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.