Trying to conceive with mental illness

I’m now in a new phase of my life. Last August, I came off of my bipolar disorder medication and have tried to regulate my mood through natural remedies such as taking 1000 mg of fish oil and multivitamins and by exercising regularly.

I’m also trying to get pregnant.

I haven’t wanted to discuss this particular phase of my life as I think it’s a very personal and private time. However, the emotional and mental toll that TTC (trying to conceive) brings upon someone who struggles with mental illness, I think, is worth discussion.

I wrongly assumed that when I decided that I wanted to have a child, I’d automatically be able to get pregnant. (Bristol Palin had no problem, right?) Several cycles later, I find myself still childless and even more desperately yearning for a child than the month before.

The mental anguish of TTC month after month is tough for any normal woman. During this phase of life, women may experience the following feelings:

  • Anger
  • Depression
  • Anxiety
  • Low self-esteem
  • Social isolation
  • Sexual dysfunction
  • Marital problems

In a woman who suffers from depression, bipolar disorder, or any other mental illness, those feelings can become so intensely extreme that they can be debilitating.

I can’t even begin to explain the psychology behind the agony a women endures when she desperately hopes for a child, only to be disappointed by a negative pregnancy test or the monthly visitation from a visitor commonly known as Aunt Flo. Month after month and year after year, the pendulum of emotions range from anger to despair. How is it possible to want and love someone so much whom you’ve never met?

For me, I’ve found that I am relatively sane and able to go on with life for about a week after trying. When I am a day or two away from my expected period, I am thrown into such emotional turmoil that I am nearly inconsolable. Part of it has to do with the sadness that accompanies my body preparing itself for the beginning of a new cycle; the other part of it is the emotional roller coaster that comes along with PMS (premenstrual syndrome). Throw in a dash of bipolar disorder and there’s no limit to how despondent I can be. I can only imagine the same would be true for women who suffer from other mental illnesses.

During those times, I’ve tried turning my eyes toward God and attempting to put my faith in His wisdom for my life, but I feel so isolated and so alone that I wonder if even God could comfort me. The pain of hoping for a child each month then discovering that it is not to be brings a sense of abandonment (for some reason). Negative thoughts creep into your mind at a furtive pace:

  • I’m not meant to be a mother because I’m already suffering from a mental illness and God is doing any kids I’d have a favor by not bringing them into this world through me.
  • I’d be a terrible mother anyway.
  • What is wrong with my body? Why can’t I conceive?
  • There’s no point in me living if I can’t have a child. I want a child of my own so desperately that I just don’t want to live anymore if I can’t have one.

Each month, a woman trying to conceive goes through the five stages of grief:

  1. Denial (The pregnancy test must be wrong; I’m pregnant for sure. Maybe my hormones haven’t been detected yet.)
  2. Anger (Why is this happening to me? What’s wrong with me?)
  3. Bargaining (I’ll do anything be pregnant. Please, just give me a baby.)
  4. Depression (I’ll never get pregnant. What’s the point? I’ll be a terrible mother anyway.)
  5. Acceptance (I’m not pregnant. [Some women can also say: But at least we can try again in the next cycle.])

I usually go through all that in the course of, oh, about 2 days.

I haven’t been trying for an extremely long period of time so I’m not classified as infertile but the internal and external pressure of trying to conceive can be stressful nonetheless:

  • Family members ask when a little one will arrive in your family
  • Friends and family members will have conceived (and even given birth) to a child within the time you’ve been attempting to conceive
  • Well-meaning people offer advice to simply “relax” and go on vacation to get pregnant
  • Pregnant women you know will complain about all the awful symptoms of pregnancy
  • Mothers you know will complain about all the downsides of parenting and rarely offer the upsides

I haven’t fully figured out how to deal with the uncomfortable situations I find myself in with others or the drained energy that comes from learning of a barren womb. This site provides coping techniques for normal women dealing with infertility, but I want to go a step farther in specifically addressing women TTC who suffer with some kind of mental issue:

  • Talk to a trusted doctor or counselor. Determine this is the path that you want to be on and discuss how to develop strategies in the face of another disappointing month.
  • Determine whether you need to take medication (if you’re not already on it). I tapered off of my mood stabilizer in the hopes of being able to have a natural birth and breastfeed. I’m altering those dreams. It’s not the end of the world if I have to have a baby in the hospital and a child won’t die if I feed it formula. (Although I’ll probably catch flak in the Christian community because what self-respecting mother doesn’t breastfeed?! [sarcasm])
  • Determine whether you need an adjustment in medication if you are taking something. Is the medication you are on relatively safe for pregnancy? Will you need to switch? Is the medication you’re currently on affecting your ability to adequately deal with the emotional pendulum that accompanies TTC?
  • Consider using natural mood-boosting remedies to bolster your mood. I know it’s cliche to mention this, but for some women suffering from mental illness, natural remedies actually do help. (For some women, natural remedies have little to no effect.) Here are a few to try:
    • Take at least 1000 mg of Omega-3 fatty acids daily. BEWARE: 1200 mg of fish oil does not equal 1200 mg of Omega-3s! I take 900 mg capsules of fish oil that only contain 450 mg of Omega-3s each. I need to take at least 3 capsules to get more than 1000 mg of Omega-3s. You can also get the weekly required amount of Omega-3s by eating fish twice a week. (Science Daily)
    • Take daily multivitamins with at least 400 mcg of folic acid. Folic acid helps lower the risk of birth defects in a baby. For me, I need the iron supplement to help me fight fatigue as I don’t eat many foods rich in iron.
    • Exercise regularly. I’ve been exercising about 3-4 times a week for about 30 minutes. Exercising temporarily boosts my mood although that’s only been a recent occurrence (within the past year).
    • Try to steer clear of mood-altering substances. The depression that accompanies not having a child can drive a woman to smoke, drink too much alcohol, or engage in the use of illegal drugs. (I’m guilty of having a bit too much wine.) Although we all know to avoid this stuff when TTC, it’s sometimes hard to resist. But try.

I hope this post can be of some help to women who are trying to conceive but also suffer from mental illness. We may be a small minority but we’re not alone. Feel to offer feedback on this post by leaving a comment.

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The MOTHERS Act: Read it for yourself

Mom and infantI’ve written about the MOTHERS Act in the past but recently there has been much debate swirling around it. There are those actively against it (Amy Philo, Doug Bremner) and those actively for it (Katherine Stone, John Grohol). I’m going to refrain from voicing my personal opinion on the act from here on out since I’m seeing tensions run rather high and I don’t care to have those tensions directed at me.

But I haven’t seen anyone link to the Congressional bill recently so before engaging in debate, I encourage people to read the actual bill for themselves and come to their own conclusions. It’s actually short (unlike our current 1,000-plus-page universal healthcare bill) and a relatively easy (see “understandable”) read.

S. 324 the most recent version I know of. If there’s a more recent version, please comment to let me know.

Loose Screws Mental Health News

ReadWriteWeb reports Stony Brook University researchers discovered too much exposure to “texting, instant messaging, and social networking” can make teenage girls more likely to suffer from anxiety and depression. This landmark discovery sampled a whopping 83 teenage girls.

computer useThe results of their tests, recently published in The Journal of Adolescence, showed that the girls who excessively talked with their friends about their issues had significantly higher levels of depression. Today’s online tools provide even more ways for this to occur. Says Dr. Davila, “Texting, instant messaging and social networking make it very easy for adolescents to become even more anxious, which can lead to depression.”

The problem with these electronic tools du jour is that they allowed the girls to discuss the same problems over and over again. This caused them to get stuck obsessing over a particular emotional setback, unable to move forward.

–snip–

It’s not necessarily the medium through which the chatter tasks place that’s the issue – it’s the amount of discussion that leads to the feelings of depression. Said Dr. Davila, “[The girls] often don’t realize that excessive talking is actually making them feel worse.”

So we can conclude then that keeping your teenage daughter from MySpace, Facebook, Twitter, AIM, and texting will help improve her mental health so she’s less likely to be depressed. Back in the day, I just wrote morbid poetry in a sad, lonely marble notebook. Alas, those days are gone. (pic via reviews-for-you.com)

On a related note, another study has discovered that teens who watch TV for long periods of time are more likely to be depressed. (Does nearly everything cause an increased risk of depression these days?) The study tracked over 4,000 teenagers and their TV-watching habits. The conclusion? Seven years later, participants were more likely to be depressed and the risk increase with each hour of television exposure. Perhaps it’s because TV creates an unrealistic perception of how a person should look and act and how life should be. Although researchers of the study did note that exposure to electronic media yielded the same result.

PregnantOn the Christian tip, I need to once again dispel this nasty rumor that the MOTHERS Act is intent on drugging pregnant women (and thereby the baby) to oblivion. (I addressed this issue around this time last year once again from Christians who think some left-wing liberal nuts are out to “indoctrinate hundreds of thousands of mothers into taking dangerous psych drugs.”) Once again, I need to repost the goal of the MOTHERS Act as stated in the original bill:

To ensure that new mothers and their families are educated about postpartum depression, screened for symptoms, and provided with essential services, and to increase research at the National Institutes of Health on postpartum depression.

The legislation is only intended to increase the resources for screening of mental issues in women. Women will NOT be forced to take medication if they do not want it.

In the Congressional findings, medication is mentioned only as a form of treating PPD. That’s not directly encouraging new moms to take drugs; it’s encouraging them to seek treatment, whether it be therapy or some other course. Not every new mom will need therapy, hospitalization, or medication, and this bill is far from attempting to “indoctrinate” moms with psych drugs. Also, the bill only mentions “medication” once. It does not even use the word “drug.”

It’s unfortunate to hear stories of women who suffered miscarriages or acted erratically as a result of medication. However, postpartum depression has become such a prevalent issue that proper screening — not necessarily medication — is needed. And the mother in conjunction with her doctor must make an informed and appropriate decision on how to proceed with treating her mental health. A great resource on the MOTHERS Act can be found at Postpartum Progress where blogger Katherine Stone vigilantly monitors the progress of this bill and clearly lays out what the bill entails:

  • Encouraging Health and Human Services (HHS) to coordinate and continue research to expand the understanding of the causes of, and find treatments for, postpartum conditions.
  • Encouraging a National Public Awareness Campaign, to be administered by HHS, to increase awareness and knowledge of postpartum depression and psychosis.
  • Requiring the Secretary of HHS to conduct a study on the benefits of screening for postpartum depression and postpartum psychosis.
  • Creating a grant program to public or nonprofit private entities to deliver or enhance outpatient, inpatient and home-based health and support services, including case management and comprehensive treatment services for individuals with or at risk for postpartum conditions.  Activities may also include providing education about postpartum conditions to new mothers and their families, including symptoms, methods of coping with the illness, and treatment resources, in order to promote earlier diagnosis and treatment.

Although a vote on the act was blocked in the Senate in September, Sen. Robert Menendez of NJ has reintroduced the bill, championing the cause for PPD awareness at the federal level.

And on a humorous note, if you are single and mentally ill, you can go to TrueAcceptance.com and find someone who suffers from mental illness just like you. That’s right, TrueAcceptance matches the mentally ill with… the mentally ill. The premise is based on the idea that matching people who both suffer from mental illness are more likely to understand and support each other. The idea amuses me but I’d be too afraid that being with someone else who suffers from mental illness would end up being an enabler. (via Fox News)

Lamictal in consideration of pregnancy

My husband and I are talking about expanding our family. While that sounds all well and good, I just have one issue:

Lamictal.

For most women, they think, “Well, I want a kid” and the most they have to do is probably get off birth control. Just finish off their contraceptives, maybe feel a little nauseous, and move forward with their plans.

(sigh) Not me. If I want to do this right, it might be a good 6 months or so before I can consider trying.

Read the rest of this entry »

Loose Screws Mental Health News

John Grohol at PsychCentral reports that the fate of the mental health parity bill is uncertain as its main champion, Sen. Ted Kennedy, takes a leave of absence to focus on treatment of his brain tumor. I echo John’s thoughts in hoping to see that other senators are willing to carry the torch and pass this important piece of legislation.


I came across a post from Kalea Chapman at pasadena therapist in which she linked to a WSJ article on whether veterans suffering from PTSD should be awarded the Purple Heart.

Supporters of awarding the Purple Heart to veterans with PTSD believe the move would reduce the stigma that surrounds the disorder and spur more soldiers and Marines to seek help without fear of limiting their careers.

Opponents argue that the Purple Heart should be reserved for physical injuries, as has been the case since the medal was reinstituted by Congress in 1932.

I side with the opponents. The Purple Heart should be awarded to be people who have visible evidence of bravery. With the rising number of PTSD prevalence, I’m afraid that the award would be handed out like candy. The rising number of veterans with PTSD on disability has caused enough of an issue that a Texas VA facility wanted mental health officials to stop diagnosing veterans with the condition.


Jordan Burnham, an 18-year-old student who survived a nine-story jump from a building, plans on walking at his graduation with the assistance of two canes. A family who used to attend my church knows this family and put him on my church’s prayer list. It’s a small world, after all.


Finally, it looks like expecting moms should have no fear of causing birth defects in their baby while taking antidepressants, according to a study being published in the British Journal of Psychiatry.

A research team from Montreal University studied more than 2000 pregnant women on antidepressants and discovered the drugs did not present any adverse effects. However, it sounds like they only oversaw the women while they were pregnant in their first trimester. I haven’t seen the actual study but it doesn’t seem to mention whether the women discontinued the antidepressants after the first trimester.

Loose Screws Mental Health News

I recently wrote about the MOTHERS Act and the unnecessary scare tactics surrounding it. A Dallas-Fort Worth TV station picked up on the story and provided a short one-sided view of the issue, continuing to purport that the bill is solely about drugging new moms. I don’t discount Ms. Philo’s terrible experience with her medication. In fact, I’d be against the act if its sole purpose was to force treatment on pregnant women – medicated or not. Again, I’d like to reiterate that the bill’s purpose is to educate moms about postpartum depression and postpartum psychosis – not to shove unnecessary pills down women’s throats.

If you have sleep apnea, your CPAP (Continuous Positive Airway Pressure) machine may alleviate depression symptoms. My husband has sleep apnea and hasn’t been able to use the CPAP machine because of sinus problems. When he doesn’t use it (he hasn’t for a while), he’s noticeably moodier and prone to depressive symptoms. But then again, anyone who doesn’t get good sleep for several days is pretty moody.

Seroquel XRAstraZeneca (AZ) is going after Teva Pharmaceutical Industries and Novartis AG’s Sandoz unit after the two companies applied to make cheaper version of Seroquel available. AZ’s patent on Seroquel expires in 2011. The trial date for patent litigation is August 11. In the meantime, according to the Bloomberg report, the FDA is considering approval of Seroquel XR for bipolar depression and bipolar mania.

What is it about the U.K. that they seem to take pharma’s power more seriously than the U.S.? The UK Medicines and Healthcare products Regulatory Agency (MHRA) charged GlaxoSmithKline (GSK), the maker of Seroxat (Paxil in the U.S.), with not fully disclosing their clinical trial data that downplayed serious side effects such as increasing suicidal tendencies among those 18 years and younger. The MHRA also asserts that Seroxat didn’t alleviate depression as much as GSK’s initial data showed. GSK, of course, denied manipulating the data to show favorable results:

GSK denies withholding data, claiming the risks did not come to light until the results of nine studies were pooled.

The UK minister of public health, Dawn Primarilo, promised to address the issue of Big Pharma hiding negative clinical trial data.

“Notwithstanding the limitations that may exist in the law, pharmaceutical companies should disclose any information they have that would have a bearing on the protection of health,” she says.

In other news, I shouldn’t be a successful writer or novelist. The correlation between creative writers and suicide is ridiculously high. More than 70 well-known writers and poets have successfully committed suicide. How much more “unknown” writers and poets have as well?

(Image from Monthly Prescribing Reference)

Pregnancy is NOT a mental illness

I stumbled upon Yankee Cowgirl’s blog that mentioned Congress is working on the MOTHERS (Mom’s Opportunity to Access Health, Education, Research, and Support for Postpartum Depression) Act which would “strongly encourage pregnant women into mental health programs – that means drugs – to combat even mild depression during or after giving birth.”

She links to a column written by Byron J. Richards on newswithviews.com. He writes:

The Mothers Act is pending legislation that will indoctrinate hundreds of thousands of mothers into taking dangerous psych drugs.

He goes on to slam Big Pharma about how they control Congress and how mothers don’t need psych drugs for a natural birth process.

The Mothers Act (S. 1375: Mom’s Opportunity to Access Health, Education, Research, and Support for Postpartum Depression Act) has the net affect of reclassifying the natural process of pregnancy and birth as a mental disorder that requires the use of unproven and extremely dangerous psychotropic medications (which can also easily harm the child).

These are some serious accusations. I got pretty riled up myself and decided to see what Congress said in the bill.

Read the rest of this entry »

Take two pills and call me if there's a birth defect

A recent article in the NYT reported that two studies released in The New England Journal of Medicine claim that an antidepressant could potentially increase the risk of a baby being born with a birth defect, but, uh,  it's unlikely and "confined to a few rare defects."

Benedict Carey, author of the article, points out that the studies didn't have a good sampling to really prove that assertion:

"In both studies, researchers interviewed mothers of more than 9,500 infants with birth defects, including cleft palate and heart valve problems. They found that mothers who remember being on antidepressants like Zoloft, Paxil, or Prozac while pregnant were at no higher risk for most defects than a control group of women who said they had not taken antidepressants."

So what's it's sounding like for me is that researchers got a group of expecting moms together, basically said, "Hey, have you taken an antidepressant?" and the ones who said yes were placed in one control group and the ones who said no were placed in another. How reliable.

Having been part of a clinical trial for bipolar disorder, I know it's likely these women got paid for their participation in this study. (Most people do, from what I understand.) So some could essentially have lied in the hopes they could snag $100. It doesn't sound like these women agreed to have their past medical history released to researchers that could prove they've been on antidepressant medication, they could have just been like:

"Uh, yeah. I took the antidepressant with the happy little egg sad face thingy."

Doctor: "Zoloft?"

"Yeah, yeah! That one. It maketed me alllll better."

Remember – it's mothers who "remembered" being on antidepressants while pregnant, not medical histories that proved that they've at least been prescribed the medication.

One doctor, not involved in the research, had reservations about the so-called findings:

"These are important papers, but they don't close the questions of whether there are major effects" of these drugs on developing babies, said Dr. Timothy Oberlander, a developmental pediatrician at the University of British Columbia, who was not involved in the studies.

Despite the seemingly positive outcomes that "support doctors' assurances that antidepressants are not a major cause of serious physical problems in newborns," both studies uncovered some pretty serious – but considered rare – conditions.

"One of the studies, led by Carol Louik of Boston University and financed in part by the drug makers GlaxoSmithKline and Sanofi-Aventis, found that use of Paxil was associated with an increased risk of a rare heart defect, which the company had previously reported.

The other study, led by Sura Alwan of the University of British Columbia, found that use of antidepressants increased the risk of craniosynostosis, a condition in which the bones in the skull fuse prematurely. Rare gastric and neural tube defects may also be more common in babies exposed to the medication, the studies suggested."

But don't worry, pregnant moms – the risks are low, "appear remote, and confined to a few rare defects." So, hey, even if your baby DID develop a rare defect, at least it's rare! [sarcasm]

I'd take the chance of depression if it meant my baby had a better chance of being born healthy. I'm lucky – I couldn't take Lamictal if I got pregnant. I wish antidepressants would have the same instruction.