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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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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