Last week I wrote about how grateful I am to Lexapro for pushing away my depression. I've been taking those happy pills for seven years and they have worked like a charm. The last three and half of those years have been by far the best, thanks to my fiancé. I'm sorry to tell you that he is not available in pill form.
But, if I want to have child with my amazing fiancé, I'll have to give up my SSRI. The antidepressants that psychiatrists (and it seems just about anyone with a prescription pad) have been dolling out since the 1990s are not recommended for pregnant ladies.
There's been a big debate about this. Some point to evidence that SSRIs increase the risk of miscarriages, birth defects, developmental delays and autism. In a recent study, researchers found that women who took antidepressants while pregnant increased their child's risk of autism up to 87%. However, untreated depression has negative consequences as well, including poor prenatal care which can lead to premature labor and low birth weight. Or worse. That’s before the baby. Rates of postpartum depression in these women are quite high.
It’s a question of risk vs. benefits, and the decision rests on the shoulders of future mothers like me.
These days, pregnant ladies give up everything from Asprin to feta cheese to gel manicures. Women I know will do everything they can to avoid taking a drug that could be dangerous to their baby. The big caveat—and it's a big, Octomom-sized one— is that because very little research is done on pregnant ladies, this is all just a guess. SSRIs are schedule C on the pregnancy safety rating, which means the risk is unknown.
Like so many reproductive decisions, it's a more of a gamble than a choice.
Staying on an antidepressant during my pregnancy and while breastfeeding could jeopardize the health of my child.
If I taper down (because you should never stop taking medication cold turkey) there’s a chance that I will be able to manage my anxiety and depression with therapy, self-care, and an excellent support system. I might glow straight through my pregnancy and have a super healthy baby.
Of course, there’s also a chance that my depression may come roaring back into my life. And considering I'll be trying to have a baby, which not the easiest thing to do when you are on the wrong side of 35, I'll probably have enough anxiety in my life already. The happiness and emotional stability I have enjoyed for the better part of a decade could come to a halt. Last time depression took over my life, I damaged some of my relationships and made decisions I regret. I have so much more to on the line now. If I become depressed while trying for a baby, will I lose everything I’ve worked for during my recovery?
It’s a roll of the dice.
I know I am not alone in this. An estimated one in ten pregnant women take an SSRIs during their pregnancy. I created Psyched to get a conversation going about the real issues around mental health. So I'd love to hear from you. Have you been in my position? Do you know something I don’t? Are you already judging me? Comment away. (No log-in needed.)