was still a shameful secret. Fortunately, I did have another five depression free years, but little did I know that the worst was still to come.

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The Road Less Travelled

I very much wanted to write another post today. And now I’m finding it difficult to start. This was going to be a continuation of my last post regarding the fight my depressed mind always puts up against anti depressants in the initial stages of treatment. If I’m brutally honest, I’ve been there enough times to know I don’t want to revisit some of the scariest periods of my life. But acceptance had changed me and given me an incredible need to share experiences I Never would have. If only to promote empathy and some understanding in those that have never had to fight with the Black Dog. Twelve months ago, I was back on anti-depressants about 2-3 weeks and all was not well. My serotonin levels were completely obliterated and unlike a healthy person, my brain Will Not reproduce serotonin of its own accord, hence my mental illness. So although anti-depressants are often referred to as ‘Happy Pills’, this is definitely not the case. A quick fix they ain’t. What they do is start to Gradually help your brain to produce the serotonin you so Badly need. But this takes time. I can remember my very concerned sister telling me I’d be better in a couple of days. She couldn’t believe it when a month into my treatment, there was very little improvement. For me it takes 8 Long very difficult weeks to feel like I’m starting to see just a glimmer of light in the long dark tunnel. And about three months in total (with counselling, and meditating twice daily) to feel like the old me has returned. I distinctly remember a particularly bad day last year when I felt really terrified. I was only back on the meds about a week. And wasn’t working on this particular day, which had dawned as blackly as any day could. When I’m sick, I become incredibly clingy towards my family and close friends. Especially my Dad for some reason. I go back to being a frightened little girl who just want to keep him near as much as possible. I didn’t want to alarm him, as he wasn’t aware my depression had returned. But I needed him very much on the day in question.So I took a deep breath and phoned him. I told him it had returned, and I was back on the meds and I needed to get out of the house for a couple of hours. I felt like a total failure for telling him and guilty for needing him so much, but I was desperate. I was putting on a brave face because I didn’t want anyone worrying about me. But I knew my Dad would be cool about it and there would be no need to pretend. He said ‘no probs’ in his naturally easygoing way. And we went for a long drive. The sun was shining in a blue cloudless sky but it didn’t make any difference to me. I felt like my stubborn sick brain would never let the sun in again. When we started out, my dad told me about a young hurler from Galway who had taken his own life some days before, his name was Niall O’Donoghue. (I’ve never forgotten his name) My stomach turned when I heard this. Because I was having black thoughts at this time. Which were bombarding me, and I was fighting them each second of each day. I assumed wrongly that he hadn’t been getting any treatment, but my father told me he had been receiving treatment, and all his friends were aware of his illness. This scared me. But I knew how he must have felt, and understood the massive struggle he had surely gone through. The meds don’t work for everyone. I’m extremely lucky in that they work for me. In my worst days, that’s what I’ve always told myself. My life depended on them working, along with counselling and meditating.But that day in the car with my dad, I couldn’t imagine fighting an illness as overwhelmingly ferocious as depression where the meds don’t work. Because the illness can and tragically does win in some cases. People who suffer from depression don’t kill themselves . Depression kills them. It’s as heartbreakingly simple as that.

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What is Clinical Depression?

Clinical depression is recurrent depression. Which unfortunately is what I have.

Around this time last year (believe me, I remember it well) I had my third bout of severe depression in three years. And as per usual it came back with a BANG! There were some warning signs ie. feelings of intense panic at times, but overall  was in good form. Then a severe low mood kicked in. And by God do you notice that. Suddenly it’s like your whole personality is completely wiped out, and there’s nothing left. You’re on autopilot, and start to feel like everything is pointless. Your sleep is seriously disturbed and you spend endless nights diving down, down, down into a black bottomless pit. Life is carrying on as normal all around you, but your mind is being attacked by hundreds and hundreds of endless black thoughts. Wave after wave after wave. There  is no let up.

So I ran back to my doctor. At that time I’d been off anti depressants for two months after a 6 month course of them. She prescribed me 20mg of Prozac. I was gutted. I felt like I’d taken twenty steps back. Then she referred me to a psychiatrist. Because my depression had recurred every year for the last three (since the birth of my daughter). I was stunned. Inwardly  I convinced myself I didn’t need to see a psychiatrist. That evening I told my husband I was not going to see a psychiatrist, because I was not mad. He told me to do what my doctor advised. I argued there was no way I was sitting in the waiting room of a psychiatric clinic because other people would see me, and I was NOT one of them. I felt so crap about it, I chickened out of going, scared of what the psychiatrist would say to me. He’d probably admit me to hospital. If I ignore it, it will go away. Wrong, I got another appointment. I phoned the secretary on the morning of the appointment, explaining how anxious I felt about being recognised by others in the waiting room. She said it would be quiet. But I’m having none of it. I arrived complete with a dark hat pulled down as far as I could manage (it sounds ridiculous to me now, but I was very much in denial of my illness at that time)

The nurse brings me to a small room where I can wait. After a while the psychiatrist is ready to see me. He shakes my hand and introduces himself. I feel like a complete basket case.Why is this happening to me? Why me? Why? Why? Why? I just want to be normal, like everyone else. He asks me how many bouts of depression I’ve had in my life. I tell him this is my fifth. He asks how I’m feeling. I tell him I’m not tired, am functioning, going to work etc. but I’m in a pretty black hole. My head is utterly destroyed.

He tells me that I more than likely have clinical depression. He said every time a bout of depression recurs, the percentage of it recurring again increases. I keep disagreeing with him, coming up with various reasons why it’s recurred. I tell him that I’d drank too much on a night out and that’s why it came back. I tell him I kick it pretty quickly each time it comes back (about two months) but I know myself it takes at least 2 months for the meds to start working. He recommends I stay on anti-depressants indefinitely, possibly for the rest of my life. I keep telling him I don’t have Clinical depression, because I just couldn’t have something like that.He also recommends I see a counsellor and meditate 3 times a day (I ignore this).

When I get home I feel very frightened and am still reeling.I tell my husband, I don’t want to have Clinical Depression. I want it to go away. I tell him I’m frightened of losing my mind, of going mad. Because if I lose my mind, I might never get it back again. And I don’t want to ever have to put him and my daughter through that, or my close friends and family.

I suppose even though I didn’t realise it at the time, I was actually on my way towards finally accepting a part of myself that I never thought I would.

Depression in itself is horrific, but in my experience the journey you go on when starting back on meds is another type of horror. And the truly sad thing about it is you look fine to everyone else. There’s no broken arm, no red spots. Just an excruciating inner turmoil. That is completely invisible to everyone, including your family and friends.
I think the only people who saw through my tough facade were friends who’d been down the same desolate road as many times as I had.
I’ll continue my story in the next blog.

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