On Going Off My Depression Medication During Pregnancy

Pregnancy is hard. Doing it without much-needed depression medication is harder.

Andrew Ti

When my daughter was about three months old, I attended a party with a bunch of other new moms. They were gushing—GUSHING—about parenthood. I stood silently in a circle of the rosiest faces you ever did see, wondering what on earth they were experiencing. Someone turned to me to ask how my daughter was. 

"She's kind of a jerk?"

Audible gasps followed. 

"I didn't say I wished her dead. I'm just not enjoying the newborn phase." 

At the grocery store, strangers would ask if my baby was my "first."

"She's my only," I'd respond. End of discussion.

I'd be chatting with close friends who were thinking about getting pregnant and my advice became, "I wouldn't recommend it."

"Really? But your kid is awesome!"

"I know, she's incredible, I got very lucky. But yeah, no, really. If I had it to do over, I wouldn't."

If you think this makes me sound like a monster, you've probably never been a depressed new mother.

You know how you get teary-eyed at stories about mothers with cancer postponing treatment for the sake of their unborn children? Rarely do we treat women who suffer from deadly mental illnesses with the same compassion. (A new documentary called Moms and Meds, coming out spring 2016, explores what happens when anxiety and depression collide with pregnancy by interviewing with moms at all stages of parenthood.) I've been there and it is a largely invisible struggle.

Rarely do we treat women who suffer from deadly mental illnesses with the same compassion.

I knew about six months before I got married that I was going to try to get pregnant immediately. Lots of things factored into my decision, including my age (34 at the time) and uncertainty about how many children I even wanted: What if I loved pregnancy and motherhood? There wasn't much time left to manufacture a brood. What if I couldn't get pregnant easily or at all? I'd need to get the ball rolling on other options, or start saving up for a vacation home and settle comfortably into our life as DINKs. 

Whatever the outcome, I wanted answers sooner than later. But, according to my therapist and family doctor, pregnancy meant no more antidepressants or anxiety medications. Which meant I would probably be depressed going into my wedding and pregnancy. I'd probably stay depressed until I went back on medication—and when would that be? After the pretty lengthy duration of pregnancy, how long did I want to nurse for? The decisions surrounding this were endless, like all parenting decisions, except for one part: the only guaranteed outcome was that I would be a miserable piece of shit the entire time.

Having a mood disorder sucks—sometimes it sucks so much that you want to die. Plus, a lot of times it makes you suck, publicly, and then people are uncomfortable around you, and friends and family fall away rather than deal with you. It's understandable. Add bringing a child into the world on top of all that garbage? Become a mentally ill  mother—"mother" being the most publicly criticized job in the world—and you're pretty much fucked. None of your choices are right, including the one to get pregnant in the first place, and not only that, you will be forced to suffer for almost two years and it had better be in silence lest you disturb the fetus, the baby, your partner, friends, or family. 

Depression has been a presence in my life for as long as I can remember. After suffering a traumatic brain injury at six years old, depression was almost a guaranteed part of my future. Some studies put the coincidence of depression after TBI at rates as high as 77 percent. Add to that any family history, and you can see the odds stacking up. Panic attacks followed years later, in high school, and kept me off flights for seven years until I found a drug that helped me even get to the airport. I've always managed my depression with a combination of therapy and medication (when needed). But I've consistently been on medication for about the last 10 years. 

Depression has been a presence in my life for as long as I can remember.

But when you're pregnant, or even thinking of letting sperm into your vagina, and you have a mental illness. The standard advice from therapists and doctors is to go off your meds for the sake of the potential kid. Why? Mainly because they can't do controlled drug studies on pregnant women and babies. Therefore, we don't know what happens to a developing fetus when, say, the mother needs to take 300 milligrams of Wellbutrin every morning, 25 milligrams of Trazodone at night, and 5 milligrams of Valium as needed for fear of flying and wide open spaces and heights. Your guess is as good as mine, literally, and guessing and mothering don't mix well. 

So I decided, right away, to try to be the BEST MOM EVER and sacrifice my mental health for what I gambled would be a healthier child. For roughly two years, I was actually the worst. Without medication, I had a hard time enjoying my wedding, even though objectively I know it was lovely. I hated pregnancy—every part of it except the muumuus. I love muumuus. The physical illness, exhaustion, and social isolation of pregnancy mimic depression so closely that it was difficult to tell which was which. I hated most of the first year of parenthood. Sleep troubles, again, are a major symptom of depression and with my sleep schedule being completely upset and out of control, I couldn't brush it off as easily as maybe some other moms do. Same with the anxiety that comes along with being a new parent. Same with low libido and fatigue and helplessness. (Gosh, someone should make a side-by-side chart of the symptoms of depression versus the symptoms of new parenthood.)

I hated most of the first year of parenthood.

Sure, everyone complains about how difficult adjusting to new parenthood is, but there was an underlying clinically diagnosed disease raging in me that made it nearly impossible to enjoy, well, anything. That's not my fault, but my lack of culpability during that time was very hard for everyone around me to keep track of. My husband would forget on a daily basis that I was actually sick. (Technically, double-sick now that I think about it since pregnancy on its own qualifies.) Same with friends, coworkers, my ob-gyn. A few times the doctors advised me to attend some workshops on postpartum depression, but I had prepartum depression. And partum depression. And then, I guess you could call it postpartum depression, but why make the distinction? 

The workshops were helpful, and I was still seeing my therapist regularly. But what I ultimately needed was to regain the ability to treat my disease and, hopefully, in time to save my closest relationships.

In the end, I nursed my daughter for six months. It then took another year to get my meds right; I'd become allergic to my previous cocktail in the interim. ( Such is the guessing game of psychopharmacology.) My daughter is two years old now and things are feeling normal again. I'm still not having a second kid, for obvious reasons, but I'm a little more sympathetic toward those moms who were appalled at my discontent. They were feeling how I feel now: delighted and euphoric in their new roles. 

Recently I was invited to a rooftop party to watch the sunset with friends, with the stipulation that I bring my daughter. Everyone is nuts for this kid, and I usually explain her transformation from screaming, miserable, colicky, pain-in-the-ass newborn to a docile, intelligent, beguiling toddler as the result of her learning how to talk. Another theory would be that when she was about one year old, she got the mother she always deserved.

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