antidepressants: please help me think about this!

[lapis]

Hello Ladies,

so I'm thinking about antidepressants.

I have spend most of my life struggling with depression and anxiety (i'm almost 28 years old now). some years are better than others and this is the first time I've ever even let myself consider antidepressants. I have however been pretty active in trying to get help and feel better by using therapy, Omega 3's (super high doses), GABA, B vits, diet changes (i'm still gluten free)...and tons of other natural supplements and lifestyle choices. but these things are not helping. I mean eating well always makes me feel better than when I don't and luckily its not hard for me to continue eating well. and therapy is always great for understanding the why of how things got so hard. I mean, I'm a high functioning depressive; my house is clean and organized, my hair washed, i dress just fine, healthy meals are made and the dog is walked. I make a lot of efforts to feel better and do a bit of the "fake it till you make it" technique... but i'm just. not. making. it. its a gorgeous day out today and i just don't care.

and granted these are my current circumstances:

I just moved overseas with my DH. our relationship is good. but he has to work a lot (at a job he loves). the new country we live in is GREAT but I don't speak the language (yet), We've been trying to get pregnant for 2 years, I've been dealing with vaginal pain for ten, and have also had to deal with digestive issues in the past (thanks to gluten) and although I've figured out A LOT, having to deal with so much health stuff for so long is just really grueling... its starting to feel better now that we are in a country with socialized medicine, but i'm far from figuring it all out. also I've worked as a nanny (and sometimes pp doula) for the past ten year but the combination of my own infertility making it feel like such sad work AND the fact that it can be extremely isolating work, just makes it not a great fit for now. and then i feel bad about myself for not having interesting work or ANY work or interests to share with people socially... and then i feel like isolating myself even more... bad cycle, i know. Its true that I may feel differently about the work stuff when/if we do have kids but for now not so much.

and there are more pieces to this puzzle, nothing crazy or wacky weird but just little pieces that make things just start to feel mountainous... like the feelings ABOUT the feelings... and my family and friends being so FAR away...

so i feel like i've exhausted all my natural options and that antidepressants are the thing to try next. I both feel relieved when i think of taking them and also scared. i mean i grew up with people who believed in therapy and healthy living. i mean my mom IS a therapist for goodness sakes! but i also have a family history of depression, so there is that too. does anyone know the science behind brain chemistry or genetics and depression?

and then there is the whole issue of being on antidepressants while pregnant and nursing. I mean i know tons of mamas do it and have healthy babies. I also know that I may be more depressed than i even admit to myself and certainly do NOT want to raise children with little ability to have fun and be pleased with the world around me. I know both my parents were pretty depressed (despite being in therapy and trying to feel better w/o using medication...) and that it was really hard for me.

so I just wanted to hear other women's thoughts on this. what has worked well for you and what hasn't? I know this isn't a cut and dry issue. I know a pill wont fix all my problems but i need something that will curb some of the hard feelings so that i can learn German and make friends and get integrated here. so that when we do have kids I'm not just a big blob who FINALLY got pregnant but was so worn by the trek through infertility that she just couldn't get happy despite getting to start the family she always wanted. and then, shit, i mean i need to be able to venture out and explore new ideas for work so that i CAN eventually be doing something I really enjoy. Right now my level of social anxiety is really high and my feelings of depression are quite enveloping. My sense of humor has been lost and I'm pretty edgy. This is not me!! I want to be able to enjoy the world, my life and the people I love.

ok, ladies, that was REALLY long so i appreciate you taking the time to help me think about this.

[lapis]

I also wanted to add that I'm specifically wondering about wellbutrin? or other tricyclics? also I know SSRI's are used a lot and tolerated well, but I've read that tricyclic antidepressant are also often used help with vulvodynia so finding something that can help in terms of depression, social anxiety (not panic attacks), vulvodynia and also can be taken while ttc, pregnant and nursing would be ideal.

I, of course, will be talking to my doctor about all of this as well... but it seems smart to have lots of information just for myself and piece of mind.

[lapis]

hmmm? should I move this to another forum?

[Theia]

I'm not sure if this will be helpful... but I didn't want you to feel bad cuz no one responded.

I am currently on 15mg Prozac. It's only been 4 months for me. I wouldn't describe myself as high functioning as you, even now, there are days I don't shower or clean my kitchen. I'm not sure how much of that is due to my circumstances as a single mom and being in my particular situation, or just part of my genetic make up - past depression issues before motherhood, as well as a mother who was depressed.

I was done BF DD when I started my antidepressant meds (I also take temazepam for insomnia). I'm not sure of the specific effects these things have upon developing babies, and what is passed through breast milk. I always assume that it is better medically to be natural. But personally, that doesn't always fly. If you are depressed, or feeling down, your baby, in utero or out, will feel it. If you are scared, angry, happy, or whatever, you baby will notice it. My personal belief and experience.

So my advice would be to take the antidepressants at the smallest dose effective to start with and see how it goes. I started fluoxetine (prozac) with 5mg a day for the first 2 weeks and then was 10mg/day for 3 months. I only now am up to 15mg/day to see how I do. The 10 wasn't quite cutting it for me. From what I've seen on the net, these are low doses. I chose prozac/fluoxetine because it is older, the side effects are more known, etc rather than the latest and greatest that big pharma is pushing. I realize you are in Europe, so I don't know how that effects your options, but I hope my experience will be helpful.

Is your main concern about the effects of an antidepressant upon a potential pregnancy? I would think that most prescribing psychiatrists are aware of what is considered "safe" and what isn't. And if you don't trust a doctors advice, seek out a second opinion. I hope others with specific knowledge will come along with suggestions on that.

I would much rather not need the pills, but really, they are helping me more than hurting me at this point. Being able to be close to normal is important to me, and if the natural attempts at controlling your mood haven't yielded results that you need/want, then pills are something to consider.

I hope this is at least a bit helpful to you.

[lapis]

Thanks Theia : )

[wemoon]

My therapists wise words: Pills and Skills

I do not take anything for depression, but do take something for anxiety. Boy, has my world changed.

[HappyMommy2]

Here is my opinion on pills - you can take it or leave it.

I think that pills might help a person "get over the hump" and get the energy/desire to do the things they need to do to feel better (like go to the gym or learn German).

There is no shame in it, even if you prefer a more natural lifestyle. It sounds like you have tried lots of things, and maybe want to try AD's. That is okay! They might work wonderfully for you.

[lapis]

that's exactly it: it's like I need help getting over the hump so I can do the things that WILL make me feel better. I really think that I have a good sense of what my "issues" are and why I am the way that I am but I've always managed to have enough support to ride out the really rough patches. this time i have none of my good resources and a bazillion times more "stuff" piled up on the general mountain of stressors... so, this experience is certainly very humbling to me. I never thought in a million years I'd find myself here : ( I think that I will come out on the other end feeling more compassionate and in a better place but still, I just thought things were going to go a lot more smoothly than this, I mean that my life was going to just bounce along and that "the job" and "the baby" and "the friends" would just continue to come easily... i'm trying to remember that I can learn a lot from all these things being thrown my way, but man, right now its totally kicking my B-u-t-t!

thanks for reminding me that there is no shame in trying medication...

[millefleur]

lapis-
You sound a lot like me. I too have struggled with depression and anxiety for years. Currently I take 20 mg of Lexapro. If I were you I would try an SSRI first (like Prozac), or an SNRI (like Cymbalta). Wellbutrin just made me more anxious. I don't know much about tricyclics (like Amitriptyline), unfortunately. You'd have to ask the health professionals about that one. There is no shame in taking medication if you need it. Keep us posted. Please feel free to PM me if you ever need to talk or have questions. Sounds like we have a lot of the same issues.
-millefleur

[oceane]

I think you really tried hard with natural alternatives first, that's awesome! could you find a therapist in Austria who speaks English? I have no personal experience with meds but I do read on here that there are safe options for pregnancy that you could always discuss with your therapist.

[tinynyota]

Hi. I really 'get' your pain, sadness and frustration. It sounds like you're doing so many good things, but it's not feeling like enough. Plus, you're trying to create a new life in a new place (in more ways than one!), which is totally exciting, but it's a huge deal and takes a lot of guts, persistence, and imagination. Things in very short supply when you're depressed.

I'm 36, and I've been on and off antidepressants for over 15 years. They can do a lot of good, but as you sort of said, they don't fix you. Nor do they change your essential YOU. There's no shame in them - at all. An antidepressant is just another tool to help in the ongoing struggle of figuring out how to be our best selves. That's how I think of it anyway.

As you can see from my sig, I'm also struggling with fertility, and I've spent a lot of time looking into antidepressants and pregnancy/breastfeeding, as well as miscarriage. I would feel comfortable with a few of the big-name SSRIs (Prozac, Zoloft, Lexapro). Unfortunately, Wellbutrin, an SNRI, which has worked decently for my own depression, needs a lot more study before I'd be OK taking it during pregnancy. Interestingly, my OB would be fine prescribing Wellbutrin, but my psychiatrist is very against it. There is so little known about it, and that makes me nervous.

Unfortunately for me, SSRIs on their own don't work well with my body. My natural tendency is toward sleepiness and lethargy, and those particular drugs dramatically heighten those symptoms in me. That is not the case for many people, just me. So, for the time being, I've chosen to not be on any antidepressant, and to be honest, it's frikkin' miserable right now.

I'm babbling. Sorry.

You have some good choices. If I were you, I would really consider starting on a low dose of Zoloft or Prozac. I think they would help lift some of the heaviness and sadness, and I'll bet you'll start feeling more excited about exploring your new home and all its possibilities. Starting on an SSRI is not nothing, but it's not irreversible if you don't like it, and it sounds like you could really use a little extra support right now.

[jillmamma]

I started seeing a psychiatrist with this pregnancy, and began taking a fairly low dosage of Prozac (started with 20 mg, then tried 30 mg, and am now taking 40 mg). She said that since it is one of the oldest, that it and Zoloft are usually recommended as being safest during pregnancy/nursing. So, I would recommend seeing a psychiatrist to find the right medicine and dosage if you decide to try an antidepressant. I am now feeling SO much better, can function, and am hoping to avoid (or at least reduce the severity of) PPD this time around (so far so good).

[lapis]

thanks again ladies,

Its REALLY helpful to hear all of this... your stories as well as info on specific drugs.

I did see my doctor and she said while we are doing this first round of basic fertility testing she'd prefer that I wait but that if I do need something, there are certainly options that are safe during pregnancy and breastfeeding... then she sent me off with a script of passionflower and lemon balm (i know, an Md prescribing herbs is pretty nice... I was totally surprised myself). I did have to resist being a know it all and telling her that "I used to study herbs and had taken that combo many times before and I want something else" ... instead I just said thanks, went and got the script and have been taking it for a week. My dh says my mood and snappiness has DRAMATICALY improved. I too feel a bit better, especially in terms of feeling so snappy towards dh, I mean I'm still feeling a lot of the anxiety, especially socially but its gotten me in distinctively different place, one that I think I can be in for the next few weeks while I wait on the test results.

I'm still getting to know my doctor but so far am feeling like she is great. I've seen a naturopath for the past ten years (different ones) and honestly have to say I prefer this doctors approach MUCH more than the ND's I've seen... super on the ball, not afraid of western medicine but not in a rush to give me pills. She knows about alternatives and always had a nice warm smile for me.

and if anyone has any more thoughts or experiences with prozac and zoloft that would be really helpful.

[lovbeingamommy]

I been on many different antidepressants throughout my life. My family has a genetic predisposition to depression and stress/anxiety. I was pregnant at 40and on generic zoloft with my ds. He's perfectly healthy and now 4 yo. I was pregnant two more times at 43 - had m/c's - on generic prozac but still having major stress/anxiety and panic. Now I've just turned 45 and pregnant again and on generic zoloft. I'm on a very low dose 12.5 mg, this is my choice since I want to be on the absolute lowest dose I can while pregnant. The two meds that I would feel the most comfortable with being pregnant and then bf would be prozac and zoloft. Many people, docs, nd's and moms here on MDC, have offered reassuring words that these would be the two meds of choice if absolutely needed.

[LisaJP]

Hang in there! I know this isn't a recent thread, but I also totally get where you're coming from!

My friend from college just wrote a book you would enjoy: Beyond Blue, Surviving Depression, Anxiety and Bad Genes. Therese Borchard is her name and she also writes a daily blog by the same name.

I am also seeing a naturopath and take a TON of vitamins/supplements, but I also have been taking Lexapro 10 mg for a year now along with GABA. Like you, I just don't feel right, and after reading Therese's book, I am now looking for another psych evaluation. I HATE admitting that I may have an 'issue' with mental health, but as several have said, who needs to know really? And a quote from Therese's book really hit the nail on the head for me, " coping your way through life is no way to live." Sigh. So, I 'think' I need new medicine. Oh well.

Just wanted to say thanks for your post and hope you're feeling better! Someone back here in the States can relate all too well!

[millefleur]

I also forgot to mention the following books:

"Pregnant on Prozac"

"The Panic Free Pregnancy"

"The Complete Guide to Everyday Risks in Pregnancy & Breastfeeding"

[lapis]

thanks so much everyone. I'm just having a down couple of days (although not as bad as when I wrote this) and wanted to come back to re read the previous posting.... and am glad to find a few more. I'm still not on antidepressants at the moment... and actually most days am feeling good enough to not even think about wanting them... but still nice to be reminded that if I do get really down again, meds are safe and an option and also that I'm not the only woman out there who gets down from time to time.

[heathergirl67]

Lapis- Your MD sounds great! I'm jealous!

I think you're putting waaaay too much shame and pressure on yourself. It sounds like your mental illness is like mine, genetic. It's something we're born with, we've done everything we can to be healthy, and if we need meds we need meds. So what? Nobody would blame someone born with diabetes for taking insulin. There are some things you just can't control.

I totally understand not wanting to put chemicals in your body. But here's the way I look at: These are the chemicals I'm supposed to have in the first place. My body couldn't give them to me, but it should have. I need outside help to get myself where I should be naturally. In that sense by taking meds I'm becoming more natural!

When I got on my meds I hated it. I tried a million and nothing worked and I felt like the only good it was doing was poisoning my body. So I stopped taking everything. I was miserable. I finally tried again with (yet another) new med, and it was like night and day. The first thing I thought: What was I waiting for?!?!?! I didn't feel drugged out, I didn't feel numb... the only side effect for me was some weight loss. I have to admit, I didn't mind having that side effect. I don't feel like it changed me. I feel like it let me be the TRUE me. The one that I was before my mental illness kicked in. It just gets me back to myself. I feel like the years that I spent in misery weren't me, they were my disease walking around in my body. I can't believe I wasted all of those years barely surviving and so unhappy when I could have been my natural, happy self.

I hope you find something natural that works perfectly for you! But if you don't, maybe give meds a try. They aren't the worst thing in the world. And if you change your mind, you just stop taking them! Let us know how things go!

[momo7]

I take 50mg of Zoloft a day. I do it because I know without it I can't function on a level where I can be a credit to myself or my family. I hate relying on medication to be normal. I hate that without it I am a horrible human being. I wish that I could pray my way through my bad spells, or level out the roller coaster ride my life becomes. The other thing is that what kind of mother or father am I setting my own children to be if they see my bad behavior and think it's ok to act the way I do. I am abusive, hateful, generally unkind. I scream and cry for no reason, on second I am super fine the next I am super sad. I slam doors, throw things and say things that the worst people say to their families. I do not want to live like that, so I take medication. Things are a 180 degree difference. I can cope. My children love me, and I love my children. They WANT to be around me because I am a completely different person. My family is the most important thing to me, instead of a burden I hate. As much as I hate medicating, I am eternally grateful that I can.

I have been pregnant and nursed 6 of my nine children while taking Zoloft. I have weaned myself from it twice in the last 13 years with no lasting side effects, though I did have them. I have never tried a different medication because it works very well for me and my doctor and midwife both tell me they don't see a reason to change. I have been told that I may very well be on it for the rest of my life, which as dissapointing as that that is, I know what I am without it so I don't really have a choice.

[lapis]

I'm definitely open to zoloft as it seems like the best for pregnancy and nursing and likely fits well with what's going on for me... i have to say though that we are realizing more and more that here in Austria they really stigmatize people on medication or who even seek any sort of mental health treatment. our doctor even giggled and blushed a little when we were asking her about someone (for dh) and said "I've NEVER seen a psychiatrist". so that is a little strange coming from north america where it is pretty normal to address mental challenges and such. I have a really great group of peer counselors that I use frequently but I'm still considering the meds... I do want to find someone who is not totally bizarre about psychiatry though and so far the guy that dh saw was pretty odd. anyhow, if any of you want to share more stories I really really get a lot of help from hearing them... I'm also really proud of all you women/moms out there who are taking good care of your mental health. i think its really important and feel lucky to also have support to do so!