“What just happened there?” My psychiatrist said, watching the vast array of emotion flit across my face after she suggested I go back on Prozac during my pregnancy.
“I just . . . I don’t . . . What if taking the Prozac was part of why I lost my other babies? What if it numbs me even more?” The superstitious if-then thinking had sent my heart quaking and my tongue felt thick. I had other thoughts racing through my mind as well—the kind that carry the undercurrent of stigma and fear of judgment because of what we are conditioned to believe is "normal." I tried not to listen to those.
My shrink just smiled. “Do you really believe that?”
“I know. I know it’s safe. I have talked to Motherisk and also talked to all my doctors. I know it would be better for both me and the baby in this case. I’m just . . . disappointed.” I sounded hollow and defeated. She sighed deeply.
“If you had a friend talk to you and tell you everything she was going through, and she told you she was going to go back to therapy and take medication to help her with it, what would you say?”
“That . . . she is amazing and strong for taking action and helping herself, that I am here for her, and that whatever she needed to do to get back to being healthy was just what she had to do.” Oh. I get it.
“Judgment leaves no room for empathy. You would never judge anyone else for going through pain and for helping themselves out of that pain, would you?” I shook my head. “So why are you judging yourself?”
“I don’t know.”
“Well why don’t you think about it until next time and we’ll set up an appointment with a therapist for later this week. I do think that in this particular case, you would really benefit from a low dose and, most importantly, so would the baby. I’m going to give you a prescription for 10mg and you can move up to 20mg over the course of a week . . . Kat . . . I don’t believe that medication fixes situations. That’s all you. I think this will help ease the physical symptoms you’re experiencing so you’re more open to using those great tools you already have.”
I had been collecting my things, but suddenly stopped when she broke the fourth wall by using my name. She was right. I knew she was. And I knew I had to try. I owe it to my kid. My kids. I smiled as I thought in plural, and then realized that was the first time in three months I’d let myself think about the baby as a reality.
I had spent thousands on medications and procedures to get pregnant with Vee, and hundreds more on prescriptions to get my Crohn's under control. Now that I was pregnant again, surely I, who believes so strongly in being an advocate for mental health, didn't have a problem helping myself?
Judgment leaves no room for empathy.
I took the prescription from her hands, and left the office marking my first steps toward change.
For more articles about mental health, read Why Do We Think Showing Emotion Is A Sign Of Weakness? and Post Partum Depression After Miscarriage.
“So many women experience anxiety, depression, and PTSD during pregnancy . . . You’re not alone.”
I was back in familiar territory at Women’s College Hospital. I’d been part of their Reproductive Life Stages Program before, but this time, sitting in front of the psychiatrist, I felt twice as vulnerable.
“I just . . . I can’t do it by myself anymore.”
She nodded, her eyes gently coaxing me to keep talking.
“I’m scared to . . . to do anything. Because I think something will set me off. I used to write so much and I can’t even because I’m just . . . frozen. I don’t know how to deal with the thought of bad news . . . I don’t know how to deal with good news. I want to write about it . . . I want to just tell my friends but I, I just can’t. I snapped at my 4-year-old for taking too long getting dressed this morning. I screamed at my dog for panting too loudly. I flew into a rage at my boyfriend who’s done nothing but be amazing . . . I just wanted to hate him and I honestly can’t even tell you why. The ultrasound technician gave me 9 photos of my baby. He said it was perfect and the heartbeat was beautiful. He told me to carry those photos around all the time and I do and I look at them and I still just don’t believe it’s happening. I’m so scared that I’m going to lose it that I don't go to the bathroom for hours because I think I’ll see blood. I, I’m broken.” It poured out of me in a crescendo, and ragged sobs cracked through the silence.
The doctor’s voice grounded me. “For what you’ve gone through, this is completely normal, and it’s great that you’ve recognized all the red flags. You’ve used all the tools that you have learned through therapy, and that has brought you through a lot. You’ve even recognized that you can’t do more by yourself. Give yourself some credit . . . and now we are going to figure out how to take some next steps together.”
I had never stopped to think of my coping mechanisms and ability to function in everyday life as any kind of success, so this stunned me a little. I had also never thought of my anguish as an opportunity to develop or grow—beyond peripheral, prosaic, existential exploration. The kind done on a lazy Sunday while sipping hot tea. The realization that I could change these feelings let me draw a deep breath.
“In addition to talking to our therapist, I also want you to consider going back on some medication while your symptoms are this close to the surface.”
I was on a minimal 20mg dose of Prozac throughout my last pregnancy for preexisting anxiety and mild depression related to my Crohn’s diagnosis. I had contacted Motherisk.org right away and felt assured that it was safe for the fetus along with my other Crohn’s meds, but a part of me always felt guilty for needing pharmaceutical bolstering even if my health depended on it. Then, in the first few months after I had Baby Girl, my Crohn’s flared along with the feeling of "overwhelmed" and all my medication doses went up.
After my first miscarriage, we upped the Prozac dose again to 40mg. After my second, we went up to 60mg. These decisions were never made by just one person and I always played an active role in how any and all medications would fit into my life.
My therapist at the time, my GP, my specialists, and my family had an open dialogue about everything—especially mental health. By the time I had separated from my husband, I had been tapered back down to 20mg, and later that year I was weaned off of it completely. I’d never felt like it was a failure to help myself any way I could—through therapy, meditation and prayer, self-help and reading, exercise, diet, and medication. So why did I feel so defeated and hurt by the sudden prospect of going back on meds?
Post Traumatic Stress Disorder has managed to carve some pretty intricate logic-loopholes as it’s etched its path through my life. A leftover relic from fertility issues, miscarriages and separation, it’s cut me deeply. Now that I’m finally pregnant and safely into my second trimester I want to feel unbridled joy, but sometimes I feel terror and paralytic trepidation instead.
More than once I’ve warred with myself, telling myself to just ‘get over the past’; staring down my volatile emotions from a perch of detached intellect. I know when I’ve been triggered and why. I know why I am now a superstitious, jumble of irrational if-then statements. But I don’t know how to stop just yet.
The other day I was cleaning a puddle of thawed blood from a package of leaky ground beef off the kitchen floor.
“It’s just some messy food.” I repeated to myself as my movements became more agitated and I tried to keep pace with breaths that came harder and faster than ever. And all of a sudden I wasn’t there.
I was in a different house, in a different time, watching the blood drip softly on the hardwood floors as I lost my baby. There was always so much blood.
I snapped back to reality in the kitchen and started dry-heaving. “Come back Kat… you’re here. You’re now. It’s over. Steady….”
Therapy has taught me how to breathe through those moments. Now I know how to re-engage the here and now, be patient with myself and understand that this is ‘normal’ for me. But I still struggle with accepting the sudden experience filter that seems to take over just when I think I have it all figured out.
Like when seeing my pregnancy test turn positive plummeted me from wonder into cold sweats. Not because I wasn’t prepared to see that answer, but because the potential of reliving the nightmare of loss sat there clearly as 2 lines in the test window.
Cap’s surge of surprise and happiness at the prospect of fatherhood was instantly squashed by my avoidance and terror. “Don’t get too excited.” I said it over and over again.
I hated myself intensely for militantly managing expectations, desperately wanting to feel elation, but petrified that I would break Cap’s heart with a miscarriage.
My trauma-brain had fused everything together into one huge solid mass of inevitability.
“If I lose another baby, I’ll ruin this relationship too.”
I told myself that was not a logical assumption, but somehow my emotions had dragged the reigns out from my hands and no one was driving. I tried to quell the past by focusing on the now, but it didn’t matter.
Every time we got any news about blood work or ultrasounds I became more and more numb. After a rocky start with low hCG levels and a slightly lower heart rate, we were doing great. Everything was as it should be, and Cap was smothering his excitement because my constant edginess and fear interchanged with stoic detachment was more than noticeable. I couldn’t get on board with the magnificent thing that was happening inside of me because I was already planning for the death of my unborn baby.
We slowly leaked the news. I told my mom. Cap told his brother. But instead of the contagious warmth we usually feel sharing news with family, it was under the guise of preparing a support network in case the worst happened.
In the week leading up to my 12-week ultrasound I kept reliving the moments I was told my babies had died. I ate, breathed, slept, those memories. When I least expected it images and sound bites would play like a painful reel in my head. It exhausted and haunted me, and everyone felt the strain.
Forget the surge of first trimester hormones I was feeling—I was jumpy, angry, defensive, emotional, and listless. I’d throw myself into work so I wouldn’t have to feel or process my thoughts and my pain. I was terrified of stopping because the moment I did, the past would bubble up again and rip my heart. I couldn’t write because when I did I’d end up shaking, locked in a superstitious double bind.
If I write about it I’ll have to feel and I don’t know what will happen… I don’t have time to fall apart… If I don’t write about it, things will get worse. But the last 2 times I told everyone and I lost the babies so what if not writing is actually keeping my baby safe?…
“Honey, it’s getting worse.”
It had taken me weeks to work up the courage to say those words. I couldn’t even look at Cap. I felt his hand softly take mine.
“I know.” he said.
I slowly raised my eyes to his and I knew too.
It was time to get help.