It's no secret among my family, friends and colleagues (not to mention the internet, through my former blog here at Today's Parent) that I've been on antidepressants for more than five years, starting in my third trimester with my second daughter, Peyton. So I wasn’t surprised when Today’s Parent asked if I'd share my experience—most of which I've tried to forget—after hearing the news of a study released this week out of the University of Montreal which reports a greater risk of autism in babies exposed to antidepressants in utero.
In the spring of 2010 I was suffering terribly from depression and severe anxiety, triggered by the postpartum depression I experienced after the birth of my 19-month-old Addyson. I was working at Today's Parent at the time and had intimate knowledge of the signs of prenatal depression (hey, as an editor at a parenting magazine, it was my job to know). I was four months pregnant with my daughter Peyton and utterly miserable — it was almost painful to work, concentrate and focus, I was often upset for no reason, and would break down in tears in random bathroom stalls at work and in public. I got irritated easily and I lived in a constant state of fear of pretty much anything I could dream up. That sweet euphoria I'd experienced during my first pregnancy was long gone; things that would normally excite me or give me pleasure (peanut butter cups, The Office, girls’ nights out) just didn't do it for me anymore. I'd lost interest in everything and everyone, and spent my time moping around– I was basically Eeyore from Winnie the Pooh.
My imagination had gone berserk and I was constantly convinced that something catastrophic would happen to Addyson and my husband, Peter. At my worst, I was afraid of common things like commuting to work (what if I'm pushed off the subway platform in front of an oncoming train, or what if there's a terrorist attack?), and if I didn't get a call from Peter at his desk by 9:30 every morning, I figured he'd died in a horrible car crash and police officers were making their way to give me the news in person. (In reality, when he didn't call it was because he was in the bathroom, in a meeting or just plain forgot, but that didn't stop me from dialling his colleagues' extensions until I found someone who'd confirm he was alive and well.) By summer (I was six months along) the anxiety, nerves and fear were downright unbearable. I'd heard on the news that a few toddlers had been run over in their driveways by loved ones not seeing them, so I'd been keeping Addyson indoors almost entirely for months.
My OB/GYN wasn't taken aback when I told him what I was going through. He calmly informed me that the kind of anxiety I was experiencing was common in expectant moms, and he referred me to a psychiatrist in the maternal health unit at the hospital. My appointment was about five weeks later and I walked out of the psychiatrist's office in tears carrying my first prescription for sertraline (more commonly known as Zoloft), one of the more popular types of selective serotonin reuptake inhibitors, or SSRIs.
I took having to go on meds while pregnant incredibly hard. I didn’t care about going on them for myself, but I spent days thinking up all kinds of side effects the drug might have on my baby: birth defects; preterm delivery; some form of rare childhood cancer; severe neurological delays; serious drug addiction; heart defects; kidney damage; blindness; and, yes, autism. I researched pros and cons, read any parenting site threads about other mothers' experiences that I could find and questioned every doctor in my life, including my psychiatrist, OB/GYN, GP, paediatrician, nurse practitioner and even the pharmacist at my local drugstore. Each healthcare professional gave me the same advice: to take the Zoloft. "The benefits far outweigh the risks. What if you hurt yourself or your baby?" they'd say. "My wife was on Zoloft when she was pregnant with our son," my family doctor told me. "And he turned out just fine."
Their approval didn't make the decision any easier for me, but in the end I filled the script and started the meds. For the last six weeks of my pregnancy I took a low dose of Zoloft every day and, while I don't remember ever feeling like I made the right choice at the time, I do recall feeling lighter and calmer just weeks after ingesting that first capsule. Since my postpartum depression after Addyson's birth, I was anticipating an even worse time emotionally after Peyton's arrival. I'll be honest—hurting myself and/or my kids crossed my mind more than once. I didn't trust myself, and worried that if I got too close to the edge, I'd jump.
The recent study's lead author, Anick Bérard, says: “Depression is very debilitating and should be treated. But there is a societal belief that depression absolutely needs to be treated with antidepressants. We need to treat it differently, at least during pregnancy.” For me, my doctors didn’t see another choice. Gambling on other time-consuming and incremental treatments like cognitive behaviour therapy and mindfulness (both of which I've studied) when I was spiralling at 33 weeks pregnant and needed to take care of myself, a toddler and my baby wasn't a risk I was willing to take. Zoloft was fast-acting and, although I wasn't "cured" (in fact, I'm still not cured; I've been on at least eight meds in the past five years and I'm still working on it), it wasn't long before I stopped catastrophizing. Thinking about Peter dying on his way to work, Addyson getting crushed in our driveway and how much better off I'd be if me and the baby just disappeared wasn't doing anything for my health—or for Peyton's. For me, the doctors were right—the benefits seemed to outweigh the oh-so scary risks. On Zoloft I was able to relax and enjoy the rest of my pregnancy and my newborn instead of living in misery.
There’s no doubt in my mind that I still would’ve decided to follow doctor’s orders (and my gut) and take the meds if this study had been around five years ago. I probably would’ve been more panicked (if that’s possible) about going on drugs six weeks before my freshly baked baby arrived, but to me there was no other option. We all felt this issue was serious enough for me to be treated medicinally—whether my baby could’ve been born autistic or not.
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