What Happens When You Have Anxiety — & Then You Get Pregnant?

Illustrated by Tristan Offit.
For two weeks, I woke up each morning in a state of severe panic. Heart palpitations, shortness of breath, dizziness, and racing, overwhelming thoughts. The world was pressing in on me as I lay in bed, in the morning light, unable to move.

I was newly pregnant, and newly unmedicated for my anxiety, having recently weaned in preparation for conceiving (which I had assumed, given my age and anxiety, would take longer than it did). Shit. I was in it, and there was no turning back. Is this what I really wanted? I wasn’t sure anymore. I had spent a long time deliberating whether or not I even wanted a child, and if it was fair that they could potentially be predisposed to mental illness because of me. Too late. Suck it up and get the hell out of bed.

That was me, a little over two years ago. For the past few years, I’ve been working on a film, Moms & Meds: Navigating Pregnancy and Psychiatric Medication, about my and other women’s experiences with mental illness, medication, and pregnancy. A quarter of American women are medicated for a mental illness, and nearly 8% of women take antidepressants during pregnancy. That’s still a controversial move, because while evidence collected in the past 30 years suggests that some medications can be used safely during pregnancy, the data is still new, and medication was traditionally discontinued, full stop, during pregnancy. So the decision for moms-to-be who are used to taking meds is complicated, no matter what they ultimately choose to do.

During the process of making this film (and throughout my own pregnancy and motherhood thus far), I’ve learned a lot. This includes the shortcomings of our healthcare industry, the importance of peer and other support systems, the pros and cons of staying on versus going off psychotropic medication before, during, and after pregnancy, and how strong and pervasive mental health stigma is in this country.

But the greatest thing I’ve learned, that I’d like to stress for all women is this: It’s okay to not be okay. It’s okay to be confused. It’s okay to not have a clear path or a clear sense of what you want. It’s okay to feel elated one minute and depressed the next. To love your baby with every cell of your body, and to then want her out of your sight immediately. There is no single, correct way to deal with these issues and be a mom. You simply do the best you can, and try to surround yourself with as much personal and professional support as possible, so that you can make informed decisions for yourself and your family. I realize that not every woman is in a position to do this, for a variety of socioeconomic, health, emotional, or other reasons.

So how did I get here from there? Through various forms of self care: vigilantly keeping appointments with my therapist, psychiatrist and high-risk Ob, talking honestly with my husband, family and friends about how I was feeling, daily journaling to get some of the anxious thoughts down on paper (and out of my head), and exercising like a madwoman, which was probably the single, biggest help, and continues to be.
Illustrated by Tristan Offit.
And the truth is, this story is far from over. Prenatal and postnatal depression often go hand in hand, and I still, more than two years after the birth of my child, struggle on and off with postpartum depression and anxiety. That’s mainly in the form of exaggerated projections of horrible, violent things happening to my daughter, and me not being able to protect her. My earliest violent thought was, in fact, the day after she was born. I nursed her in the hospital room and stared at the wall and all of a sudden had a jarring thought and fleeting image of what would happen to her if she were thrown against the wall, which I quickly pushed out of my mind. Although I was disturbed, I was also rational enough to know that it was just a thought, and that it was relatively normal to be thinking and feeling something like that so soon after delivery.

Two years later, these thoughts still occur at the end of particularly long, exhausting days. I deal with it with the same self-awareness that I’m grateful to have developed over the years in my general struggle with anxiety, outside of motherhood. I can acknowledge that the thoughts are just that — thoughts, triggered by my anxiety. I know that they are not real, and I know that they will pass and that I will not act on them. (Again, I realize this isn’t a realistic solution for every woman, and that is why medication is definitely a viable option before, during, and after pregnancy.)

Although I’ve been doing a lot of work to dispel the shame and stigma associated with mental illness and the use of medication during pregnancy, for now, I’ve chosen to stay off medication, as a challenge to myself, and as a way to not allow anxiety to take precedence in my life. It is sometimes a struggle to find alternative solutions, or to keep going on days when I want to give up and pop a Klonopin. My anxiety, at times in the past, has been debilitating, and if that were to occur again at some point in the future, then I know I’d need to get back on my medication. But for now, as long as I can keep my head above water, I’ll keep trying without, and also continue to support women who make either decision. Mine is just one path, but there are many others.

I remember thinking that having a baby was hard, and it is. Nursing, pumping, eating, sleeping, round the clock vigilance and caretaking. It was utterly exhausting. And that hasn’t ended, even now, with a toddler. In fact, sometimes I feel worse, two years in. So, keep watching moms. Don’t forget about them and assume they’re “over it” because their children aren’t babies anymore. Support legislation like the Bringing Postpartum Depression Out of the Shadows Act of 2015 [H.R. 3235] so there can be a clear, standardized set of procedures for providing information and assistance to women in need.

And remember, it’s okay to not be okay. If you’re struggling, please reach out to a family member, friend or doctor for support. You’re not alone. The path isn’t clear or easy, but there is help out there.

Moms & Meds: Navigating Pregnancy and Psychiatric Medication is currently available to rent or purchase on VHX, and for educational use via Janson Media and Alexander Street Press.

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