Thank you for sharing this. I’m glad you found an antidepressant that helps and that you’re seeking a more effective dose.
I hope anyone with similar experiences or concerns will consider seeing a reproductive psychiatrist. Regular doctors and psychiatrists often don’t know what they’re doing when it comes to pregnancy.
Thank you for sharing this. I’m glad you found an antidepressant that helps and that you’re seeking a more effective dose.
I hope anyone with similar experiences or concerns will consider seeing a reproductive psychiatrist. Regular doctors and psychiatrists often don’t know what they’re doing when it comes to pregnancy.
For years, doctors told women to go off their psych meds for pregnancy and breastfeeding. The guidance was to suck it up for 9 months because medication might harm the baby.
Now we know this is wrong. There are many psych meds that carry minimal risk to the baby, and going off meds is often a terrible idea for the mother AND the baby. Unhealthy choices aren’t good for the baby. High stress hormones aren’t good for the baby. It’s a myth that suffering for 9 months is the best thing you can do for your child.
I tell everyone, if your doctor says to stop taking your psych meds for pregnancy, see a reproductive psychiatrist. They will tell you the latest research on every medication and explore alternatives if necessary, but they won’t just say “stop everything.”
My original psychiatrist told me to go off *Zoloft.* One of the safest psych meds for pregnancy. Fortunately, my spouse is a psychiatrist so she told me “Yeah that’s wrong. See a reproductive psychiatrist.” And it made a huge difference for me. I kept my anxiety under control throughout pregnancy and the stressful newborn months (when I was terrified of SIDS).
As always, I just wonder how difficult finding and gaining access to such a psychiatrist would be for the average person. I was literally suicidal and barely functioning after having my first kid, and unfortunately I did not have the resources I have now and was being seen in a community clinic for primary care. I called them and they told me they couldn’t get me into any therapist for 9 weeks. I ended up going to urgent care and they still didn’t give my a psych referral but told me to try matching with a therapist through my work’s EAP.
It’s an unfortunate irony that finding a mental health provider is incredibly difficult and takes the kind of executive functioning skills and resources that people in a crisis most lack.
Yes, this is a huge problem. It's hard to find someone if you don't live near a city, and many reproductive psychiatrists do not take insurance. They have a rare speciality, so they can afford it. I am lucky that I lived in a major city, and I was able to find someone through a university.
I had suicidal prenatal depression that seemed to be triggered by, of all things, asthma. That is, we eventually realized during my first pregnancy that the times when hurling self and the poor unborn one with the misfortune to have me as a mom off a cliff seemed like a good idea corresponded with my lung function deteriorating into the "yellow zone" or worse. I also had weird rheumatic problems pre- and post-partum thanks to a congenital thing diagnosed only after my first kid.
Both hospital systems I received maternal care through are reputed to be excellent, and both *can* give excellent pre- and post-natal care (psychiatric care tends to be self-pay but affordab-ish). I got some excellent care, but also some crappy care -- including enough episodes of simply not being believed or my basic comfort and function not being valued "because the baby should still be OK" that I stopped wanting to go back.
Any interruption to continuity of psychiatric care can blow it all to hell, in my experience, risking whoever you redo intake with trying to rediagnose you with red herrings that have already been ruled out.
One of the benefits of consolidated hospital systems with electronic medical records should be that Provider A within the system shares your whole chart with Provider B, so that if you have conditions C, D, E... every provider is alerted to all of them, so that the Specialist in C doesn't have to assume a complaint is caused by C when it's fairly obviously attributable D.
Yeah, no. Especially, it seems, not where psychiatry is concerned. I had some good care, then lost it during COVID because the provider left the system. I would describe re-intake as positively demeaning to me as a patient and mom as well as unmedical (seeming lack of awareness of the basics right at the top of my chart!).
Despite aspirations to world-class pre- and post-natal care for moms, including psychiatry, in these hospital systems, resources have simply been too strained since COVID to deliver.
My wife struggled a lot after the birth of our first son (had a pretty traumatic birth experience that led to significant physical recovery time). Our pediatrician was great, saw the signs, and got her to someone who could help.
Excellent advice. One destructive myth in our Puritanical culture is that suffering is good, and that if something makes your experience somewhat easier, it must be harmful or wrong. Now that you mention it, why DO doctors worry about medications and not about cortisol?!
Thank you for sharing this. I’m glad you found an antidepressant that helps and that you’re seeking a more effective dose.
I hope anyone with similar experiences or concerns will consider seeing a reproductive psychiatrist. Regular doctors and psychiatrists often don’t know what they’re doing when it comes to pregnancy.
For years, doctors told women to go off their psych meds for pregnancy and breastfeeding. The guidance was to suck it up for 9 months because medication might harm the baby.
Now we know this is wrong. There are many psych meds that carry minimal risk to the baby, and going off meds is often a terrible idea for the mother AND the baby. Unhealthy choices aren’t good for the baby. High stress hormones aren’t good for the baby. It’s a myth that suffering for 9 months is the best thing you can do for your child.
I tell everyone, if your doctor says to stop taking your psych meds for pregnancy, see a reproductive psychiatrist. They will tell you the latest research on every medication and explore alternatives if necessary, but they won’t just say “stop everything.”
My original psychiatrist told me to go off *Zoloft.* One of the safest psych meds for pregnancy. Fortunately, my spouse is a psychiatrist so she told me “Yeah that’s wrong. See a reproductive psychiatrist.” And it made a huge difference for me. I kept my anxiety under control throughout pregnancy and the stressful newborn months (when I was terrified of SIDS).
As always, I just wonder how difficult finding and gaining access to such a psychiatrist would be for the average person. I was literally suicidal and barely functioning after having my first kid, and unfortunately I did not have the resources I have now and was being seen in a community clinic for primary care. I called them and they told me they couldn’t get me into any therapist for 9 weeks. I ended up going to urgent care and they still didn’t give my a psych referral but told me to try matching with a therapist through my work’s EAP.
It’s an unfortunate irony that finding a mental health provider is incredibly difficult and takes the kind of executive functioning skills and resources that people in a crisis most lack.
Yes, this is a huge problem. It's hard to find someone if you don't live near a city, and many reproductive psychiatrists do not take insurance. They have a rare speciality, so they can afford it. I am lucky that I lived in a major city, and I was able to find someone through a university.
I had suicidal prenatal depression that seemed to be triggered by, of all things, asthma. That is, we eventually realized during my first pregnancy that the times when hurling self and the poor unborn one with the misfortune to have me as a mom off a cliff seemed like a good idea corresponded with my lung function deteriorating into the "yellow zone" or worse. I also had weird rheumatic problems pre- and post-partum thanks to a congenital thing diagnosed only after my first kid.
Both hospital systems I received maternal care through are reputed to be excellent, and both *can* give excellent pre- and post-natal care (psychiatric care tends to be self-pay but affordab-ish). I got some excellent care, but also some crappy care -- including enough episodes of simply not being believed or my basic comfort and function not being valued "because the baby should still be OK" that I stopped wanting to go back.
Any interruption to continuity of psychiatric care can blow it all to hell, in my experience, risking whoever you redo intake with trying to rediagnose you with red herrings that have already been ruled out.
One of the benefits of consolidated hospital systems with electronic medical records should be that Provider A within the system shares your whole chart with Provider B, so that if you have conditions C, D, E... every provider is alerted to all of them, so that the Specialist in C doesn't have to assume a complaint is caused by C when it's fairly obviously attributable D.
Yeah, no. Especially, it seems, not where psychiatry is concerned. I had some good care, then lost it during COVID because the provider left the system. I would describe re-intake as positively demeaning to me as a patient and mom as well as unmedical (seeming lack of awareness of the basics right at the top of my chart!).
Despite aspirations to world-class pre- and post-natal care for moms, including psychiatry, in these hospital systems, resources have simply been too strained since COVID to deliver.
This is a great comment.
My wife struggled a lot after the birth of our first son (had a pretty traumatic birth experience that led to significant physical recovery time). Our pediatrician was great, saw the signs, and got her to someone who could help.
And it helped tremendously.
Excellent advice. One destructive myth in our Puritanical culture is that suffering is good, and that if something makes your experience somewhat easier, it must be harmful or wrong. Now that you mention it, why DO doctors worry about medications and not about cortisol?!
because one is regulated by the FDA and the other is not.
You could sue a doctor for adverse effects to your baby for taking a medication. You can't do that for cortisol exposure.