Antenatal Depression, Part 1 – The Steep Descent can be found here, on the new WordPress site. .. And here, on the old Tumblr site.
I thought I would have more time.
When I found out I was pregnant, I had immediately started thinking about the possibility of the PPD returning. I spoke with my doctor, let my close friends know I might need help, and started planning to be proactive. I thought I would have 8 months to prepare…to ready myself and my family…to batten down the hatches. So though everything, from the symptoms to the treatment, was familiar, I felt blindsided when the depression and anxiety returned only 7 weeks into the pregnancy. The hopelessness was crushing.
And then I remembered…hopelessness is a symptom of depression. As tangible and debilitating as it feels, it isn’t real. Two years of therapy trained me to separate myself from the symptoms. And somewhere deep down I knew that if I could get just a little bit of that hope back, I might have a chance.
So I got online. As strange as it may sound, hope lives in this little corner of the internet created by Katherine Stone over at Postpartum Progress. Her blog brings survivor stories, honest discussion, support, and resources to mothers suffering from postpartum mood and anxiety disorders. And sure enough, not only was I able to read story after story from women who had fought and won their battle with antenatal depression, I was able to find the name of an area psychiatrist specializing in medication use during pregnancy. If I had to fight this again, I was going in armed with the best damn arsenal I could find. This was a familiar foe, one whose pattern of destruction I knew well. The hopelessness lifted just enough to let me think I just might have an advatage in the fight this time around.
Surely this specialist would have a magic answer for me…perhaps a magic pill. One without side effects and that provides immediate relief. Made of unicorn horn and fairy dust. Maybe she would tell me I could stay on my old meds. I don’t know…I guess I was honestly hoping for a miracle. When she told me she wanted me to do exactly as my regular psychiatrist prescribed, I was disappointed. Certainly psychotropic medications were unsafe during pregnancy, right? Wasn’t I going to hurt my baby by taking them? Wouldn’t the side effects be too much to bear? She spent an hour covering relevant studies regarding the safety of SSRI use during pregnancy, interpreting both the results and the validity of each study. She told me of countless patients who had experienced little or no problems and had benefited greatly from treatment. And then she won me over with two simple statements:
1. I could choose to expose my baby to medication, which carries the risk of some very rare complications. Or, I could choose to expose my baby to the depression, which would likely lead to complications including low birth weight and premature labor, not to mention issues after the birth. Put another way, there is no such thing as non-exposure.
2. If I worked with my doctors to find the best treatment now…if I did the work in therapy and took care of myself, she felt I had a very good chance of recovering and then having no PPD after the baby was born.
The thought of being able to enjoy the new baby, of being able to care for myself and my family, and to continue to be my husband’s partner instead of needing him to care for me – it brought me to tears. I was ready to give it a shot.
The side effects came in like the tide: unrelenting. And just as I had predicted, they were torturous. On top of morning sickness and the normal lethargy pregnancy brings, the meds caused headaches, nausea, and zombie-brain. I had trouble putting sentences together. DoodleBug spent hours watching PBS. I can’t even guess at how many frozen pizzas and cans of soup we ate for those three months. I struggled with all of this while my reality was warped by depression. So even though I started to feel like a terrible mom and I worried I would never feel better, I had to hold on with a death grip to what I knew for sure: the side effects would go away. The medication would eventually begin helping. Sometimes with depression, all you have left to do is wait.
It was a long three months. But what I learned from last time was that even though I wanted to hibernate, I would need a support network. Not only has asking for help always been a challenge for me, the shame that accompanies depression makes it hard to share with friends and family. But this time, I did it anyway. In fact, I showed up on my best friend’s doorstep in tears. She answered the door in a towel and I poured my heart out to her. I called my old therapist and made an appointment. I reached out to my #ppdchat army (shoutout, ladies!), who understood how I was feeling and knew just what to say. I let my family know I was having a hard time, and asked my long-distance bestie to check on me each week.

Today I am 19 weeks pregnant with a little girl.
I find myself rubbing my belly and talking to her when she kicks. I revel in the moments when DoodleBug lays her ear on my stomach and swears she can hear the baby. I’m finding it easier and easier to laugh. We’re thinking of baby names. And now instead of comparing this pregnancy to how I felt the first time and feeling guilty, I feel empowered. And yet. Pregnancy is still hard for me, physically and mentally. I recently had a string of bad days that led me to talk to my doctor and increase one of my medication doses. I will probably have more.
I do many things with ease – math, friendship, teaching – pregnancy is not one of them. But I know now that I don’t have to do this gracefully. This will be a long road with many difficult weeks, but at the end of the day, all I have to do is grow a human being and get it out somehow.
I’m prepared to increase medication doses as my body changes. I’m ready to put a plan in place to ensure I have support after the baby is born. I’ve accepted the possibility that the PPD may return after the baby is born and I may need to change medications or therapies. But for now, my anxiety is manageable. And although tired and sometimes moody, I am no longer hopeless. I can separate myself from the symptoms and identify when I need to ask for help. But most importantly, this time I know I am not alone. Not only do I have an army of friends, family, and online mamas ready to help me fight (fist-pump time!), but through being vulnerable, I have learned that I am worth the fight.
I CAN do this.
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Tags: antenatal depression, depression, hope, No. 2, PPD, pregnancy, truth