41 and Pregnant, Episode 3: Depression in Pregnancy

Previously on “41 and Pregnant“: Gigi anxiously awaited the results of genetic testing so she could have her gender reveal party. Up next, depression in pregnancy. 

Here I am, smack-dab in the middle of the 2nd trimester and nothing is going right. Well, the big stuff–the important stuff–is going just fine. The baby is healthy and growing, and so am I. I would feel really excited about that, except that I’m finding it difficult to feel anything at all.

Well, except nauseated. And tired. I’m really really good at feeling both of those things. Despite the fact that I am well past the first trimester and well past the alleged “deadline” for “morning” sickness, I am still throwing up nearly every day, multiple times. I’ve maxed out the anti-nausea drugs and am told there is nothing else anyone can do for me. A fun side effect of the drugs is that they make you tired. As if a geriatric pregnancy and relentless vomiting didn’t make me tired enough already. So, I’m like a cat, basically, either sleeping or barfing, and it’s pretty miserable. As a result, when people ask me if I’m excited about the baby, it’s very near impossible to fake the joy they expect to see.

Confession: I’m currently not excited about the baby. Not because of anything baby-related but because I’m not excited about anything. I am barely surviving.

What I’m really struggling with is knowing how much of this apathy is a function of feeling awful all the time, and how much of it is due to being taken off my anti-depressants. I’m fairly sure it’s a combination of both. I mean, sleeping 18 hours a day and throwing up 3+ times a day, and doing very little by way of household chores and meal prep leads me to feel guilty. I feel like I’m not pulling my weight as a mom. And so then I feel lazy and ashamed of myself. But I’m just so nauseated and sleepy–doing stuff is impossible. That said, I think those events and those feelings in a non-depressed person would cause at least a mild level of depression. 

In my case, I had worked with my doctor for about a year to get the right medication at the right dosage, and just before I got pregnant, I was feeling really good. Better than I had felt in years, in fact. At my first prenatal appointment, I wasn’t surprised that I was told to stop taking the anti-depressants. It was all the follow up (and lack thereof) that has surprised and disappointed me. At about 10 weeks pregnant I asked when I could resume the anti-depressants, and the nurse recoiled in horror. She caught herself and muttered something about meeting with a specialist to go over all the risks to the fetus so that I could decide for myself, but she didn’t refer me to that specialist or otherwise offer help. Listen…when you’re depressed, just making that phone call is overwhelming. I’m sitting there as the patient telling you that I need help. As a medical professional, you should help! 

It shouldn’t be scary or shameful to ask for help with mental health issues, but it still is, and the nurse’s clear horror at my depression didn’t help. I figured I’d survive the first trimester and then bring it up again. A few weeks later at another appointment, a new nurse read my medical history and asked, with the tone, how long into my first trimester did I stop the antidepressants. When I told her it was nearly immediate, she breathed an actual sigh of relief and said, “Ok, good, I’m glad we don’t need to have THAT conversation.” As a result, we had no conversation and I just shut up about whether I could resume them.

At my next appointment, I asked my doctor when or if I could resume them. The reply was that during the first trimester, “we want you to take nothing because the risks to the baby are too great.” I reminded her I was well into my second trimester, and she made a noncommittal sound but said nothing further. I let it drop. It’s too exhausting to advocate for yourself when you feel like you’re operating in a vacuum.

I’ve consulted the Oracle (aka Google) regarding depression in pregnancy and it seems that many women do take antidepressants while pregnant. Of course, there are many different drugs and some are safer than others. I’m not qualified to sort through that information, which is why I was trying to ask my caregivers. We see how that went.

So, here I am, powering through and managing my mental health as best I can. I sleep a lot, due both to depression and side effects of the anti-nausea meds. I am gentle with myself and what I can and cannot do. I have a great support system with friends and family, and I do talk openly with them about my feelings of frustration at being so listless and unproductive. 

What really gets me, though, is that none of the medical professionals have ever asked me how I’m doing. My health–especially my mental health–is apparently irrelevant. My personhood is diminished if not gone. My sole purpose is to incubate this baby. Of course, I want a healthy pregnancy and a healthy baby, but there is something about the way my feelings and needs are being ignored that is hurtful. 

We know that mental health is overlooked and underfunded in America. We know it has a stigma. I guess I’m just shocked that when medical professionals see a history of depression and anti-depressants on a medical chart, they never think to check in and ask how you’re doing. There has been no discussion of options or alternatives, and while I have tried to bring it up, I feel that I’ve been shut down. Yes, I could be more forceful and direct, and perhaps I will be in the future. But I can feel and hear the judgment in their voices, and it’s clear that if I wanted to resume my medication, I would not be supported and would likely be criticized.

Is the way it has to be? I am the patient, not the fetus. I should be treated as a whole person. Depression in pregnancy is not an uncommon thing! I firmly believe that a happy mama is the best mama–a happy mama will get the right exercise and nutrition, manage her stress, and all the other things the lead to a healthy baby. I’m disappointed that the medical industry focuses so little on something so simple.