Antidepressants and breastfeeding? « Back to Group Discussions

[scowgirl]

I have a question about mental health and breastfeeding. I have a history of depression and anxiety, and looking back I had been feeling pretty bad prior to this pregnancy for quite a while. I discontinued my antidepressant when we started TTC, and haven't gone back on it. I had my rough patches in the first trimester (though I really think this was mostly due to stress at work and worrying a lot about how my weight/health might be affecting the baby) but since then I have felt great, relatively speaking. I haven't felt this normal (even happy) in years. It has been fantastic, and to tell you the truth, I had been lulled into a bit of a false sense of security, thinking that this was the "new normal" and maybe I could actually be happy. I started taking it for granted and forgetting how it used to be before.

However... last night, out of nowhere, I had a bit of a panic attack and the feeling of being totally overwhelmed at the prospect of having a baby. I couldn't stop crying for hours and I just felt terrible. It really scared me because I think I had gotten used to being depressed before, rationalized it as being "my fault" or something I would be able to get rid of someday when I built up the willpower, etc. etc. But this just crashed down on me like a ton of bricks and it was very unwelcome to remember how I used to feel before I got pregnant. It was a little more clear to me, since it came on so suddenly, that there is probably some weird brain chemistry thing going on here beyond "I just have a bad attitude" or "if I were a stronger person, I would be happy." My crazy upset self was right about one thing, there is no way I can effectively care for a baby if I'm going to be feeling like that. I hate to think about it but if it's medication or PPD, I may have to go back on medication after I give birth. Not that any of them have been that effective in the past, but I feel like I am going to have to try something if I have more incidents like this.

So now I'm trying to figure out which options may be the least harmful to the nursing baby. I'm seeing Zoloft as an option but again, I have tried that before and it didn't seem to do much for me other than add 10-20 pounds. This is part of why I feel like my depression is all in my head or I'm just a wimp... I have never really found a medication that actually helps all that much.

I am worried about weight gain, as I'm already quite overweight, and loss of libido because I already have a problem with that. But obviously I'd rather have something that causes more side effects for me and less stress to the baby if I had to choose. Also, does anyone have any thoughts on hormones or other factors that might account for me feeling so great (I'm also sweating less than usual, have more energy, and my skin has cleared up) during pregnancy when lots of people have the opposite experience? If I could somehow balance my hormones and "fix" this, I'd rather do that than take antidepressants.

Thanks for any help you might have. Please feel free to PM me instead if you don't want to talk about your experience on the board.

Again thank you so much in advance. This really scared me into realizing I need a game plan. If I am OK after the birth, then great, but if not, then I need to start thinking about what to do.

[GoofyInOK]

Hugs...  I also have struggled off and on with depression and anxiety.  I have to say that just because you weren't able to find a medication that worked well for you doesn't mean your depression and anxiety isn't real...  Please try not to tell yourself that.  Your feelings are real, no matter what medication does, no matter what anyone says.  There's no certain way you "should" feel.  Please don't beat yourself up about these feelings, especially since that just feeds the negative thought cycle.  You are a very nice person, you are a good person, and (as I'm sure you know) these thoughts and feelings are symptoms of a bigger underlying physiological issue, not who you truly are as a person.  I always have to make myself remember that when I'm going through it, too.

Anyway, if you think that your imbalance may be related to your hormones, have you ever been screened for PCOS?  I have PCOS and when I become really insulin resistant, I gain SO much weight and I am extremely depressed. Like, can't leave the house depressed.  Once I was put on metformin and I began exercising, it was a night and day difference for me.  I can't say that this is what you might be going through for sure, but it's worth looking into.  If something else is going on, a good psychiatrist may be helpful.  Some people who ruminate in their thoughts find relief from Fluoxetine...  I don't know how safe it is for breastfeeding, though.  :(

[Sojourner]

Jennifer, in regards to breastfeeding, would this site be helpful to you? http://www.infantrisk.com/category/depression

also if you look at the top of that page there is a tab labeled "forums" you will see Thomas Hale's responses to literally hundreds of inquiries about certain medications and breastmilk. Anti-depression meds are included as well. http://www.infantrisk.com/forum/forumdisplay.php?9-Antidepressants

    -Cynthia
 

[scowgirl]

Thanks to both of you for the support and ideas. Thanks Cynthia--I will check out that site!

I guess I have just assumed that I don't have PCOS because no doctor has ever mentioned it to me, plus I was lucky enough to get pregnant pretty easily, and my A1C was low-normal when I had it checked in the first trimester. But maybe those are not good reasons to make that assumption. I have to admit I haven't educated myself about PCOS very much. It sounds like a huge challenge, GoofyInOK. I have to agree with you that I have always found exercise to be a big help. I felt so drained and just couldn't talk myself into going to the gym this morning, but I know it would have helped me.

[lbkw]

I have not tried this before, but many people feel like Placenta Encapsulation helps with the baby blues post partum. I believe we have an old thread about it. Maybe it's worth trying as you feel out the first few weeks?

[cheryllynn]

If possible,  I would have your progesterone levels checked.  Progesterone is a woman's feel-good hormone and is one reason women feel so good during pregnancy and also have troubles afterwards as progesterone levels decrease after baby is born. 

Another suggestion would be to add DHA essential fatty acid - this specific one is helpful for mood elevation and balance. 

I also have read a lot of stories about the placenta encapsulation helping women and would probably look at this first before meds. 

[DecemberSun]

Obviously everyone is different, but this is what worked for me.  I'd see a Naturopathic Physician to get everything dialed in, too.  :)

Omega 3's
http://www.vitaminshoppe.com/store/en/browse/sku_detail.jsp?id=CF-1825&sourceType=ps&source=google&adGroup=Gen_Prod_Country_Life_Omega_3_Mood_CF-1825&keyword=omega+3+mood&cm_mmc=paid%20search-_-google-_-Gen_Prod_Country_Life_Omega_3_Mood_CF-1825-_-omega+3+mood&mkwid=sBKsAW4BY&pcrid=12998407189
 

Good quality, food-based multivitamin

http://www.vitaminshoppe.com/store/en/browse/sku_detail.jsp?id=CN-1019

Vitamin B complex (a deficiency can cause depression)

http://www.vitaminshoppe.com/store/en/browse/sku_detail.jsp?id=VS-2723

Bach's Rescue Remedy

http://www.vitaminshoppe.com/store/en/browse/sku_detail.jsp?id=EL-1097

Calm's
http://www.vitaminshoppe.com/store/en/browse/sku_detail.jsp?id=SH-1017

Also, St. John's Wort tincture, but not while nursing

http://www.mountainroseherbs.com/extract/n-z.html

Get plenty of sunshine, exercise, good food, and water.  Listen to music.  Meditate and pray.  Spend time with friends.  Make time for good sex.  ;)  

I took SSRIs from age 17 to 24, including while I nursed my son.  I thought I needed it.  I finally found a wonderful combination of supplements that got me off the chemicals!  Don't beat yourself up, chemical imbalances do exist and are very real.  I would also suggest getting your hormones tested.  

And definitely consume your placenta!  It's actually a lot easier to prepare than you think.  :)

http://heal-thyself.ning.com/profiles/blogs/placental-encapsulation

[scowgirl]

Thanks to all of you! I had pretty much written off placenta encapsulation (I've heard it has a lot of benefits but I am skeptical about the why part of it) but maybe it's time to do some more research.

Some of the supplements being recommended also make me wonder if part of this is that I've just been more diligent about supplementing some of these substances (esp. Omega-3's) during pregnancy than I usually would be.

Thanks again for the comprehensive list, DecemberSun. This really gives me something to work with and think about.

[DecemberSun]

That site I linked to has awesome info on the Qi/energy of the placenta, which has a lot to do with it's healing properties.  Plus the nutritional/medicinal benefits.  I hadn't done it with either of my other births (I've never had ppd or milk supply issues- my hormones are also really "balanced" during pregnancy and nursing so I feel great... until I wean, then I crash...), but after I read the info I figured I'd like to try it.  It's about $300 locally to have someone prepare (encapsulate) it for me, but I definitely think I can do it myself.  Good luck!  

[ms.shell]

Good luck, mama.  I don't know about what antidepressants are safe during nursing, so I can't help with that.  But I thought I would let you know about my experience, in case it may help you to worry less.  I suffered from horrible, debilitating depression for years and years.  I did get SOME relief from meds, Luvox was the most helpful, but nothing ever knocked it out completely.  I am talking about not able to get out of bed, constant thoughts of suicide, major depression.  I stopped taking medicine when I was pregnant with my first 10 years ago, and I am happy to say I have never needed them since!  I have had a very few, mostly mild and short lived, bouts with low grade depression during these years, but ever since I became a mother I have never once had that old feeling of what's the point of living, kwim?  My children have brought me SO MUCH pure joy and definitely reasons for living and they are the best things that have ever happened to me, and I am so thankful that I don't get those horrible feelings anymore!  I hope you might have the same luck as I have with this!  Either way, good luck!

[scowgirl]

I definitely hope that happens to me too!! What a wonderful perspective. Thank you for sharing your story and I'm so glad your kids have brought you so much happiness!