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.

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.

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.

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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.

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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.

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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.

AstraZeneca (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.