Tuesday, January 17, 2012

Closer to Fine: My Life on Prozac

I'm the first to admit that I'm not a happy-go-lucky kind of person.  Never have been, never will be.  I have a tendency toward melancholy and worry that probably starting showing in infancy.  What was diagnosed as colic or reflux was probably just my inner grump beginning to show. 

I took Prozac and similar medications, other selective serotonin reuptake inhibitors (SSRIs), all through my 20's.  My dose was probably too low to be optimal in retrospect but I managed ok.  Whenever I'd try to taper off, sadness would return and I'd go right back on the pills.  Before we started trying to get pregnant, though, I was determined to taper off for good.  I didn't want to expose my baby to meds and that was that.

I stayed off of SSRIs for two full years while we struggled to get pregnant and suffered our first miscarriage (or, more accurately, suffered a miscarriage early in the process and then had trouble getting pregnant afterward).  The months after my first miscarriage were bleak.  Much to my surprise, I could function at work, showing up on time and even producing, while I was severely depressed.  All of my relationships suffered along with me, including my marriage.  Instead of having a partner, my husband had a shell of a person sitting next to him at dinner every night.   My misery and isolation were overwhelming.

The depression let up a little after several months but still lurked.  It came out in full force when I'd walk past pregnant women and racks of onesies at Target.  I thought that because I was functional—I could work and socialize and even fix my hair most days—I was having a normal response to infertility and loss.

Depression wasn't my only ghost.  I frequently had panic attacks but didn't know what they were.  Wouldn't any baby-crazed woman burst into tears when she realized hot baths were going to annihilate her husband's sperm?  Although I didn't recognize the panic attacks, I knew I felt hyped up and generally miserable all the time. 

I became a self-help junkie.  Listening to guided meditations calmed me down a little, so I meditated two or three times a day.  I practiced yoga and journaled.  I went to individual and group therapy.  I spent time with friends.  It all helped...a little.  I still felt oppressed by sadness and worry.

My husband and I started discussing my going back on medication.   He admitted he wasn't entirely sure I was depressed enough to take a medication, whatever "enough" means.   I wasn't entirely sure, either.  I wasn't down all the time.  I was able to enjoy things sometimes and smile and laugh.   But I felt like something had to change.  The happiness I fought to feel and project wasn't fooling anyone.  I felt like I was constantly fighting depression not to pull me under.  Acting normal, you know, like not bursting into tears when a pregnant woman walked by, was so hard.  I was so tired of the act.

Before I went on meds again, we agonized about the safety of taking SSRIs for a gestating or nursing baby.   After a long Q&A session with a pregnancy-specialized psychiatrist, we decided to go for it. 

The timing was perfect.  I started taking Prozac again last spring and had miscarriage #2 in the fall.  Grieving that loss was a completely different experience from the first one.  My heart still broke into a million pieces, but the backdrop of anxiety and depression was gone.  It's been four months since the miscarriage and I can honestly say I feel ok.   Not on top of the world, "I'm gonna have a baby in 8 months!," but pretty good.   No more 3 a.m. panic attacks.   No crying at the drop of a hat.   In other words, very, very different from how I felt after my last miscarriage.

The difference can't all be attributed to Prozac.  I've changed and adapted over time, too, thanks to tons of therapy and support from friends.  I think Prozac is making a significant contribution, though.

In an ideal world, we wouldn't take any medications at all, especially when we're pregnant.  However, living med-free isn't for me, at least for the time being and probably for the rest of my life.  Off meds, I constantly struggle to stay afloat.  On them, I can begin to believe that someday, this will all work out, and the present isn't such a horrible place, either.


  1. I'm glad that you've found a regiment that works for you. Too often, women give in to the "what you should be doing" ideal at the expense of their own mental health. If I've learned one thing throughout this process, being miserable all the time doesn't help, but what works for each person is different. Thank you for writing candidly about your experience.

  2. I had to make the same decision after much conferencing with my PCP, psychiatrist, RE, and a specialist. There is a lot of evidence that fetuses are more at risk being exposed to depressed mothers (on a chemical level) than to the meds. Good for you for taking care of yourself.
    You have to put on your own mask before helping others...

  3. Sometimes we need the help of SSRI's. I've been on zoloft before due to the depression associated with the fibromyalgia. It helped for a little while. I'm not on them now but I sure could have used them with the last two miscarriages.

    Hope life starts treating you a bit better soon.

  4. Love the Indigo Girls reference. :)

    And I love what Her Royal Fabulousness says about taking care of yourself first. How can we parent when we are only shells of ourselves? Not to mention that there's the additional risk of pospartum depression ...

    I have started to think that maybe I am depressed, and that I've always had that tendency, too. It's scary to admit, because of the implications it could have for my life, but I know that I want to be there for my kids in as full a way as I can.

    Great post.

    Thanks for stopping by for CDLC, too!

    1. Hi jhl--I hope you get to feeling better soon. Yeah, it's scary to confront the fact that you may be depressed. There's some part of me that feels like I'm giving into it when I admit I'm having a problem with it. Take care!

    2. Hi Detour, I know I'm late to the party on this one...but I was catching up with all of your blog entries, and I caught this post. I feel as if you are describing me to a "tee". I have never been on SSRIs, but my husband and I have weighed the pros and cons of me going on one. At first, I was angry at him for even thinking I may need to go on one, but the hard truth is that I have been battling depression for my entire life--even as a young girl I was anxious, solitary and found it difficult to relax. Masking it is draining. Feeling like I'm unable to experience a relaxed joy or happiness over things has made me tough to live with...I've been a self help junkie, too, but I just don't know if I can fight the fight without medication. Thanks for this makes me feel less alone.

  5. I've never really considered meds for depression. I feel like they could come in handy sometimes when I have a hard week, but feel like I have to find a way to deal with our loss without. Maybe it would be something to look into but I'm worried that it could be a dependancy.
    If this is what helps you and keeps you looking forward, then don't feel bad about it. Do what's best for you.

  6. I'm glad you're doing what's best for you. It's hard enough going through this process, made that much harder when you're already dealing with depression/anxiety.

  7. I never had to take anything to keep me happy until now, I can relate to the sadness, hang in there, I'm still here and I'm doing anything I can to keep busy...we do what we can do...sometimes we need help...hang in there lady!

  8. My heart goes out to you, friend. I know that pain - miscarriage followed by infertility - all too well. I've never suffered from clinical depression, but I have felt very, very sad and helpless. I can only imagine how difficult these last few months have been for you. There's no shame in depression or in needing to take medication. I'm so glad that you're taking care of you and that you're figuring out what your body needs.