Dealing With Medication Changes As A New Mom
When I can, I like to feature guest posts from people who have grown up taking psychiatric medications, and for today’s post we’re lucky to have a firsthand account of dealing with medication switches as a new mom from Claire Robson.
Claire, who gave birth to her daughter last September, is one of the people whose stories I feature in detail in my new book, Dosed: The Medication Generation Grows Up.
Claire began taking antidepressants for mood swings and depression when she was eleven years old. Medication was never a quick fix for her, in large part because it caused intense side effects, primarily extreme exhaustion. Two decades later, she is still adjusting her regimen, most recently because she has had her first child and is struggling with postpartum depression.
Postpartum depression affects between 10 and 20 percent of women who give birth, which blogger Katherine Stone over at Postpartum Progress calculates works out to about 950,000 women per year. I thought readers might be particularly interested to hear how someone with a long history of both depression and medication use before pregnancy has dealt with the challenges of PPD and the necessary med changes that come along with it.
Claire has been kind enough to share her story. It’s a poignant reminder that even people who receive early intervention for their psychiatric disorders aren’t likely to find a single, magic drug and be cured. Symptoms change, drugs stop working, hormones intervene – and meanwhile the demands of new motherhood call.
And now, from Claire, in her own words:
I have decided it would really just be best if I went off by myself and lived as an ascetic monk.
The grumpiest monk ever.
That way I won’t inflict the innocent with the obscene mood swings that have been haunting me while I am adjusting my medication postpartum.
Ever since I found out I was pregnant, almost a year and a half ago, I have been weaving my way through the medication jungle, trying to find the right balance of safe for baby and good for mama.
In an effort to avoid the minimal risks of birth defects, I began going off all my medication, a regimen of Cymbalta with gabapentin as needed. Unfortunately, I found myself almost immediately falling into a truly nightmarish relapse, and got my butt on some Zoloft, which is regarded as fairly safe for pregnancy.
After my baby girl was born in September, I returned to my trusty Cymbalta with my gabapentin chaser and struggled a bit for six months, and then things began to get hard.
At four months most babies hit a sleep regression, wherein they wake up a little more often as they adjust to being able to stay awake during the day more often. My daughter just decided to go on sleep strike, not sleeping longer than about an hour and a half at a stretch; ever.
In the meantime, I am in a decidedly bad mood as I wait to appease my rapidly changing hormones.
In the past when I have gotten in these moods, I have not been overly concerned with innocent bystanders. No, that’s not true at all. What I mean to say is that in the past, when I got in these moods, I had absolutely no issue with taking everyone down with me.
Until I was married, my general attitude when slumping through a depressive spell was something along the lines of, “Stay out of my way or you will get what is coming to you.” Back then, if I ever needed to adjust my medication, I could keep my head down at work, and then live very much like an ascetic monk otherwise until the whole thing passed.
When I got married, I was introduced to the idea of sharing myself with another. And not just sharing my heart, my space or my stuff. But my moods also began trickling into another person’s mood like colors blending on a watercolor. It was difficult, but kind of nice. We could talk through it, give each other space, go for a walk.
I felt like I became more sensitive to the ways that my fits of depression affected those around me, became more cognizant in taking my medication regularly, and was careful to be extra nice if I accidentally forgot a day or two. I tried to take better care of myself so that I was an easier person to live with. I tried to be more patient with myself and others. It was very Zen.
Since the birth of my little girl, the Zen-like period of maturation has ended. Moms don’t have space. We know that. Moms don’t have space or time, or even personal objects. My own body is shared by another human being. Literally. Everything I do, consume, or feel is shared by another little person who does not have even the vaguest idea that I am a person separate from her.
That makes depression, and especially medication, a lot trickier. Unfortunately, as a depressed person, becoming a mother was pretty much a guaranteed medication adjustment, if not several medication adjustments both because of the massive body changes, from hormones to blood volume, as well as the risks of birth defects and consideration for breastfeeding.
Just worrying about how each medication might affect my daughter, both in utero and while breast feeding, is enough to make a person chew through cabled wire.
I wrote about it on my blog at length because it honestly makes me consider salves, tinctures, and exorcism, because frankly, they sometimes seem to have more evidence supporting them than medications. Sigh. It is very frustrating.
But the complications of medication change do not end with my concern for the physical effects on my daughter. There is also the unpleasant complication of not really having any test window.
I can’t give a medication three weeks and see how it makes me feel. I can’t take a few days off to see if it makes me sleepy. Any unexpected side effects are not something that can be carefully considered and worked through. Sleepiness, dizziness, rage, inability to focus: these kind of things are not just idle possibilities. They are threats, and can’t be considered lightly.
So, I always adjust my medication on the weekend, and if by Monday I am not feeling stellar, if there is a hint of overtired or impatience, I am in the doctor’s office by Monday afternoon. I think it makes her a little crazy, but she can join the club.
What really would be best would be for the medical profession to have figured all this out already. To have tested all drugs ever invented for a person in my exact situation with my exact biological make up. That way I could just follow the directed course of action and no one would have to suffer while I am conducting my personal chemistry experiments.
However, given the unlikelihood of that happening…at least not by tomorrow… does anyone have any suggestions for families when a loved one transitions between medications?
For more of Claire’s thoughts on medication, depression and motherhood, check out her blog, Mommy Mentality.
Bell Barnett, K. (2012). Dealing With Medication Changes As A New Mom. Psych Central. Retrieved on September 2, 2015, from http://blogs.psychcentral.com/my-meds/2012/06/dealing-with-medication-changes-as-a-mom/