I’ve been taking fluoxetine, an SSRI, for around 16 years and I’ll probably never get off of it. I stayed on it through numerous bouts of depression and anxiety (which would have been much worse otherwise), after the birth of my baby (yes, I was breastfeeding) and while I was pregnant. I’m on the lowest dose but whether it’s placebo or not, I don’t want to risk it.
More than four million people in England are long-term users of antidepressants and one in six people in the country were prescribed antidepressants in 2017. And of course, depression doesn’t go away because of good news like the viability of a pregnancy or the birth of a healthy baby.
While there are no statistics available on the number of women taking antidepressants while pregnant, pure maths tells me I can’t be the only one. But it was a scary decision to make when research says risks include birth defects (heart defects, spina bifida, cleft lip), increased risk of miscarriage and premature birth, and withdrawal symptoms in the newborn baby (restlessness, jitteriness, poor muscle tone, not being able to cry loudly, difficulty breathing, low blood sugar, and high blood pressure in the lungs).
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Not a day went by when I didn’t worry about the effects of these tiny green and white pills on the human growing inside me. I felt I couldn’t tell my friends I was taking antidepressants while pregnant and even worried my husband would think I was being irresponsible for making the choice to stay on them. No matter my rationalising, it ultimately felt like I was prioritising my life over my baby’s.
But then, there were risks to not taking my antidepressants. Experiencing major depression during pregnancy is associated with an increased risk of premature birth, low birth weight, decreased fetal growth or other problems for the baby. Moreover, unstable depression during pregnancy also increases the risk of postpartum depression, early termination of breastfeeding and difficulty bonding with your baby. Because of my already high risk for PND, I wanted to give myself the best possible chance at being able to look after my baby in those early first weeks and months.
Regardless of the risks and perceived stigmas attached, I never stopped taking the drug while pregnant. But when I spoke to my GP about this (around the three month mark) she suggested I switch to sertraline, one of the better studied antidepressants during pregnancy. I couldn't meet her eyes when I went in for the appointment. But she didn’t judge me for wanting to continue treatment; she was very clinical about simply testing a more researched drug.
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About two weeks after switching medication, the familiar, enduring hopelessness I’d been running from my entire adult life returned. Thankfully, I recognised it immediately and switched back to my old stablemate fluoxetine, but not before a week off work where I could hardly get out of bed.
I started taking medication during my parents' divorce. I was 16 - the height of teenage self-consciousness - and I was so bereft of care I used to wear oversized t-shirts I’d slept in with holes in the armpits into school. Thankfully my parents sent me to a child psychologist, who after months of therapy, recommended I start on medication. It allowed me to grow into a functioning adult, graduate university, hold down high-stress journalism jobs, and enjoy my pregnancy. And now, be a mother.
I have tried periods without it - the longest I’ve lasted is 3 months (and it takes 2 weeks to leave your system entirely). What I’ve realised is, why put myself on a rollercoaster if I know the end result is one that paralyses me?
Ultimately, as any healthcare professional will tell you, you need to balance the possible risks to your baby against any potential harm in not taking your medication, and come to your own decision about what's best for you, based on your own experience. Thankfully my husband was supportive of me continuing to take antidepressants during pregnancy - and if we ever have a second I will, too.
I’m probably, most likely a lifer. And I’m not ashamed at all.