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

August 3, 2011

Just the name of my most helpful prescription medication used to bring me comfort: Klonopin. Also known by the generic name clonazepam, it’s an anti-anxiety medication, and about an hour after I take it in the morning, I can feel it kick in. My heart rate slows, and my thoughts proceed at a more leisurely pace. While I used to take it three times a day, I take a much smaller dose, now, and only in the mornings, mainly because I wake up feeling more anxious than I feel at any other time of day. It was supposed to be a “bridge” drug. It was supposed to help me transition from no medication to the SNRI [Serotonin–norepinephrine reuptake inhibitor] that needed time to build up in my system before becoming effective. This plan, like so many made in a doctor’s office, was interrupted.

In early 2007, despair grew like mold inside me. I felt increasingly hopeless, useless and helpless as rejection letters from twelve different graduate programs conspired with letters from my father, full of accusations that I had aggravated his own deteriorating mental condition. I still don’t know why I thought it would be so simple, but I actually emailed my psychiatrist, whom I had met about twice at that point, and casually mentioned that I thought I might be suicidal and could he perhaps increase my dose of daily medication. After spending a few nights involuntarily committed to the Pyschiatric ER (the worst place I have ever been, without question), I voluntarily entered an inpatient program at Columbia-Presbyterian Hospital.

I worked harder during my two weeks in that hospital than I had ever worked at anything. I put my body and soul into therapy, group therapy, art therapy, journalling, knitting, playing their out-of-tune piano–I pushed everything else aside and tried with all my might to just be. Thanks to the support of everyone from deans to faculty members at Barnard College, where I was a senior, I was able to truly put my outside activities on hold. I also took higher doses of my medication. [Note: I have never and will never take medication *without* going to therapy. My doctor has said that he would not prescribe mediation for someone with my diagnoses unless weekly or, preferably, twice-weekly psychotherapy accompanied the pharmaceutical component.] By the time I got back to my dorm room, I felt like I had gone twelve rounds in a boxing match while my friends had been on spring break. But I did get into one graduate school–a good school. I was on track to graduate. I “had a future.” Most importantly, however, I understood that “getting better” meant continuing to believe that my accomplishments were simply things that I did, not the things that make up a meaningful life. I’m still working on that one, but I’ve come a very long way since those awful nights in the Emergency Room.

When I finally went off the Klonopin, the “bridge drug” that was always supposed to be temporary, I did it properly. With the advice of my doctor, I decreased my dose by a half-milligram at a time over many weeks. When it was finally out of my system, I stopped leaving my apartment for a days at a time. I took the breakup of a long-distance relationship so badly that I actually started self-cutting. (In this state of mind, it seemed like a small cut, on the arm, in my case, would be a welcome distraction from all the pain swirling around on the inside. Yes, it’s hard to imagine for someone who has never felt the urge. Yes, it’s really unhealthy. Yes, it’s a sign that one needs help immediately. Yes, I told my doctor.) As you might imagine, I went right back on the drug.

This summer, a new crisis finally erupted, after spending almost five years as a tiny spot on the horizon. Taking less Klonopin and less often was working out well, but now that I want to have a baby, I am trying to come off of it again. We only know about its effects on a fetus from experiments on rats, but the evidence is scary enough to land Klonopin deep in the NO! category of drugs for pregnant women. A new job and a move to a new apartment meant putting on hold the difficult process of “stepping down” Klonopin; essentially, it’s hard to tell if one is dealing well with anxiety when two of life’s biggest stressors hit at once. My anxiety told me that if I put it on hold, I would never “get off” and would never be able to have a child. “Never” is a word that comes up often when my anxiety takes over my mind.

How does all this land me with a diet of whole foods and natural supplements? Well, to start with, read this nice explanation from the Mayo Clinic, and you’ll understand why I make myself swallow a half teaspoon of lemon-flavored fish oil from the fancy brand Nordic Naturals twice a day. I’m making an effort to eat small meals every two and a half to three hours (except breakfast, which, as I mentioned before, is not a small meal anymore) and this has helped decrease my “baseline” level of anxiety. Jan, The Amazing Nutritionist, explained that this is helping even out my blood sugar over the course of the day, preventing the glycemic spikes and drops that cause the body to produce adrenaline. If you’ve ever felt anxious about anything, you can understand why an immediate decrease in my adrenaline levels would be an exciting prospect!

My goal is not to replace drugs with food. What I want is to be as healthy as I can be, because with a healthy body and mind and plenty of energy, I am simply better able to deal with difficult emotions. If my life is in balance, emotionally and physically, before I get pregnant, then that balance acts like the control group in a scientific experiment. By comparing my moods and thoughts during pregnancy/trying to get pregnant to my moods and thoughts beforehand, I should be better able to spot the irrational fears and manage them. I will feel anxious. I might feel depressed. I will probably want my drugs back. But I will be as well-prepared as anyone can be for this unknown and unpredictable experience.

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2 Comments leave one →
  1. August 5, 2011 12:29 am

    Wow, thank you for sharing. That’s very brave of you to be so open about all that. I wish the best for you with pregnancy and all, it’s definitely more complicated with mental illness, but surely possible! I believe you will work through all this and it sure sounds like you have a supportive network of people backing you up (docs, nutritionist, and of course family).

    • August 5, 2011 8:31 am

      You nailed it, Jess–that support network, as long as it includes a team of professionals on it, is the biggest thing I can do to set myself up for success. It ensures that there’s always someone to go to, no matter what happens. The hard stuff is easier to overcome, and they make sure I don’t forget to celebrate the good!

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