Okay, admittedly I started panicking about my antidepressants right after the first positive test. I took the next day off of work so I could pester both my gynecologist and psychiatrist in between crying spells because fuckit, even though this child was unexpected, what if my antidepressants ruined his/her nervous system? DID I SCREW THIS CHILD OVER FOR LIFE?
But nearly four weeks later, I'm not worried. We have a plan. Or maybe I'm too tired to worry about it (yay fatigue). I AM worried about affording childcare and am trying to figure out how to find something that's not more than all of our monthly bills combined, but that'll be the subject of another post. Or two. Or a gazillion.
For the sake of information, I was doing quite well on two medicines: 10mg of Lexapro, and 75mg of Effexor XR.
My gynecologist (also an OB) said that she thinks I need to stay on an antidepressant. I need SOMETHING. But, if I can, she'd like me down to only one kind of AD, instead of two, just to make it easier to understand the effects. She didn't care which kind--just go off of one of them.
My first thought was kicking Lexapro. Like hell I'm going to go through the agony of an Effexor withdrawal while I'm also going through the agony of first trimester symptoms AND all the anxiety that comes with being pregnant. My psychiatrist concurred, and because the Lexapro dose was so small, he thought a fast withdrawal would be okay. I went down to 5mg of Lexapro for one week, and then I stopped.
I had some mild brain zaps and a spacy feeling and headaches (on top of the nausea) and I was just not able to function at work (yet I showed up anyway and got at least some things done...) but thank God the withdrawal symptoms only lasted a few days after my last dose.
So, our plan for Effexor. I'm going to stay on this dose, although if I need it, we can add more. But, in the last month, he suggests going as low as I possibly can on Effexor before the child is born, to minimize the kiddo's own withdrawal symptoms. However, if I breastfeed, that will also help ease the withdrawal since some of it does come out in breastmilk.
And then after birth, I can up the dose again to deal with postpartum. Because I'm like 99% sure I'm going to struggle with postpartum depression. I don't want to be a crappy mom. If I am for a few weeks, that's one thing, but I can't afford to be depressed as fuck. I need to be able to hop right back to work because I only have so much vacation and sick time to cobble together for a makeshift maternity leave. (And I fucking have to use up all of that time before I can get onto the short term disability program of 60% pay, which is crap no matter how you cut it.)
So, I'm not worried about antidepressants. I'm worried about being depressed. Apparently pregnant moms who aren't on ADs have a 60% chance of relapse, while the ones who are on ADs have only a 20% chance of relapse while pregnant.
You see, depression is going to hurt the kiddo FAR FAR more than the relatively low dose of Effexor that I'm on. If I'm depressed, the kid will feel it in utero, and will have issues when born. You know what happens if babies are ignored? They start failing to thrive. They can sense it. They need love to grow, and if mom are too depressed to feel anything, then the baby senses that, too. This was so well explained in Why Love Matters, which I actually bought because I liked the book so much and wanted to keep the information on hand to encourage me should I ever have kids.
So depression will have a far more lasting effect on my kiddo than any antidepressant ever will.
That's why my doctors and I agreed that the very slight risk with Effexor was worth it to prevent the greater risk of being a depressed mother. It will help my child, and it will help me.
It helps that while Effexor is a category C for pregnancy (risk can't be ruled out), studies seem to show that it has no lasting effect other than withdrawal symptoms at birth, and it seems to be more beneficial to the child for the mother to be not depressed. Worst case, we'll both be in the hospital for a few days for monitoring and any immediate treatment before we'll be allowed to go home, and breastfeeding will help ease the withdrawal.
I feel confident with our plan.
Now, childcare on the other hand...
Filed under: pregnancy