Mummy’s Marvellous Medicine – a journey with psychiatric medication

From: https://motherhoodwithaddedextras.wordpress.com/

Let’s talk about meds and maternal mental health. I write this on the precipice of being free from one of the meds that held me together during the worst time of my life. 

I don’t know whether to start at the beginning with my medication journey or go backwards from what I’m on now… for the sake of my sanity let’s be chronological and go way way back to the dark days of my youth. Looking back, though they weren’t that dark compared to what awaited me in new motherhood.

Pre-Motherhood Meds

I took my first antidepressant as a university student. I remember going to the doctor and actually asking for them. I’d heard in particular that Seroxat was meant to be good for social anxiety. So, after a l-o-n-g discussion with my doctor I came away with that golden prescription for a mind altering pill. Did I need them? Oh that’s the million dollar question isn’t it? Who knows? Maybe I would have been okay without them. Maybe they made all the difference. Who knows because we don’t have a time machine to go back and do things differently.

At the time I was very shy and quite probably a bit depressed about the shyness. The pills certainly didn’t send me heading into extrovert territory. But, maybe they made some of that socialising just a tiny bit easier. 

Then, I forget the reason, I stopped taking them. And I stopped quite abruptly. Big mistake. Big. I learnt my first lesson about psychiatric drugs – I cannot, cannot, cannot come off them suddenly. I don’t remember all the feelings I had at the time, what I do remember was that all my university housemates literally stopped talking to me. One of them totally blanked me at the bus stop one day. It went on for days, weeks; I was persona non grata. Looking back I probably was horrible to live with. But inside I was just a great big ball of hurting. I was almost dying inside and to have my so-called-friends turn their backs on me was something that still hurts me to this day. I shed a lot of tears. I curled up into a comparatively severe depression. My father was dying of cancer at the time as well which didn’t help. 

I didn’t get the support I needed and even now I’m super wary of reducing medication. I always do it at a snail’s pace. 

All through my 20s and into my early 30s I was on and off a succession of different antidepressants. Looking back – oh isn’t hindsight great – I wasn’t all that bad. But there were times that I probably did need that extra help. 

Psychiatric medicine is such a minefield. When you’re on it you want to be off it and when you’re off it you can’t see that you might just need to be on it. Or that was the pattern for me.

Over the years I’ve dabbled in Seroxat, Effexor, Citalopram (or it may have been Cipralex) and Fluoxetine.

Meds and Motherhood

So once I hit 35 and with a husband by my side I decided to come off my current antidepressant of choice – Fluoxetine – in order to try for a baby. 

I’d weighed up the cost and benefits of staying on an antidepressant when pregnant and I didn’t want to take the risk. This of course isn’t always an easy choice to make. Every woman is different and has different needs. I think I probably did do the right thing in coming off them to have a baby. I was happy and stable at that point and felt able to cope. I reduced gradually and don’t remember too bad a withdrawal.

In the early months of pregnancy I was doing okay with my mood. Then things gradually got worse and I’m fairly sure I suffered prenatal anxiety and depression. As my bump got bigger so too did the worries. My midwife referred me to a therapist and I had plenty of tricky conversations about whether to start up the antidepressants again. It wasn’t easy. Even though I hadn’t really bonded with my unborn due to the anxiety I knew I needed to protect him from all the scary sounding side effects of medication during pregnancy. 

In the end though, heavily pregnant, it was viewed that my baby’s brain was sufficiently developed that the effect on him was likely to be minimal. Certainly not a clear cut decision, but in the end I came round to the idea that to help him we needed to help me. 

And so Iwas prescribed Sertraline. This drug is apparently deemed ‘safer’ in pregnancy than other antidepressants. It didn’t agree with me at all. I think I only ever took one tablet. It made me feel more nauseous than the morning sickness. A meds failure left me on my own again.

Then just weeks before my due date I started back on Fluoxetine. I guess my mood must have been sufficiently bad to take the risks to my baby. This is a hazy time in my memory.

Due date came and went and, well, I’ve recounted bits of my birth story before in other posts herehere and here.

Needless to say it was all a bit crap. Baby was fine. But I’d been cut open in an emergency c-section. Who knows what drugs I was on at that time? 

Then 2 days later the psychotic episode happened and I suppose I was immediately put on olanzapine, an antipsychotic. I guess I was lucky (ha!) that the episode happened whilst I was still in hospital and I was able to be ‘treated’ straight away.

Then off to the mother and baby unit we headed. Yes they are an amazing resource. No, I didn’t want to be there. At all. 

At some point I was also put on pregabalin (anti anxiety) and lorazepan (also anti anxiety). I think I was also on Fluoxetine. Are you keeping up?! I wasn’t. That’s a total of 4 different drugs.

Then a few weeks later I had another ‘episode’ of questionable diagnosis. I think mania was mentioned and I got a nice label of bi-polar disorder. My husband, who witnessed this and my earlier episode, is convinced it was a panic attack. I wasn’t really in my right mind so who knows. It wasn’t fun, that’s for sure.

But, I guess mania meant a mood stabiliser – so Lithium was added to my list. I also had my antidepressants swapped around as my psychiatrist believed that Fluoxetine was more likely to trigger mania. I don’t remember which one I was switched to – I wasn’t exactly living my best life – so it could have been anything.

What I do remember is the nurses on the MBU coming round the ward with those tiny paper cups containing the meds and a glass of water to wash them down. They sat and watched to make sure the medication was taken. All part of the psychiatric ward cliches that confirmed I was living in a madhouse. There is no nice way of being in a psychiatric hospital. Yes I can see that they are incredible places, staffed by incredible humans, but it all led to the trauma. It led to the story I tell myself of being an inmate in an asylum.

More trauma of course came with the regular blood tests that are required when you’re on Lithium. Something about salt levels. I don’t know the details. But it involved nurses and needles. The blood tests were horrible. I’m not a needle phobic but having a constant bruise on my forearm was a physical reminder of my mental illness. 

I learnt fairly early on not to read up on all the medication that I was on. I’m not a very disciplined person but I’ve been pretty consistent on this one. If I went down a rabbit hole of google searching then my inner hypochondriac would convince me that I had every one of the side effects. I am highly suggestable.

I wasn’t really getting better and the doctors muttered about ‘drug resistant depression’. I guess it was around this time – little man was 3 months old – that I was given a course of ECT. I’ve written more about that here. If you want the short version: horrible. 

I’m not sure if it was before or after the ECT but my psychiatrist decided to switch me back to Fluoxetine – the other antidepressant clearly wasn’t doing it for me. Fluoxetine had been my favourite antidepressant up until then – but it proved yet another should I/shouldn’t I medication battle.

On leaving the MBU 5 months postpartum I was on 5 different drugs. A year after my son was born I was still far from ‘well’. But it was decided that I should come off the olanzapine. I was making steady (although very slow) process and I guess it was thought that I was out of the psychotic woods so to speak. 

I was reluctant to come off it – I needed quite some persuasion. The dilemma with reducing any of the medication I’ve been on since giving birth was: how do I know that this drug isn’t what is making me feel better? What if it all happens again if I come off it?

I came off olanzapine slowly, as agreed with medical professionals, but even so I’m fairly sure I had withdrawal effects. I found myself incredibly paranoid – distrusting even of my husband – the most solid constant during all this mess. I remember a lot of feeling that all those around me were discussing my ill health – making decisions and choices for me. I didn’t like that sense of vulnerability. I snapped at him for suggesting he was my ‘carer’. It wasn’t a great time. 

I also had a phobia over even the word ‘relapse’. Somehow just thinking about that possibility threw up huge levels of anxiety. And of course the anxiety made me feel slightly crazy (as it does) and of course that made me wonder if I was having a relapse (still hate that word).

Oh one of the added bonuses of being on all these drugs is that I put on a LOT of weight. I went up 2-3 dress sizes because I just wanted to eat cake and carbs – all the time. It’s a side effect of 3 of the different meds I was taking so I totally ballooned. My body became unrecognisable to me along with my mind. 

Neither mind nor body were very happy places to be. Weight gain isn’t of course a reason to not take the drugs, but it has possibly been the toughest side effect for me. 

I don’t think any body bounces back after a baby but this body is still a very different vessel to the one that became pregnant over 5 years ago. Hitting the middle age of 40 doesn’t help matters but I digress – I could, and might, write a whole blog about this post-natal body.

After the olanzapine withdrawal it was a long time before I felt comfortable to reduce anything else. 

I think at this time I would occasionally use an additional medicine, promethazine (I forget what it was referred to by the medics) but I was given a few pills that I could take in the instance of a really bad anxiety day. It was some sort of sedative that normally sent me to sleep pretty quickly. There were a handful of days when I felt I couldn’t cope and reached for this.

Then it was time to come off the lorazepam – that was fun! Because of it’s highly addictive nature with an apparently awful withdrawal I needed to start taking diazepam which is less addictive in order to stop the lorazepam! Starting one drug in order to stop another was yet another hurdle in my recovery. So I switched meds, I think I was okay-ish with a few bad days. Then once my body had the first one out of the system I could slowly, ever so slowly, come off the diazepam. 

Right so I was off 2 powerful drugs and still on 3 of them. Somewhere along the line I’d also slightly reduced the pregabalin – taking it just twice a day instead of 3 times. 

Reducing some of the more sedating drugs perked me up a little. It also meant I wasn’t always guaranteed to drop straight off to sleep and sleep right through. Sleep was a saviour and drugs that helped me sleep helped my recovery.

Side note: taking all these sedatives meant I usually didn’t even hear the little guy when he cried. My husband was doing all the night feeds and other wake ups for the majority of the first 2 years. Little one was fortunately a good sleeper, but even so I found myself quite emotional during the 2.5 year sleep regression as I was finally able to sit with my tiny boy as he fell back to sleep. It was one of the mummy milestones I’d missed out on and I wanted to be the strong, reassuring adult presence he needed during his nightmares. I finally felt as though I had some idea of what it was like to be up at 3am with a crying newborn. Something I’d never done before. 

Along the way I tried synthetic hormones with a private doctor – I had PMT for half the month it seemed. I think these helped for a while. And I take any vitamin that promises to help anxiety: magnesium, vitamin B Complex, omega 3 and Vitamin D.

So at some point I was handed over from perinatal to general psychiatric and then back to my GP. I didn’t feel ready of course at any point in this process. 

This was when they wanted me to stop the lithium. That was last year. Then the pandemic struck so I didn’t feel that was the right time to stop. But this spring I finally began the journey to stop the lithium. I tailed off ever so slowly and I think now as I dropped from several tablets to half a tablet every other day I may have just taken my last one. And it feels good.

I think the lithium kept me in a fug. A brain fog. Now everything seems clearer. I’m more present. I’m more awake. I’m more capable.

I don’t see myself stopping the fluoxetine or pregabalin for now. I’m happy to stay on these meds that help me day to day. But I have to say that I’m happy to no longer be a slave to Lithium.

After all that, what do I think about psychiatric meds? I’m not sure whether I’m firmly in a for or against camp. They have certainly helped me along the way. And I’m sure they aided my recovery, no doubt. But was I on the right ones? Was I on too many? Was I on them for too long? Quite possibly. More research needs to be done into medication, for sure. They are not a catch-all type of treatment – one drug works wonders for one person and is too much for another. It still feels as though doctors are dishing them out in trial and error mode. ‘Lets try this. Or we could try that’. Wouldn’t it be wonderful if there was a way to just know which would work?

And what about medication shame? If I broke a bone would anyone criticise me for taking a painkiller? Well what about when that pain is deep within your head? There shouldn’t’ be any shame in taking medication to make our brains feel better.

And as for being a mummy on meds – I tell my boy they are my vitamins. He knows not to touch – he’s yet to ask how they make mummy feel better. And maybe along the way they have helped me get well, even if they, along with my illness, have prevented me always being the most present mummy. I’m just trying to be the best mummy I can for my little one.

This might indeed be my longest post yet. I’ve you’ve made it all the way here you need a medal! But do let me know your thoughts on mothers and medication. What helped you? What would you do differently? I’d love to hear your stories.

15 Nov, 2021

S.E London

https://motherhoodwithaddedextras.wordpress.com/

Author: Workers' Archive

Covering sensitivity at work and beyond on my website: https://samuelaliblog.wordpress.com/

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