Coming Off Antidepressants When Pregnant

When I first started taking antidepressants, pregnancy was a wishful fantasy. Nevertheless, I made sure I went on one which could be taken in the unlikely event miracle I became pregnant. Fast forward just over a year, and when I first saw my doctor after finding out I was pregnant she raised the issue of my antidepressants. It was quite clear that she thought it best I stay on them, although she would not assure me that there were no side effects. Instead she sent me away with a leaflet all about my medication and pregnancy. I didn’t have to read much before I knew I was getting off this medication as soon as possible. Like the doctor, the leaflet emphasised that the best thing for a baby was a healthy mum and the risk of becoming mentally unwell in pregnancy was seen as much worse than being on antidepressants. I am sure where the mum is likely to become more mentally unwell this is absolutely true and I believe that, as with most medical cases, doctors know best. However, I also know it’s hard for a doctor who’s never seen me before to make an assessment of whether I would become ill or not without antidepressants. Yes, on average a mother (or mother to be) who has mental ill health and is using antidepressants is (probably) better staying on them, rather than rushing off them due to a pregnancy. However, I didn’t feel I fitted into this average situation.

I’m not ashamed to say I’ve suffered from depression, if I look back eighteen months ago I was barely functioning. On the outside to most people I probably looked OK (I mean, I (generally) went to work and showed up to things as expected), but behind the scenes was a different matter entirely (and in all honesty, that says a lot about what people were looking at, not just how I was managing). My depression and anxiety was a specific blend of PTSD and reactive depression. I’m not saying that made it easier to deal with (or harder), just that it may have made it slightly easier to assess whether I’d dealt with those underlying causes before making a decision to come off antidepressants or not. I knew that I’d been working on a lot of the triggers in my history, and that I’d been processing a lot of the trauma I’d experienced. The meds helped for sure, but so did counselling, CBT, distancing myself from my ex, changing where I worked, moving house, writing about my experiences, and – more recently – getting pregnant! Pregnancy often gets a bad rep for being negative for your mental health, but it can have the exact opposite effect. So, armed with all the knowledge I had, I took the decision to come off my medication. With the doctors support, I halved my dose the next day. I was a few weeks pregnant. 

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Today is my fifth day on the lower dose. For the first time in a long time, I found myself falling apart over the simplest tasks. I couldn’t get the sound to work on my laptop, then I couldn’t get something to save. I burst into tears. I was surprised by my reaction, it’s one I’ve not had in a while and it’s hard to know what it’s from. It reminded me of all those months where that was how I lived day in, day out. How everything was too much and the simplest of challenges sent me into a tailspin. Despite, ironically, dealing with some of the biggest challenges single handedly without a scent of emotion. I think it’s called displacement. I was in bed ill when this was happening, plus of course I had the pregnancy hormones rushing through my body. The exhaustion of early pregnancy, plus being ill is not exactly a recipe for a fun Saturday afternoon. However, it was the first time I also realised that perhaps it was the meds leaving my system and I’d need to deal with these things ‘alone’ again. It was scary to think I could end up back where I had been a year or two ago, but I also knew that this might just be a small blip.

By that evening this was not looking like a blip. After getting little one to bed I went downstairs. Inhaled cheese and biscuits, chain eating them with tears streaming down my face. It was like I’d been transported back two years, when every evening was me crying alone in my flat. It felt surreal, like the interlude of relative calm hadn’t happened at all. I was still the same broken person. Sitting there, angry with all the people who’d let me down, sad at all the friends who hadn’t gathered round me, distraught at the way my life was turning out.

I’m not sinking though, not like before. Just floundering. My son is nearly four – he’s a whole lot more fun and easier than he was. My mum gets it much more now and I’ve made new friends who I know if I had the guts to ask for help would be there for me. These extra feelings aren’t all bad either. Since being on the medication I feel like I haven’t written anything deep because I haven’t felt anything deep. I’m looking forward to my life returning to technicolour. Even if the greys will be darker, the oranges, yellows and reds will shine even brighter, of that I am sure.

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A week later, I came off the meds entirely. The changes have been minimal if I’m honest. Though again, it’s hard to know which way is up when there has been so much going on in my body physically and mentally. The jury is out on whether the last two weeks of incredible dizzyness, to the extent it’s disorientating to turn my head, is a side effect of coming off the meds, or a symptom of pregnancy. There have been moments when I’ve felt scared. Times when I’ve suddenly, almost without warning, been sucked back into the vortex of depression – it’s deep, dark, hole trying to pull me under and keep me there. But each and every time it’s been short lived. I’ve opened the manhole cover and come out to see that the light is still shining and life is carrying on around me. So far I’ve been able to join back in without too much of a problem. At times it’s felt like a lid has been lifted on me too. My words come tumbling out, excited and alive, in a way I haven’t felt in a long time. I’m enjoying this return to being me. I just need to stop crying so I can see what kaleidoscope of colour awaits me.

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Four months later, and things are generally pretty stable, both compared to how I was before the meds and compared to how I was on the meds. A few years ago, although I had good days – days where I got through without any major ordeals, without having to drag myself off the floor – it was rare to have days when I felt good. There’s a big difference between the two. One day of feeling good was typically followed by numerous days of not. Antidepressants helped me. They weren’t, however, some wonder pill. During the fourteen months I swallowed them day in, day out, life was still hard. The anxiety, the belief that everyone hated me (or at least didn’t give a shit enough to prioritise me) and the deep, deep sadness I had  with my life, were still a constant. They existed because of the situation I was in and the people I was (and wasn’t) surrounded by. A pill cannot change this. However, I can. That’s not a flippant statement, I’ve been trying for years to do just that and I’ll probably be doing it for a good few more to come. It’s generally been a case of two steps forward and one step back. This however, is much better than the days when it was one step forward and two steps back. Going on the meds – and coming off them – has been part of my journey to ‘get better’. Nowadays the good feelings can last almost a week. They still end with a sudden jolt back to reality, but usually, within a few days to a week, I’m back on track. I have no idea if (given various factors) I will ever not be at the mercy of those negative thoughts, but I do know that they are becoming easier to crush. Whilst it’s still not uncommon for me to fall asleep crying, there is also a brightness to my step. A brightness which I now trust to strengthen and keep me afloat.

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Notes

Please seek medical support if you are thinking of coming off antidepressants.

I came off my medication with the full support of my GP. I had counselling in place for the first few months and I am clear that should things become too much for me I will be heading straight back to the doctors to work out a new way forward. Coming off antidepressants isn’t for everyone and I would hate to think this post might encourage people who aren’t ready to do so. There are many types of depression, mine was PTSD. I went through a lot of different approaches to get better. I dealt with each and every one of the negative mental health symptoms I was suffering – the anxiety, the flashbacks, the nightmares, the paranoia, the depression. Additionally, I worked on rebuilding my life. For me, trying to get pregnant as a solo mum via donor conception – as hard as it was – was an incredibly positive and empowering decision. I regained my life and, although I wasn’t following plan A (I’d love to have a partner to share this all with), I was in a much, much better place than when I first became a single parent. If there was any miniscule risk – no matter how small – to that pregnancy, I was not willing to take it. For me, this was the perfect opportunity to try going medication free.