Trigger warning; this post covers an unpleasant (but later discredited) way of talking about taking anti-depressants while pregnant by a health professional and may be triggering for some.
‘A Toxic environment’
These were the exact words used by my then GP to describe ‘my womb’ and what kind of home it was set to be for my unborn child. He was responding to the fact that when I fell pregnant I was on anti-depressants (the highest dose possible of Citalopram, to be precise).
And before I go into the detail of how I arrived there and what happened next, please know that countless other health professionals discredited what he said. They went to great lengths to show me the data proving that the risks were low and akin to many other factors that all women face in pregnancy that turn out not to come to pass.
But those words took some getting past. After my bursting into tears – the GP himself implored that he simply meant that we should figure out a plan to reduce my dose safely. Which was ironic as I’d gone in there asking about the possibility of coming off my prescription and or how to safely reduce.
See in the months leading up to falling pregnant, after many tests we had been told that our chances of having a baby (either naturally or responding well to IVF) were slim to none due to my new diagnosis of ‘Diminished Ovarian Syndrome’.
Up to that point, I think I’d been dealing with it all pretty well, but then one day I found I couldn’t get out of bed. And I couldn’t call anyone to explain nor talk to my husband – I just kind of sat there and stared at the wall for about 10 hours straight.
It was a familiar feeling, but one that I’d not encountered for so so many years that I thought I’d kind of grown immune to its powers.
It was depression and it was back.
For me it felt like a fog, one so dense that I was unable to really move past it and engage with my life. Instead I just kind of observed from the sidelines with no ‘real’ emotions coming to the fore of any kind.
It still scares me a bit, a ’slow mood’ I can take, but the ‘unfeeling’, the ‘numbness’ of a depressive episode just removed the ability for me to be fully present in my own life.
Luckily though, having had nearly two decades of working through such relapses – I had people around me who knew the signs and from somewhere within the fog I trusted them more than myself in that moment.
But there was something around being told we wouldn’t be able to have a child that had kicked up some deep-seated shame around traumatic events in my past. Things that I thought I’d been healing but that obviously still needed work.
So going back on medication wasn’t so much a choice at the time, as I knew that I needed assistance to be able to function at that point.
Within weeks I began to see a change. I was able to reinstate and actually ‘feel’ the effects of the practices that usually keep me well (my meditations, breathe work, gratitude, journaling, movement, and so on). Things began to make a bit more sense to me again, I was beginning to feel like a participant in my own life once more.
Skip forward a few months still and I was all of a sudden feeling on top of the world, it was weird – I’d not had an experience like that before where I’d found myself ‘coming out’ of the depression as fully and as quickly, but I just knew within myself things were feeling right, good and grounded.
And it was then that I realised my period was a couple of days late. I didn’t think much of it as my ‘window’ varies month to month. But we had been ‘trying’ to conceive – even though we knew our chances were minimal it felt like all we could do. Another day passed and I thought, what if I am pregnant? I was in two minds about doing a test because I wasn’t sure I could actually take another negative but I did and it was only flipping POSITIVE.
I was pregnant, we were going to have a baby – this was amazing, and I could ‘feel’ all of it. But then it struck me… ‘I’m on anti-depressants, shit, what happens here’? . Having spent years getting myself to a place where I felt well, strong and mentally resilient before considering having a child – it was just so confusing to now be pregnant and on medication. Also to be feeling so ‘well’ with it.
I don’t know if it was the hormones or that I just felt as good as I had before the diagnosis, if not better. But yeah – so that swings us back round to the appointment with the Doctor where we discussed my options – and he made that flippant, careless comment.
In many ways I felt grateful that it was said to me and that I was strong enough to call him up on the wording of it, and how deeply inappropriate language like that is when dealing with people who’ve come to you for mental health support (that was after having a bit of a cry that is).
But yeah it was decided that coming off the medication would be too risky and that I could safely try to wean to a lower dose and see how it goes but that it was recommended that I make my peace with growing my baby whilst taking anti-depressants.
Wanting to do what was best for my child and me, I followed the medical advice. I went on to do hypnobirthing with Keri at Do It Like A Mother and never have I been more grateful for that combined with my mindfulness practice.
It took a ton of work to try to deal with the guilt, the anxiety – the intrusive negative thoughts that would creep in. Because this situation played to my long-established sense of ‘not being good enough’ and ‘not doing enough’ and I had to call in near the learning I’d done in the past decade to not let that become the story of my pregnancy.
I’d write myself mantra’s about my baby being strong and healthy, I’d follow Mindfulness-Based Stress Reduction techniques, not allowing myself to ‘attach’ to much or any negativity that arose and I used CBT techniques to review ‘the facts’ and allow myself to believe them over the alternative fiction my mind was weaving.
It wasn’t necessarily easy and there were definitely good days and bad days.
I was under the perinatal mental health service at Southend, with the same amazing midwife treating me the whole time and I picked up some counselling once more.
At no point did I take for granted how privileged I was to be in that position, but it still wasn’t enough to fully quash the anxiety on the bad days, the feeling that I would lose the baby, that she’d be damaged in some way, that maybe she’d be mentally unwell herself, that she hadn’t chosen to have this be the environment in which she grew, that maybe she deserved more?
Even typing that out makes my eyes well up and my hands shake a little.
It’s hard to detach yourself from these thoughts when in some sense they feel so valid. BUT, as I did then, I had to (and have) come back to the facts at hand: I have a healthy toddler now, who showed no signs of having had an adverse effect to my being on medication.
Naturally I was put at ‘high risk’ of developing PND – although I always found that a strange prognosis given I was currently being treated for depression as it was. But, for me, PND didn’t manifest. However, as someone who’d managed mental health issues for two decades, early motherhood still tested me in ways I thought I’d outgrown.
OCD tendencies cropped up again, the intrusive negative thoughts and circular thinking were all present. But I felt able to work through them and did and for that I am so grateful.
I won’t lie nearly two years on and it’s still a process, I very much define myself as a mum who manages depression, as to me that gives it the weight and respect necessary for me to stay on top of what’s needed to be well.
But I wanted to share this because pregnancy is complex, mental health is complex, motherhood is complex, parenthood is complex and children are complex – it’s all just ‘a lot’ and there is no ‘one size fits all’.
Maternal Mental Health very much does cover the pregnancy period and goodness knows should also take into account the often extremely difficult journey many have (myself included) in trying to conceive and all that that throws up. Yet medicated pregnancy and managing depression whilst considering parenthood aren’t necessarily things I see spoken about very often. It still feels a little vulnerable to share this because of that, and also because of what ‘I do’ in teaching mindfulness. But I stand by the fact that my ‘awareness’, gained through mindfulness, therapy and intermittent medicated periods, has provided me with a healthy ’non-attachment’ to the bad stuff and that’s allowed me to live a happy and fulfilled life whilst working through it.
If anything here speaks to you and you want to reach out – then please do. I’m happy to talk, and share free mindfulness tips with any and everyone and have since trained in the Mindful Based Stress Reduction that I’ve been practicing for over a decade now, as I truly believe it’s a super useful tool to have in your box.
More mindfulness tips can be found on my instagram page too.