Side affects of medication for depression and anxiety

[Farawayfromhere]

I suffered a long, ongoing period of trauma whilst pregnant and following that some very severe anxiety and postnatal depression after the baby was born. I thought about death continually, felt incredibly anxious to the point where about 1 in 3 nights for several months after I had the baby I stayed up on guard the whole night in case someone broke in to take my children or a war broke out and we needed to hide in the cellar or pack up the car and escape. I lost all sense of myself, could barely function and was very, very angry and irrational.
Looking back there were points when I completely lost all hold on reality. I thought I had a brain tumour and that my children would die of various rare diseases. I would think about it all night over many weeks. It was awful and gradually got better over about a year but I didn't tell anyone and didn't seek help until my child was about to be one because in part I knew something was wrong and also because I felt at the time that people would not take it seriously and this could jeopardise the children's safety further.
I tried talking therapy which helped a bit, but again didn't want to admit the extent of it, and I've found that although the anxiety has lessened over time I'm left with what I think is more severe depression than before- I feel exhausted, find it hard to motivate myself to get dressed or shower and feel like everything is meaningless and pointless.
I know this is so shallow but I have worked hard to lose the baby weight and exercise lots and eat healthily and I'm worried that starting medication will make me fat again, which I think will make me feel even worse.
Does medication always cause weight gain? It sounds so shallow and I really need to try and get on top of this as it is ruining my life, but I am scared to start medication. Thank you!

It really depends what medication it is, and on you. Do you know what medication you're likely to be going on? Weight gain is normally associated with antipsychotics. I didn't experience weight gain from antidepressants, but I did when I started taking Quetiapine.

Different medications have different side effect profiles. Some antidepressants do cause weight gain (two have for me, a tricyclic and an SSRI), but you can minimise it if you're aware of it. You have to understand how the medication works, for instance quetiapine (an antipsychotic sometimes given for depression) alters the metabolism and how you process certain foods and handles blood sugar, so weight gain probably won't be stopped by being judicious about diet and exercise.

Best thing to do is research user experiences of different medications and then discuss prescribing with your GP based on your preferences. You're most likely to be given an SSRI so start there. I find user experiences are best rather than scientific research stuff - for instance, the manufacturer of quetiapine says it causes moderate weight gain of about 4-8 pounds but user experiences will tell you it's more like 4 stone plus for many people (you won't be offered quetiapine by your GP!)