I’m not sure that I’ve gone into this in detail before, but ordinarily I am on a regimen of 225 mg of Effexor per day to treat my major clinical depression. This treatment has worked for me pretty well for several years now, though before I began with the Effexor I was on a cocktail of Wellbutrin and Lexapro, which more or less does the same thing as the Effexor, but for some reason it stopped working after about ten years of use. When I’m medicated, I go through life almost as if I’m not a depressed person, but for keeping my regular psychotherapy appointments and my tendency to be attracted to cultural productions that veer toward the morose (e.g. music by The Smiths, novels by Kazuo Ishiguro, and movies that are about “basically just chicks and being depressed,” as per Mr. Right-Click).
In recent years, many studies have suggested that a mother suffering from major clinical depression is better off to stay medicated whilst pregnant, mostly because of the tendency for the body to produce stress hormones that are likely to be more damaging to a developing fetus than any drug side effect. For people who are on traditional serotonin reuptake blockers (e.g. Prozac, Zoloft, and the like), the choice of whether or not to go off medication when pregnant is pretty clear — there have been so many studies and examples of successful pregnancies while medicated that it’s (relatively) easy to decide to stay on the drugs.
Naturally, my situation is more complicated, as I am a special snowflake.
There haven’t been many studies on being medicated with Effexor while pregnant. The few that have been done suggest that the first and second trimester are fine, but the third is risky because of withdrawal for the kid when it finally comes out. Before I got pregnant with Mini, I had been on the Wellbutrin/Lexapro cocktail, and few studies had been done on that combo. So I went off the medicine, because I was worried about what might happen, and because nobody could give me any concrete answers about the right thing to do.
I made it into the second trimester before I had to go back on a low dose of Lexapro, white knuckling it through the rest of the pregnancy and breastfeeding (which with Mini was a short six weeks because of his protein intolerance) before I finally got back on my regular meds.
A year is a really long time to not feel like yourself.
But then, even non-depressed people don’t feel like themselves when they are pregnant. I’m not sure whether I made the “right” decision that time — I do know that I made it through, and that Mini is healthy, and in retrospect whatever I had to deal with during pregnancy was worth it a million times over.
And I’m really glad I have that experience to draw from this time, because last time I wasn’t totally convinced that it would be worth it. I really wasn’t sold on it, particularly during the first trimester when I had the double whammy of no depression medication and HG to deal with. Now I’m right back where I was about four and a half years ago, and sometimes I have to say to myself, “I love Mini so much, I love Mini so much,” just to make it through the rest of the day.
Yesterday, I came downstairs to give Mr. Right-Click his Valentine’s Day present. Mini, who hadn’t seen much of me for the whole weekend, was disproportionately excited to see me. “Mama, are you better? Are you all better now?” he asked.
I want to be able to write about other stuff but it seems like this is what my life is about now, for better or worse. I hope you all will stick around and see how it turns out.