My Choice To Stay On Antidepressants During Pregnancy

What if I went off the drugs and was just fine? What if I’m taking them for the rest of my life for no reason other than fear? What if I could meet the “real” me?

When you are pregnant, the world is full of advice and warnings. No soft cheeses! Get your prenatal vitamins! No more coffee! I tried to take each of these with a grain of salt (while watching my sodium intake, of course), but there are some areas that even the Internet could not advise me on.

You see, I have dysthymia, a form of depression. I’ve had it since high school, and have every reason to assume I will have it for the rest of my life. Very luckily, I was able to find medication that treats my symptoms and allows me to live a normal life. It’s been almost 15 years since those little pills changed everything for me, and I am grateful for each year I’ve been given.

Which is why I struggled with the decision of whether to give them up while pregnant. Wellbutrin is a Category C drug, meaning we really don’t know what effect it may have on a fetus. While that sounds bad, it is very common, because studies on pregnant women are extremely difficult to come by (understandably, few pregnant women volunteer for anything even vaguely risky). So when discussing this with my doctor, we had very little medical evidence to help with the decision.

Could I really risk being unmedicated after so many years? Could I face that abyss of depression again while dealing with the influx of hormones and stress brought on by pregnancy? My memories of the darkest days are clear, even 20 years later. I remember falling to my knees in the middle of my room some nights, sobbing in the dark, completely in despair. I was desperate for help but had no hope of it, since even I couldn’t identify why any of this was happening. There was no logic, no reason for my despair. That was me without medication.

The risk of a return to that life was very real, and yet the risk to the fetus was unknown. With my doctor, I made the decision to stay on my meds. My daughter needed a healthy mother. For what it’s worth, she has shown zero signs of being affected — it was the right choice for both of us.

The decision itself has highlighted the fact that I will likely take this medication for the rest of my life. It is simply a part of me. I am more “me” with this medication than I am without — so what does that mean about “me?” Is my personality truly mine, or is it somehow synthesized? Does that matter at this point?

These questions don’t trouble me on a daily basis, but they lurk in the back of my mind, especially when I have trouble getting access to my meds. Every couple of years, I end up with a doctor who refuses to renew my prescription, and I start a panicked runaround with the ticking clock of a slowly emptying prescription bottle in the background. Last time, a doctor was filling in for my regular physician on maternity leave, and she required me to find a psychiatrist with the clinic instead. The clinic required me to attend the group “intro” session first...seven weeks later. At the end of the session, they offered to schedule me with a psychiatrist...another 10 weeks later. I cried and walked out of the building.

Luckily, I had started the process early that time. I made an appointment with my regular doctor the week she was due back, and rationed my pills every other day until then. I just couldn’t face the red tape anymore.

At times like that, part of me wonders if I have magically recovered from the dysthymia and don’t even know it. What if I went off the drugs and was just fine? What if I’m taking them for the rest of my life for no reason other than fear? What if I could meet the “real” me?

But what if I haven’t recovered? What if I went off them, and then they didn’t work anymore when I tried to go back? A friend in the mental health profession once told me about patients for whom the efficacy of the drug decreased on subsequent rounds, and the idea terrifies me.

Once again, I am faced with weighing the various risks of this medicine. It has made so many things possible for me. I can’t imagine turning away for a nebulous, unknown “me” that may or may not exist underneath. I am fortunate to have health insurance and access (usually) to a medication that balances the chemicals in my brain to where they should be. That is an amazing thing, really. So every morning, I choose the medication. And this is me.

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