Mental health and conception

[BeachYogi]

Hi all... I'm TTC #1 and also have mental health problems. Bipolar 2 and generalised ancient disorder with panic attacks. Fun! Anyway I've just entered the two week wait and my mental health has deteriorated significantly. I had panic attacks last night and for an hour this morning. I almost threw up because I couldn't breathe and was coughing so much. I'm feeling depressed too. Anyway - does all this cortisol/adrenaline affect my chances of conceiving? I feel so ashamed of my mental health & inability to cope. Got signed off work by my GP today for 10 days (at least) as I'm not fit to see my patients. Anyone else struggle and have success stories? Guessing or hoping I'm not alone with this issue.

Have you discussed TTC with your doctor? Are you taking any medication at the moment which could be adjusted to help?

@PaperdollCartoon Thanks for replying. My GP knows I'm TTC. I take lamotrigine (which is apparently safe in pregnancy, I've done a lot of research!) as a mood stabiliser and I take diazepam and propranolol when needed. I don't think the latter are safe during pregnancy though. I've spoken to a perinatal psych in the past and she said my only other options are antipsychotics and I'm not going down that route. Maybe I should up my lamotrigine (I reduced it to minimise risk to potential baby).

I found my anxiety (I have Bipolar 1 and anxiety) got worse when I was off hormonal birth control. I get quite bad anxiety just before AF and also through pregnancy.
Please don't feel ashamed, with the right support it's all doable. Do speak to your MH team if you haven't already. I got fantastic support when planning my family and incredible support from the perinatal mental health team during pregnancy and the first year after my babies were born.
They helped me sort out medications I could take and develop ways to cope without medication when I decided to come off it.
It's so important to be able to discuss it with your loved ones and professionals though. There's honestly nothing to be ashamed of, it's not your fault that your brain chemistry is wonky and there are things that can help make you feel better.

Just realised I typed "generalised ancient disorder" - first time I've laughed today. I'm in my thirties now but not ancient! I meant "generalised anxiety disorder"

@NoseringGirl Thank you so much, I got tearful reading your reply and it made me feel more hopeful & less alone. I think the contraceptive pill kept my mood more stable too, it's been hard adjusting to a "proper" cycle.

I found the perinatal psych I saw amazing but I won't see her again unless I get pregnant. Worrying that all this chaos in my head/body might stop that from happening but it's reassuring to know others have got there!

@NoseringGirl Out of curiosity, what meds did you take when ttc and during pregnancy? If you don't mind saying.

The first time around I was on venlafaxine and quetiapine. I came off the venlafaxine when I got pregnant but stayed in the quetiapine throughout pregnancy. DS1 is a healthy and developmentally normal 4 year old now. I came off quetiapine when he was born as I was at first told I couldn't breastfeed on it (I had a nightmare getting anyone to say what I could take when breastfeeding, it's the field I work in now so I'm a lot more clued up!)
I became ill (manic) when he was around 4 months and went back on quetiapine but my psychiatrist (I was under community then as I'd been with her for so long) had looked into it and said I could continue breastfeeding. I stabilised quickly. I also had lorazepam as a PRN to calm me down.

I came off my meds while TTC DS2 (weight gain issues) and remained stable throughout pregnancy (I had anxiety but was managing it) but the perinatal psychiatrist suggested going onto medication when DS2 was born to prevent me having an episode (this was all planned during my pregnancy). It was a first generation antipsychotic (I can't remember the name at the moment!) but the side effects were awful so I came off it after a week. I had a depressive episode with some psychosis when DS2 was 3 weeks old. My CPN was at my house within 45 minutes of DH phoning her and I was back on quetiapine within hours and started to feel better after a few days. It all sounds a lot worse than it seemed at the time as it was treated very quickly.

Sorry that's really long, more than happy to answer any questions though. It can seem overwhelming but I found the perinatal team normalised it all so much that when I was under them with DS2 it felt so manageable. I had a great community team before that as well but in my experience, perinatal care is second to none.

Sorry, OP. I have no advice but just wanted to wish you all the very best of luck during your TTC journey xx

Thanks @NoseringGirl - I appreciate you taking the time to tell me about your experiences. I have tried quetiapine but I felt too sedated to function! I'm glad it helped you & you got the support you needed. X

@sirlee66 That's really kind of you - sometimes knowing people are rooting for you is enough! X

@BeachYogi it's definitely sedating. I've had to have a lot of help from DH during the night. The extended release isn't as sedating mind. I'm not a big fan of antipsychotics because of the weight gain but when I'm not well, Quetiapine and Olanzapine are the only meds that have helped. Sounds like Lamotrigine is working for you though and I know others that have been on it during pregnancy.
If you look up Dr Hale, he's compiled loads of evidence based information on the effects of medication in pregnancy and breastfeeding. Worth a look for the reassurance!

Mental health problems are nothing to be ashamed of they are illnesses just like diabetes or MS. My husband has depression and episodes psychosis, I have had depression and PTSD and currently am suffering from anxiety.

My husband's mental health team have been really supportive and his psychiatrist confirmed that his meds are safe whilst TTC. In fact she said she has had women on much higher doses of antipsychotics whilst pregnant than what he is on. I have had one very unsupportive GP who told me to "consider the moral implications" of having a baby with my husband because of his mental health problems (judgemental bitch) she told me that I must not get pregnant on antidepressants, but having researched it the risks appear to be very low until the 3rd trimester. I felt like she was judging me a bad mother just for wanting to have a child.

My anxiety has got really bad again last week and I am now also signed off work too as I've been having pannic attacks. I went to see a different GP who was much more supportive and talked through options with me. I really feel like I need to be on antidepressants again but even with all the research I've read when the GP looked me straight in the eyes and said that if I take an antidepressant I increase the risk of my baby having heart problems, I felt that pressure on me again of being judged. I felt like if I said yes I still want to take it (which I do) he would judge me a bad mother. I sat there judging myself a bad mother for even considering taking medication that could harm my child, yet at the same time knowing that I am not coping and knowing how ill I've got in the past I think on balance taking the antidepressants is the more sensible option, but then I question if that makes me selfish. Though I tend to operate on the theory that in order to look after others well you need to look after yourself first. Any way the upshot was that I walked away without a prescription with the plan of trying some therapy first.

Sorry that turned into a bit of a rant.

I'm TTC and taking 80mg propranolol each day. When my GP prescribed it I let her know that we're TTC and asked if it was safe and she said it was - OP I see you said you don't think it is, should I be worried? I'm on it due to palpitations and dizziness but nothing I don't feel I could live with if I was risking harming my baby.

@Emma198 Sorry if my post worried you. The psychiatrist I saw said that propranolol can slow a baby's heartbeat & therefore suggested it should be avoided. However, we did not talk about it in depth so I'm not sure how serious the risk is. She may have been overly cautious? Also I think sometimes they weight up risks to baby from medication versus risks to you AND the baby if you do not have medication to help with your mental health. Perhaps in your case the risks of you not taking it are too high. Maybe check again with your doctor just to be safe? X

@pinkdonkey Sorry you are struggling too. I know mental health problems are nothing to be ashamed of & would never judge anyone else for their struggle. However I think one of my mental health symptoms is shame & lack of self worth so I judge myself for everything I do. Even if it's not in line with my beliefs/values concerning mental health in general. Hopefully that explains my post a bit. X

Thanks BeachYogi. I've got anxiety with depression and the propranolol is the only medication I'm on currently. I didn't really discuss it in depth with my GP, just said that we're thinking about trying to conceive is it safe and she just smiled and nodded her head, she also said she didn't think an upset tummy is a side effect but I'm quite certain it is! I think if I was to get pregnant I'd make an appointment and come off them straight away as I don't feel that the symptoms they are controlling are worth the risk.

In answer to your initial question I am worried that my anxiety is effecting my chances of conceiving as being less stressed seems to be common advice... I've been taking meditation classes at my local Buddhist temple and I always feel much better when I've been there.

@BeachYogi I wasn't criticising you just concerned about you.

I have felt stigma and judgement around our decision to start a family and found myself worrying about being judged if I choose to take medication. Normally I don't care much what others think about me but the idea of being thought a bad mother is just too much. I don't know if it's the anxiety talking but now but I'm worrying if I'm struggling to do what is right for me now for fear of judgement will it be even worse when we are making parenting decisions once we actually have a child.

@pinkdonkey Tbh I think that is a valid fear; as women we get judged for almost everything we do and the choices we make regarding pregnancy/parenting are no exception. Plus there's stigma and misunderstanding around mental health as the icing on the cake. So really it's not surprising we worry about being judged, we may well be. But the people in my life who matter won't judge me and basically f*ck those that do, is my current attitude! Just got to work on being kind to myself. To me it's sounds like you are caring and thinking about the decisions you make re: meds & ultimately it's not your fault you are unwell and needs meds. X

Thanks, normally I don't care what others think either, I think it's the anxiety being bad that is magnifying all my little bits of self doubt. Maybe it's me who is worried that taking medication that carries a risk however small does make me a bad mum, even though in my head I know that it doesn't and not looking after my mental health is not an option and actually not looking after myself and letting myself get more unwell would actually be worse for all concerned. I suppose it's more a case of me judging myself that's the issue. We are lucky that DHs mental health team are incredibly supportive of us starting a family. I'm trying to get an appointment with my family liaison CPN as he is always able to reassure me and make me feel better.