Are antidepressants warranted in this scenario?

[Feelinglow1]

I've suffered first with primary infertility for years, then we had our wonderful DS. Tried for a second, first I was very chilled about it but as the years have gone on I've become increasingly desperate/ depressed about it. I'm immensely grateful for the one we have but I'm at the point where if anyone just announces a pregnancy I'm breaking down in tears. I tried therapy, sports, being busy, the works- I feel down and guilty and somehow less than, and I just cannot help it. Add to this I'm so anxious about my one precious child and if he gets as much as a fever I'm panicking. Im generally very anxious but this whole thing has made it so much worse. I sometimes get heart palpitations and stomach upset from the worrying. AIBU to get antidepressants for this?

I'd say no YANBU. Do it - make an appointment today.

I suffered 8 miscarriages-2 at over 20 weeks & never expected to be able to carry a baby to full term. Eventually, by some miracle, I had my son who was born by elective CS due to injuries that I'd sustained in a serious car accident many years before, I'm only 5' tall & he was a very big baby (9lbs 13oz). I became very anxious & for a long time was overprotective of my DS. It didn't help that my DH died while I was PG so I was a single mum.

GP put me on anti-depressants & it really helped -that and an excellent Health Visitor.

So sorry you are dealing with this op.
I was so desperate for a second (ivf baby) I couldn’t even see baby clothes in a shop without crying, and sobbed for hours when someone’s dog got pregnant!

I do think AD could help, they certainly helped me. Have yo had blood tests? Low iron and thyroid issues (amongst other things) can cause depression, anxiety, palpitations, tearfulness and other issues. Have a chat to the GP.
Wishing you well

Are you having therapy OP? I would start there and talk through the idea of antidepressants with your therapist. I made all the lifestyle changes and worked on things myself and then, did eventually succumb and started a low dose of antidepressants. But I have a much better understanding of my illness having done that. Obviously if your therapist feels you’d benefit from the off then do that.

Hi there thanks for your reply! I've done therapy a lot and with different therapists and it hasn't really helped unfortunately. I'm very reluctant to take medication but I think it might be time

100% get an appointment with you GP. These are absolutely not trivial feelings you should just get on with. Hope you get the help you need and a brilliant, supportive GP.

You are not "less than" - you are worthy.

I'm very reluctant to take medication but I think it might be time

If you have a headache you take a paracetamol, if you have a chest infection, you take anti-biotics. ADs no different to any other meds. This isn't the 1960's when Valium was handed out as a cure-all to anyone. GPs don't prescribe ADs these days without other advice such as referral to counselling, recommending exercise & other things that may help.

I was really reluctant to take medication too - I spent two years avoiding it. I’m on a very low dose - 5mg Escitalopram and it’s made a huge difference.

The lifestyle changes also helped enormously and I do think it was useless to make changes slowly so I could get a feel for what was really helping and maintain it.

Just one piece of advice. I didn't realise until DH mentioned it (his late wife had this problem) some ADs can affect your ability to orgasm (Citalopram for example). Although it's quite normal to feel sleepy, woozy/dizzy, sicky when you first start taking them, this is a sign that they are working, if the symptoms persist after about 4-6 weeks don't be afraid to go back to your doctor & they will change it.

Hey there, before going down the medication route please take a look at Georgia Ede, she is a US based psychiatrist who talks about the link between diet, the body's ability to produce hormones, and mental health. The talk linked below is less than an hour, informative and actually amusing in places.

Key words if you don't trust links, Geogia Ede, PHC, 2023, What is nutritional and metabolic psychiatry?

Of course you should take ADs they can be life changing for you and relationships with others

but… I think there are studies that they increase prolactin and hence ovulation so perhaps monitor via blood tests if you’d like to try again to conceive

I read this as a rare, but possible side effect.

I'm really sorry you're having such a difficult time.

It would certainly be worth seeing your GP and medication is definitely one of the things that might help you. Obviously it's not like a taking a magic pill that makes everything all right, but it certainly might just help you feel a bit more able to manage your feelings and navigate your way through what you're experiencing. Antidepressants won't make you feel instantly better (you might even feel a bit worse for two or three weeks at first) but long term they can certainly help.

I've taken Seroxat, citalopram and sertraline and have had slightly different experiences with all of them in terms of side effects, but they've all ultimately been effective. I'm currently on Sertraline and I had some side effects for the first three weeks (mostly nausea) but after that, no side effects at all really. Everyone's experience is different but that was how it was for me.

Omg! useful not useless!

YANBU. Secondary infertility is so painful and there is no escape from it. It was all consuming for me - the first and last thing I thought of every day, and I was constantly bombarded with intrusive thoughts that no amount of counselling or CBT could remove. Therapy gave me a space to vent about my feelings, but until you either conceive or decide to stop then you're just stuck in the trying and it's torture. You might find that a low dose might takes the edge off and quietens that inner voice. Just make sure you are open with your GP about the reason and ask for something that is ok for ttc and pregnancy. Also just fyi setraline is known to crush your libido, which is probably already taking a battering from the ttc so I'm afraid that is likely to get even more joyless!

I'd say no as there isn't anything wrong with you and your emotions are normal in response to the trauma you are experiencing. There isn't an illness in your brain that needs fixing and medication will not fix the root cause of this.

She mentions anxiety etc though and I think we underestimate how those normal responses creep into our lives and become an issue, that isn’t part of our response to the initial upset. Things manifest.

AD’s can help bring your baseline anxiety etc down and give you some space to focus on the bigger issues and carve a way forwards.

Yes good idea, they can really help you get your head above water.

You do also need therapy alongside to deal with the grief though.

Where did you get that information from?

I have heard of particular anti psychotic medications like olanzapine triggering gallactorrhea (abnormal milk production) because it suppresses dopamine which in turn can lead to overproduction of prolactin, but never heard this about antidepressants? Which ones particularly?

AD dopes and does nothing else. Not sure how it brings it down when anxiety isn't a biological issue so meds will have no impact on it.

That’s not true - anti depressants are effective in treating anxiety too.

That is true - first what is the test for anxiety, what is broken in the body that needs fixing? What tests do they do and then what does the meds do in the body to change that?

There’s plenty of medical trials and literature on the topic - Google is your friend.

Oh I have and it all points that AD do naff all as anxiety isn't biological, thanks for the advice though!

Medical trials have shown that the placebos either create the same impact or work better. The study by Kostic was interesting. You might wanna read it.

googling brings lots of sites highlighting potential issue

one example here https://www.psychiatrictimes.com/view/ssris-decrease-fertility

Yes I did hear about the antipsychotics too - anything that potentially lowers dopamine might cause this

That’s interesting, thanks.

OP, talk to your GP. If you tell them you are TTC, they can recommend something suitable.
There are lots of ADs which aren’t SSRIs.
However, it’s quite restricted what you can take while ttc/ pregnant/ bf, especially if you are not already in it or have been before.
Honestly, it’s not a very good idea to ttc when you are suffering from depression and anxiety. A doctor can help you work out whether you are clinically depressed and/ or have problem anxiety.
If you can, I would recommend you focus on getting yourself to a better place emotionally and park ttc til then. I know sometimes time is not on your side but you have to consider that conceiving might not necessarily immediately fix everything and think about whether you are in the best place to be ttc if you aren’t feeling well in yourself.
I had ppd/ anxiety and had to go on meds not suitable for ttc/ pregnancy. I had been holding off going on them so I could try for number two but I was cracking up and couldn’t go on any longer.
Eventually I had to make the very difficult decision to accept that I probably wouldn’t have another child and prioritise getting myself in better shape so I could be the best mother I can be to the child I already have.
Now that I’m thinking straight, I realise there’s no way I could have coped with a second pregnancy/ baby anyway when I was feeling so low. My thinking was all over the place.
It is the last thing you want to hear at the time, but honestly once you accept it it really can start to get easier.
Then for me I noticed, as you start to move away from that point in your life, you get less focused on it. For most people, I think the pain does lessen with time.
I think hormones have a big part to play in it and it can be helpful to bear in mind how much hormones can influence how you think and feel and try to see things objectively.