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The Whole Truth: Planning a Pregnancy + Mood Disorder = Change, Part I

July 31, 2011

My heart rate is often abnormally high in the mornings. I know this because I tracked my pulse for awhile, determined to understand this feeling that I’ve just run a mile in my sleep. Sure enough, sometimes, when I wake up and sometimes when I’m lying in bed trying to sleep unsuccessfully, my pulse hovers around 100 bpm, which is at the very high end of healthy. Why does this matter? My pulse goes down soon enough. What’s the big deal? Well, this:

“According to the American Heart Association, mornings are really the best time for women to measure their resting pulse rate.” via Normal Resting Pulse Rate For Women | LIVESTRONG.COM.

Yeah, okay, but… not for me. For me, it’s upside-down, Wonderland-style. I knew the answer to this riddle before I even asked the question: my brain. I live with what psychiatrists classify as three different “disorders”–Generalized Anxiety Disorder, Panic Disorder and Major Depressive Disorder. I use the example of my “resting” heart-rate to illustrate how my anxiety is different from that of your garden-variety worrier. I regularly feel panic in my sleep, in the absence of any specific circumstances that might explain anxiety-ridden dreams or nightmares.

When my psychiatrist told me about my diagnoses in late 2006, he put it something like this: “These words don’t seal your fate or define you. We use these terms so that we can establish categories useful for everything from research to insurance claims.” To which I replied, “Those are actual medical terms? Because I could have told you that, in general, I feel more anxious about everything than other people. I hyper-ventilate about things like doing my laundry and panic about going to the grocery store and the ATM. And after awhile, it all makes me really exhausted and really miserable.” He told me that this was a pretty accurate summary.

At this point in time, all three of my diagnoses are considered Highly Hereditary (I don’t have a source for you, but my doctor does have an MD and a PhD, and he graduated from both Harvard and Columbia). I also learned that because of the large hereditary component, I had probably been experiencing symptoms all my life. Suddenly, the tantrums I threw when I did not want to go to school (I was not being a brat, I tried to explain, I really was inexplicably terrified of going to school), the insomnia that plagued me throughout elementary and middle school, the childhood stomach aches that came and went seemingly without reason–it all makes sense now.

Not everyone in my family wakes up feeling like she’s run a mile. More of us do feel this way, though, than people in families with no history of anxiety or depression. That seems to be how it works, but doctors don’t know why. Again, I cite my doctor with fancy degrees in neurology and psychiatry–all we can tell from looking at brain scans is where we see the highest blood flow. We can learn a lot from that, but despite what you read in the newspapers, we can only guess at why I feel crippling anxiety while my sister just doesn’t. But I do not see this as an inheritance split unequally or unfairly. Obviously, I love my sister and wouldn’t wish any of this on her. But she was also eleven-years-old when I was born. It’s hardly surprising that we turned out a little differently. And, for purely selfish reasons, I love having a sane and usually calm sister. She helped raise me. She came out of our crazy, chaotic family with an uncanny ability to stay calm in a crisis. Scientists are a long way off from isolating the precise factors that produced these differences, but it is proof that genetics are not fate. At the moment, I really need that assurance.

At my baby shower: Mom, Dad, Sister & Me as a fetus made up my immediate family of four. Now that I'm married, my sister is married with children and my parents are re-married to other people, it's much more complicated. But when we're talking heredity, this is where it starts.

The whole truth behind my new whole foods diet and supplement regimen is this: in order to become a parent, I need a non-pharmaceutical alternative to the treatment that has been working so well. Just to be clear: these pills helped SAVE MY LIFE. But one drug in particular is simply not safe for a fetus. In my next post, I’ll write more about that drug, why I take it and why it’s been so difficult to stop taking it. I’ll also explain how Jan, The Amazing Nutritionist, gave me new hope and energy when she explained some science behind how diet and nutrition can help me.

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2 Comments leave one →
  1. Calley permalink
    August 1, 2011 11:48 am

    Congratulations on planning to have a baby! I have depression and aniexty myself. I was ok with when I was pregnant with the oldest two without meds. When Ava came along I was very depressed the doctor suggested I start taking meds again (Prozac) I refused after reading what it can do to a fetus. I was able to deal with the depression on my own though it was very hard. I did not breast feed so I could start taking the meds after she was born. Post partem depression on top of my normal depression would not have been well.
    I hope the nutritionist can help you find healthy alternatives to taking meds. I do not know if you work out but that can also help depression when you get the endorphins going and would be good for any future baby.
    People really do not understand depression or anxiety unless they have it or have lived with someone who has it. So I know how hard that can be. Do you think you can handle life without the meds? Sometimes coming off the meds is harder then it was before you started taking them . Not sure if this is helpful at all but I am here if you need to chat.

    • August 1, 2011 12:19 pm

      Thank you so much for sharing this, Calley! To be honest, I’m glad your doctor even talked to you about it and wrote a prescription (or offered to). Have you read “Pregnant on Prozac”? It’s the only book I’ve found that actually discusses all the nuanced choices that go into a pregnancy when a woman has a mood disorder.
      To answer your question: I don’t know how life without meds will be. But I am lucky in that managing anxiety is easier, and if I manage the anxiety, then I don’t experience the depression. So going to therapy twice a week and this nutrition stuff and a lot of work at home on various cognitive techniques could lead to many years or the rest of my life without meds. Or, I could manage to stay off of them during pregnancy and go back on them after a couple weeks of breastfeeding. Or I could take the risk and take something while I’m pregnant. I was just reading, in fact, that the fetus of a woman with untreated depression physically responds to her moods in a more sensitive way that the fetus of a woman without depression or who is being successfully treated with therapy. The heart rate of the fetus actually goes up with the mother’s in the first case, but not in the other two groups. We’re not sure what that means, yet, but weighing the risks or all the choices is so much more complicated than people realize.

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