Depression During Pregnancy?

Prior to my current pregnancy, I hadn’t done a whole lot of research on perinatal depression – depression symptoms and episodes that take place during pregnancy and in the first year after delivering the baby (this includes postpartum depression). I’ve learned that there is a lot of stigma around moms who struggle with depression, especially during what is supposed to be a very joyful time.

If my own struggles with depression, self-harm, and suicidal tendencies have taught me anything, it is that these psychological struggles make normal life nearly impossible. In some cases, literally impossible. And then when you add the hormone wackiness, the physical changes, and nausea/vomiting to what is already a difficult situation to traverse… hoo boy. My research on this subject shows that while mental illness in general isn’t talked about nearly enough, mental illness during and immediately after pregnancy is talked about even less. This I find perturbing, considering that women who have clinical depression (and there are more of us than you might think) are at a high risk of developing perinatal depression – and in some cases, though rare, even postpartum psychosis. My reasoning for writing about my experiences with depression during pregnancy is this: perhaps if I share my story, it will break that stigma a little bit more and encourage moms who feel shamed into silence because their misery currently outweighs their excitement.

Because I want to give our baby its best chance, I haven’t taken my antidepressants since I found out I was pregnant. Usually you’re supposed to wean off of the meds I was taking, but I quit cold turkey because I’m smart like that. Luckily, the newlywed high was still working its magic, so I didn’t suffer withdrawal effects nearly as badly as I might have otherwise. By the time I started experiencing serious depressive symptoms again, I had been off my meds for long enough that my doctor said it wasn’t withdrawal causing them. Getting back on my meds would be an absolute last resort. That meant that over the next month and a half, we would be doing a process of elimination to see if it had to do with my pregnancy hormone levels, my depression itself, or an external source such as unhealthy levels of stress.

Blood tests determined that my hormone levels were all well within the normal range, but because I miscarried my first child, my doctor wrote me a prescription for a progesterone supplement. Just in case. One of my depression symptoms has always been disturbed sleep – being perpetually tired, but not being able to get restful sleep – and the doctor told me that one of the perks of progesterone was that it helps the mother relax and sleep better, and deal with anxiety better in general. It all sounded great to me.

The first two weeks were somewhat better – or at least things didn’t get any worse. But then my already not-so-great sleep became filled with disturbing nightmares, some of which included traumatic memories that are normally reserved for my PTSD episodes. I felt even less energy than I had before, and it took every ounce of willpower I had to go to work every day. (Just getting dressed took so much effort, makeup certainly didn’t make the cut.) By the time I got home, I was so exhausted from fighting my nausea and trying so hard not to break down that I would collapse on the couch and basically not move until it was time to go to bed. I cried, hopeless and despairing, nearly daily. For the first time in months, I was fantasizing about death and was actually tempted to harm myself.

My poor husband! We had been married for less than a month when this all started to spiral. He has been through my side through years of struggling with my mental illness, but adjusting to living with me amped this up to a whole new level. I don’t think either of us was prepared for the level of misery I was experiencing, let alone for the first two months of our marriage to be so much more stressful than we expected.

When I went in for my 12 week checkup, I described my symptoms to the doctor and we decided to reduce my progesterone dosage just in case it was high enough to exacerbate my depressive episodes. And then, even though we hadn’t been planning on it, he offered to give me an ultrasound to show me the baby and put my mind more at ease.

The picture quality wasn’t as clear as normal (since I had given them a urine sample and emptied my bladder already), but there was Baby: wiggling jerkily around with their developing muscles, and clearly rolling from side to side, as though trying to get comfortable. I almost thought I could see their little face. Hearing the doctor say, “You have a really active baby” nearly brought me to tears; in my previous pregnancy, when I was but a college freshman in a desperate situation, I hadn’t been able to so much as hear my child’s heartbeat before I received the devastating news that I was going to miscarry. Seeing my baby moving around on the ultrasound, even with a fuzzy picture, was something I had never expected to see – and until that moment, I hadn’t realized that.

Speaking with my counselor only drove that point further home. I have been preemptively grieving this baby, expecting to lose it. My old thought-traps of “Anything that seems too good to be true is just that” and “Nothing good could ever happen to me” have been rearing their ugly heads… the remnants of three years of emotional and psychological abuse at the hands of someone who had claimed to love me.

Talking through this with my counselor and with my husband has only helped me to start improving – and now that my nausea has dramatically improved, the physical relief I feel is adding to my progress. I have far fewer nightmares now, and sometimes wake up feeling rested. I am able to step back when I feel the beginnings of a PTSD episode, and remind myself that I am safe, I am loved, and that my husband is not my former abuser. I have given myself permission to be excited, to plan for the future, and to bond with the baby that I saw dancing around on the ultrasound.

I know that this roller coaster is only beginning, and that my depression could very well worsen again as the pregnancy progresses. I know that no matter how small, there is always a chance that something bad could happen. I know that I still have a great deal of healing to do. But that’s okay. Because I would rather be happy now with the possibility of grief later, than to be overwhelmed by grief from start to finish.

So, for the moms out there who are struggling with depression or the anguish of loss during a pregnancy, hang in there. Your pain is real, and it should be acknowledged. I, too, have heard the well-meaning but blissfully unaware comments that “You’re having a baby, so you should just be happy!” or “You should stop focusing on the negative!” Telling a deaf person to listen harder doesn’t help them – telling a person with mental illness to be happy doesn’t help them, either. I hear you.

If you’re a friend or relative of an expecting mom (or mom who just had a baby) who is struggling with depression or grief, sometimes the most helpful thing is to not offer advice. It’s to simply be there, and to remind her that you’re there. It’s to ask what she needs from you. It’s to offer support, in whatever fashion she needs most. Have her write you a list of a few things that you can do to help relieve her of some of the stress that is exacerbating her symptoms, or to help her prepare for the little one coming into her life.

It is an exciting time. For some of us, the sheer amount of suffering we endure blindsides us and takes over our vision; but regardless, it is an exciting time. There’s a brand new little person growing in our womb, and we’re going to get to meet them soon. God created another unique, immortal soul – and with our help. That’s some pretty awesome stuff. We just need enough relief to be able to see that again.

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