Anti-depressants while pregnant…
I am sure that this will get me a lot of flack. A lot of you know that I have suffered from severe depression on and off since I was a teenager- I have written about it a couple of times, probably in the most detail here. It is not something I rave on and on about because to be honest it is just a small part of my life and something I learned to live with a long time ago.
When I went back to Australia I spoke with my doctor about changing my medication to something that was a little bit more safe during pregnancy and also to something that would be available in Japan. At that stage goma-chan was just a little thought at the back of our minds and not yet a reality but I knew that I would need to be under the care of my doctor in Australia to change medications and I had been thinking about it before I even returned to Australia.
I successfully changed to something else without too many hiccups.
Earlier this year when I found out I was pregnant I broached the subject again with my doctor and did my own research into how safe it actually was to continue taking the anti-depressants I was on while pregnant. There is a lot of conflicting advice out there and even amongst doctors the advice varies. With the help of my doctor, I decided to half my regular dosage and see how I went. We spoke about the pros and cons of this decision in great detail and it was decided that considering my history going off them completely would not be an option that would be safe for me or the baby so the pros of staying on them outweighed the cons. If I was to go into a deep depression off my medication then it could severely impact on the pregnancy, my own health and the health of the baby. Obviously a sane mother to be is better than a depressed one- in particular a depressed mother to be who is in a country where depression is not always seen as a medical disorder.
I am on a 1/4 of my regular dose as I write this- I was on 1/2 but decided when I returned to Japan that I would try 1/4 of the dose and see how I go. So far things are going well- I hope to stay on this dose until after the baby is born and see how I go from there. Some say that when pregnant they felt no need to be on anti-depressants any more because the pregnancy hormones took away a lot of the chemical imbalance which causes depression and I can totally see how that could be the case. I honestly feel great and have had no issues on a lower dose that I could see myself going off them without problems but I have my reasons for staying on them, even at such a small dose and from what others have told me this is probably a good thing.
If someone has suffered from depression before they have a higher likelihood of suffering from post-natal depression and I am well aware of this fact. It is something that I, and those close to me, will be on the look out for I am sure. This is another reason my doctor in Australia advised that I should stay on medication throughout the pregnancy as if I am to suffer from post-natal depression the fact I am already medicated, even if it is a lower dose, could mean the difference between having to be hospitalized and not being hospitalized for the condition.
I know the risks that are associated with taking anti-depressants while pregnant- the main one being withdrawal in the baby once it is born which can be as severe as tremors, distressed crying, sleeplessness and/or disturbed sleep. In case of the medication I am on these side-effects have appeared in limited cases. Another, more serious but rare complication, is PPHN ( Persistent Pulmonary Hypertension of the newborn) which seems to appear more often in cases where the mother took anti-depressants after the 20 week mark. This disorder can also occur in other circumstances, namely difficult births(in which baby was denied oxygen) and can be a very serious issue. I have been open with my clinic here in Japan about being on anti-depressants and so far nobody has said anything about it…The anti-depressants I am on are considered to be one of the safest options to take during pregnancy.
The point is taking anti-depressants during pregnancy is not a clear cut issue. There is no right or wrong. It needs to be a decision you make after weighing up the pros and cons of your own situation. I decided to write about this because I am sure there are others out there who have had to make this same decision or are now battling to try and make the decision and I wanted to explain why and how I came to the decision I made. There are people out there who will probably read this and think that I don`t care enough about my unborn child but honestly my baby is better off having me in this state than in a state of depression and I have enough experience with my own history to know that the decision I made was the right one.
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Wow, as if there aren’t enough things to worry about when pregnant, hey?
I think the effort you’re putting in to researching all this shows you’re not a negligent mum at all- you care enough to make an informed decision.
Great that you found a clinic that was understanding of what I’m guessing is a not so common situation here.
Congratulations on your pregnancy. I hope that things continue to go well for both you and your baby.
You uncaring?To the contrary…you are showing the love for your unborn child by your concern and determination to reduce your medication safely as well as your research.Lucky baby!
I agree… I don’t think you would make a decision that you DIDN’T think was in your or your baby’s best interest. Don’t we all always do what we think is best in each situation? Even if the risk is low, I’m sure it’s at least a little scary and worrisome for you but I’m sure Goma chan will be fine. =) Stay positive and the risk percentage will go down to 0 surely.
It seems as if you`d made the best decision for yourself and your baby..I`m sure there is a lot of worry atattched to it all but as you said, being on meds is a much better, healthier state-of-mind you than a non medicated person and being pregnant is one thing where you need to stay positive and forward looking.
I hope all goes well as I`m sure it will.
I definitely agree with the others, you`ve done your research to become informed about risks and complications and used that information to come to the best decision for you and for goma-chan.
I don`t think anyone who has met you would think of you as anything but a loving mother.
Being a new mom is tricky anyways and you never know how your body is going to react, physically and mentally so it’s good that you’re thinking ahead.
Have you ready dooce.com? She’s written a lot about taking meds while pregnant and nursing. She’s very eloquent and the comments she gets are amazing. If you haven’t ready her then I totally recommend it. She didn’t take any medication with her first baby and she ended up committing herself for a weekend when that baby was around 6 months so she decided to be more prepared for her second baby but she still had difficulties. I’ll let you read it for yourself.
Start here. She includes links back to the relevant parts of her story.
http://www.dooce.com/2009/06/30/familiar-territory
Good luck!
Me too, what everyone else has said, you’re already a fantastic mother by thinknig of the best interests of your bubby. Depression is a horrible illness that affects so many people yet often so many are ashamed to admit it because of the stigma. I think you’re making the best decision for yourself and Goma-chan.
Don’t care what other people think, who are we/they to judge, you have to do what is best for you and your bub, there is nothing Taboo about depression, you’ve had your share of hardships growing up (me too).
If it makes you feel better, I’ve had to learn to live with panic attacks = ) since I was 19, they come and go, but daily exercise has worked for me for the most part (those endorphins are something else).
The most important issue is that you are “happy” and that is all that should matter.. people can be so judgmental (I am guilty of that myself).
I don’t know any of what you are going through with the depression or the pregnancy but I do know that you’ve obviously given it a lot of thought and, with the help of professionals, come to a decision that you feel is best for you and your baby. That’s your right and don’t let anyone make you feel bad about your choice. Hopefully everything goes smoothly for you – it sounds like marriage and pregnancy is a wonderful experience for you and I hope this helps your depression, even in just a small way.
We have spoken a lot about this before and I know how much thought you have put into your decision – you are doing exactly what is right for both you and goma-chan. You are definitely proving that you are going to be a fantastic mother already. Goma-chan is lucky to have you as his mum!!
Thank you to everyone for the lovely and supportive comments- I wrote this because, like I said, I want anyone else out there who is worrying about the same thing or battling with themselves to make a decision to know that there is light at the end of the tunnel. And just because you have to make tough decisions about your own mental health does not mean that you do not give a crap about your baby- in fact it is just the opposite.
Sarah, I want to also say to you that one of the things that prompted me to write this post is the relatively recent release of Heather Armstrong from Dooce.com book on her stay in the hospital and postpartam depression she suffered from with her first baby and again now with her second. I have not read the book yet but it is definitely on the top of my must read list. She writes about it so much more eloquantly (and humorously) than I ever could and she really is an inspiration to many out there who have gone through the same thing. Thank you for posting the link to her recent post about it- I had read it before (and most of the comments) but I am sure others will find it very useful.
Choosing to take medication during pregnancy is a personal choice just like whether to drink coffee or alcohol, only you can know what’s best for you! Well done on cutting down your dose so much! That’s excellent! Managing depression is all about knowing yourself and what works for you and you seem to be doing that well! I know I wouldn’t be able to survive the stresses of living in Japan while pregnant without medication! Good on you for being brave and sharing your story!
I really commend you for your decision, and for speaking up about this topic Lulu! There are always going to be people out there who knock you for your parenting choices — this is just the first of many! You’re doing what’s best for you and Goma-chan, and you just have to trust your own judgement, no matter what anyone else says.
You deserve praise, not slack. You are the only one (along with your doctor) who knows what is right for you and I think goma-chan is lucky to have you as a mom. You did your research and made a thoughtful, informed decision which would be good for both of you
I agree with everyone else. By researching your options and making an informed decision, you are doing the right thing for all concerned. Only YOU can make the decision because you are the only one who knows what it feels like without meds. Sounds like you have been very sensible about it and as Tiffany says above, you deserve praise not flack because someone else doesn’t agree with your decisions. As you will discover over the next few years, there will always be someone who disagrees with the decisions you make for your child and they will no doubt be very vocal about it but at the end of the day as parents, all we can do is make the most informed and sensible decisions we can manage, follow our gut instincts and hope for the best!
I think it is great that you decided to document your decision on your blog for others out there who may be going through something similar. Blogs are such an important and ever increasing source of information, where we can read people’s accounts right from the horses mouth, so to speak. I think they are much more helpful than some blurp from a doctor or acamedic, kwim? I know I use blogs alot when researching stuff, especially medical related topics. So, I think it is great that you wrote about your decision for others to reference!!! Way to go girlie!
It’s really hard to be a new parent -having to learn everything from scratch and having to make all these decisions for yourself (take the meds or not? immunize or not? breastfeed or not? crib or futon? etc). I say you need to do what you know in your heart is the right thing for you and clearly you’ve found that. Good for you for thinking of yourself and your baby and family. If I’m honest, I’m a firm believer in the “put on your oxygen mask first before putting on the baby’s” approach. What good is a mama if she isn’t well enough to care for her baby? (well, some good, but not as much good maybe) I think sometimes we neglect our own health too much.