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Alexis on choosing to take antidepressants while breastfeeding

portrait of a woman wearing a red dress - essay on antidepressants while breastfeeding

Content warning: Discussion of postpartum depression, birth trauma, domestic abuse or other tough topics ahead. If you or someone you know is struggling with a postpartum mental health challenge, including postpartum depression or anxiety, call 1-833-9-HELP4MOMS (tel:18009435746)—The National Maternal Mental Health Hotline This free, confidential service provides access to trained counselors and resources 24 hours a day, 7 days a week in English, Spanish, and more than 60 other languages. They can offer support and information related to before, during, and after pregnancy.

Depression, in some form, has dipped in and out of my adult life, like an old boyfriend who, every couple of years, sends you an email or a text that ends up derailing your entire day. Except, unlike with the old boyfriend, the feeling doesn’t go away in a night or two. It lingers around, seeping-black, to take hold and suffocate the air you breathe and erase all the joy you may have found in life before you knew him.

I had been on a good run of being off antidepressants before my husband and I decided that we were ready for me to try to get pregnant. The thing with me and antidepressants, is that I can have long stretches of good periods—but all it takes is a bad event to trigger me, and I’ll be thrown into a horrible depression that feels like it’s the one I’ll never escape that time. (I’ve since learned that I work best when I’m on them all the time, so they can catch me when I fall.)

Related: To the mama battling depression: You are not alone

My pregnancy was, besides the seven months of vomiting, a really magical time. Really. We were living at my husband’s grandmother’s house by the beach, and my summer was filled with freelance writing gigs, slow bike rides on the boardwalk, lunches with Grandma, and perfecting my Amazon wishlist for when the baby arrived. Sure, I complained about looking like an ogre most of the time, and I had to contend with gestational diabetes—but my mood was the best I could ever remember feeling. Maybe in my entire life. Those pregnancy hormones did me good.

Fast forward to my son’s birth. An emergency c-section landed me, unprepared for nearly a week’s stay in the hospital. Even though I had known that a c-section was a possibility when it came to delivery methods, I had pretty much tuned out that it was a possibility for me. I thought I had done everything to avoid surgery — from watching my sugar intake (re: the diabetes), to having a painful procedure procedure a few weeks before my due date to turn my breech baby. 

Related: 27 things I wish I’d known before my C-section

On the day of my son’s birth, the doctors noticed something strange with his heart, and we spent that first day taking him for tests with the pediatric cardiologist, and feeling like our whole world might come crashing down at any moment. He turned out to be OK, but all that rest that I had been told to do after the baby was born? Well, being scared sh*tless kind of takes any ability or desire to relax out of the realm of possibility.

When friends and family visited, I mainly took it as an opportunity to share my war story. I cried most of the day, through almost all my visits. I felt so, very sorry for myself, and what my body had endured. I didn’t understand what had happened, or what I had done “wrong” to deserve a c-section. 

I found it impossible to stay still, rest, or sleep, the first week in the hospital, (and later, at home with my baby). I gave myself lists of tasks to do from my hospital bed: journaling, taking pictures, emails, doing those breath exercises they instruct for you to do, writing every single thing my baby did down. 

Related: An overlooked tool in pregnancy and birth? Breathwork

And when I came home, it was worse: I sat with all the books, highlighter in hand, thinking that if I studied up on what babies are supposed to do, I could somehow guarantee that I could make my baby fall in line.

I don’t remember much about my c-section incision, or the pain. I popped painkillers as instructed, and wasn’t shy about it. What I remember is the screaming. My baby never stopped crying, it seemed. Looking back, I did myself a great disservice by constantly trying to put him down in a bassinet or a crib—as the books said to do—knowing that he was perfectly happy in my arms. He wouldn’t sleep at night unless we held him, but we were terrified of sleeping with him, so instead I stayed awake the entire night, fighting him to sleep. As each day passed, I felt myself getting more and more depleted.

I became vigilant about pumping. I busied myself with the task, about three to four times a day. I was already looking forward to some future time when I would not have to be available to this creature who seemed so ungrateful for all the trauma I endured on his behalf. 

Related: Your postpartum recovery kit: Feel your best after a C-section

By the time we moved back to Brooklyn, when my son was about 5 weeks old, I had hired the first nanny I interviewed and gave her my baby without so much as a glance back. I ran out of my building, eager for freedom and agency. 

I never wanted to go home. The nights that awaited me felt like absolute terror. I began to formulate strange thoughts. I didn’t say them aloud to anyone, because I knew they sounded completely bizarre and I chalked them up to being a creative person, and sometimes just a weirdo.

“My baby is trying to kill me.”

“My baby is evil.”

“This was a horrible idea. I should never have gotten pregnant.”

During one of my early OBGYN appointments, my wonderful doctor noticed that something was terribly off. I had done my best to hide this darkness from the people around me—maintaining my funny, sometimes goofy demeanor throughout that time.

Related: No, your OB/GYN should not be your primary care provider. Here’s why

She looked at me, with my legs dangling from the exam table, my baby making that beginning-of-a-cry coughing sound.

“What happened to you?” She asked. “You’re not you. You’re a light. You’re whole pregnancy, you had a light inside you. But the light is gone…It’s just gone.”

She went down a checklist of questions doctors ask patients who might have postpartum depression, and it was like she was reading my mind. There it was: “Do you have thoughts that your baby is trying to cause you harm? Do you regret having had your baby?” Until that moment, I had had no idea that what I was feeling was something other people might have experienced. I thought I was special. But in all the worst ways.

It took some convincing of family members, and my husband, that I had a clinical problem that required medication. The thought of my taking antidepressants while breastfeeding concerned my husband greatly. We both went to my meeting with a psychiatrist who specializes in postpartum depression and breastfeeding, and felt comfortable with the plan she created for me. I went on Zoloft, and found almost immediate relief.

A few weeks later, my son and I were alone in my kitchen, where I had placed him on a little blanket on the countertop (yes, I know, but he was fine) while I tidied up. I put on a Regina Spektor album, and the song “Samson” came on. I had the urge to pick up my son, and start dancing, like I had always imagined happy mothers did with their babies, in kitchens all over the world. We had never danced before. I swayed, and held him close, and began to cry — but it was the first time I was crying while being happy at the same time. I looked at his face, and my heart swelled the way people had always said it would — and that was the moment I realized I was getting better, and it was also the moment I fell in love.

For more from Alexis, visit Not Safe for Mom Group.