Early pregnancy and anti depressants - please help

[jacquettalux]

Hi everyone,

I have recently (within the last 3 months) experienced several life stressors (work stress, shingles, bereavement) and my sleep has just gone to pot. This has happened once in my life before (during Covid) but was rectified by a short course of zopiclone. This time I have continued to struggle with sleep - often only getting a few broken hours a night. This has triggered anxiety and I am experiencing absolutely horrendous anxiety at night which terrifies me. I am also getting anxiety in the day which I am less resilient to as I am exhausted.

I started a CBT-I course for insomnia but the night time anxiety prevents me from taking the 'laid back' approach to wakefulness that they want me to achieve. I can read, watch tv etc but ultimately I am sat there at 3am with a racing heart, nausea, numbness etc. My anxiety in the day is also getting worse.

I am having talking therapy but only one session in. I have been doing this sleep course and relearning healthy habits about sleep. I am doing all of the good lifestyle stuff to try and improve my mental health.

Last night and today have been particularly awful with sleep and anxiety. I feel so so anxious and frightened that I'll be stuck like this forever. I am literally terrified and ruminating on worst case scenarios. I have spoken to several GPs, a MH nurse and sleep coach. No one is offering me consistent guidance and I feel so at sea.

I also found out that I am around 5 weeks pregnant with a much wanted baby. I feel numb. All I can focus on is my anxiety.

I am due to speak to the GP again today. Previously they indicated that antidepressants were only useful for anxiety when the person also has depression (which I don't feel I do - when I get a good natural sleep, I feel fine). However I am now desperate to feel better and feel really scared. I can't look forward to anything in my life.

Does anyone have any experience of taking anti depressants for anxiety or taking them during pregnancy? I do not want to hurt my baby. I would be so grateful for any experiences.

Spoke to a GP and he wouldn't describe Sertraline as I'm 5 weeks pregnant. I feel so low and frightened. I have found a private perinatal psychiatrist so hoping they can help me somehow.

Sertraline is safe in pregnancy, baby might need a little bit of monitoring after being born to make sure they adjust to the outside world ok. Some babies struggle to adjust in the first 24-72h and just need a little bit of monitoring some medication increases the likelihood of this happening a little.

I would try another gp and ask for a consultation with the perinatal team. Get the referral in with the midwife quickly they should be able to advocate for you too.

I have bipolar and am on an antipsychotic to manage my moods. Due to this I will be under a consultant at the hospital who specialises in maternal mental health in pregnancy. I was on this medication when I had my daughter too and the consultant was very clear it is better to be on medication and well than not on medication and struggling. When my daughter was born she was in hospital for 3 days and every 4 h they checked her temperature, alertness and her pulse/sats etc. she passed every one and was able to go home. I went on to breastfeed on my medication and three different antidepressants. It was only when I had to go onto lithium that I had to stop breastfeeding. So if that's a concern for you there are definitely options.

I have also had anti emetics prescribed quite easily for hyperemesis as they were very keen to minimise the impact that the sickness was having on my mental health too.

Thank you so much for your response. It has brought me some peace.

I am seeing the psychiatrist next week so just need to get by until then. I am so scared. I feel really numb and this is a pregnancy I desperately wanted. I really hope medication can help me. I have tried everything else.

I took sertraline while pregnant. My doctor advised it was fine and actually the risk to me off coming off it was greater than continuing with it.

I would second what the poster above has said - ask for a referral to the perinatal team. They were great with me. I had experienced a traumatic event just weeks before I found out I was pregnant and was a total wreck. The combination of medication and support from the perinatal team, plus counselling made a huge difference.

Thank you so much.

I think the concern is because I'm not yet on it, so I don't think the GP wants to run the risk of starting it.

Can I ask how quickly Sertraline worked for you? My symptoms are high anxiety, low mood, no energy, tearfulness, poor sleep. I feel so scared.

@jacquettalux my symptoms were quite similar. I was crying a lot and didn't really trust myself to go out in public, couldn't sleep, and generally just felt wretched. It was fucking bleak. The insomnia was a huge issue and I was unravelling.

In terms of time frame, it was 5 years ago, so am not sure how reliable my memories are, but I think I recall it helping with my sleep fairly fast (in a few weeks), and taking slightly longer to help with my mood, maybe about 6 ish weeks.

Your Dr will have weigh up the risks of starting you on it (or on something else) against the risks of not.

Sertraline has been hugely helpful for me. Essentially, it got me functioning to the point I could start to address some of the other issues going on in therapy. I was too vulnerable to do so without it.

The perinatal team kept a close eye throughout pregnancy and provided extra support after my DD was born.

Please don't give up hope.

And feel free to DM if you want to discuss further, am happy to chat.

Thank you so much for your kindness in replying and reassuring me. How do I send a DM from the app?

I've also just read up a bit on early pregnancy and have reflected that perhaps some of my symptoms (high emotions, low energy) could be due to the pregnancy itself?

I was on Venlafaxine when pregnant with an unplanned DS3, I was switched to Prozac, and given early scans to check he was ok
I then restarted Venlafaxine after his birth
This was 22 years ago so I think there will be many more safe medications
The important thing is to inform them asap

Sorry just reread you haven't yet started
The same applies.
Your symptoms sound like Depression to me possibly exacerbated by hormonal changes, but please accept treatment. If it works well, you can enjoy rather than endure your pregnancy

@jacquettalux I hope I can add to the reassurance. I have been on and off Citalopram (but mostly on) for the last several years and I'm currently on it. I'm 13 weeks pregnant and everything is looking really good.

I was diagnosed with anxiety and depression but, to be honest, it's predominantly generalised anxiety. I checked with my doctor when I started trying for a baby and he had absolutely no concerns. Nor does my midwife. They said they see so many women nowadays on anti-anxiety medication or antidepressants. I can't speak for any others but I know Citalopram has no link to any pregnancy issues - well, that's what I've been told.

Different medications will have different effects. But the main thing - which my doctor told me when I spoke to him - is that you yourself are in a good space, physically and mentally. I would not be dealing with this anywhere near so well if I weren't on my medication. It has been genuinely transformative.

Good luck. I hope you find something that works for you 🤗 x

@jacquettalux yes, the pregnancy hormones etc will also be kicking in and having an effect, so some of it may well be related to the pregnancy, in addition to the underlying issues.

I'm on the desktop site, so not sure how to message via the app but I will see if I can message you!

Thank you so much for taking the time to respond. I am definitely willing to accept help. Did medication make a big difference to you?

Thank you so much. You have hugely reassured me. I felt so alone before this thread.

Has medication been really effective for you? How long did it take to see a positive difference?

Good luck in your pregnancy. Thanks again.

Thank you!

I feel a bit reassured by what I have read e.g that some of my exhaustion may be pregnancy related and not serious depression! I appreciate that there is definitely a mh element though.

I will log in to the desktop later today to see if I've got it. Thank you.

@jacquettalux In terms of timings - and this is specifically for Citalopram, and obviously everyone's experience is different - I genuinely started feeling better about two weeks into it (before then I already felt better but I'm sure it was just relief and psychosomatic!). With this particular medication they ease you into it, so I had 10mg per day for two weeks and then 20mg a day after. I'm still on that now.

I cannot overestimate the effect it has on me, both personally and professionally. I have a job where I have to give a lot of tours and lectures, and it can be daunting. The Citalopram has helped quieten down the background noise and panic, and given me the space to be myself again.

I would also stress: you are not alone. I'm 39 and my two closest friends, plus several of my female colleagues, take medication too, and find it enormously helpful. Now, obviously there's a conversation to be had about what kind of world makes capable, successful women feel that they need this kind of help... but for now, I'm just glad it exists.

I wish you all the best. Citalopram may not be the right thing for you, but if not, hopefully you'll find something else that works. I too tried CBT and it really didn't work for me, so this has been the perfect solution for me.

Yes, it made a huge difference I was able to feel a connection with DS,
I was able to happily prepare for his arrival and he had no adverse affects after birth.
He's now 6' healthy and successful
I hope you feel better as pregnancy progresses

@Normallynumb and @UrbanSquirrel Thank you both for replying again. I am feeling hopeful.

Thanks to all of you lovely people on this thread, I spoke to the GP again today. It was a different GP with more experience of mental health. She prescribed Sertraline without hesitation.

I am collecting the prescription in the morning. I am feeling so, so nervous. Please send me some strength. Thank you all again

OP, I hope this reassures you.

I have been on fluoxetine (same class as sertraline) on the maximum dose for both of my pregnancies. I am also on quetiapine, an antipsychotic.

I saw a private perinatal psychiatrist who confirmed to me it is a case of balancing risk and benefit and in my case, the benefits clearly outweigh the small risks.

The risks for SSRIs during pregnancy are fairly low. Your GP would have been reluctant prescribing as they are not an expert in this field but your perinatal psychiatrist will put your mind at rest I am sure.

I had two healthy babies. My second had slight SSRI withdrawal at birth which settled after a day, and I was advised not to breastfeed. But all fine.

Please try not to worry OP. Sending you a hug.

Sorry Op just seen your update. So glad you saw a different GP and you have been prescribed sertraline. This is good news. It is so important you stay well for your own sake, as well as your baby's.

Take care.

I'm glad you saw the GP, who seems to have a good understanding of MH.. lots don't
Please don't be nervous, this medication is safe and won't harm you or your baby
It's so important that you are well and happy, to give him/ her the best start
Don't hesitate to lean on your midwife.
There is also Perinatal services should you need their input, so you are not on your own
I hope you feel better very soon
Take care of yourself

Hi everyone. I just wanted to provide a little update and perhaps get a bit more reassurance.

I've now been on Sertraline for 10 days. I have already noticed a positive improvement in my mood - far less anxious in the day. Initially I also noted a positive improvement in my sleep initially.

However, the last 2 days I've felt a bit jittery / shaky and this seems to get far more severe in the night. It's like i'm wired. I feel jittery and unable to settle / calm my thoughts. I'm finding it really upsetting.

Can anyone reassure me about whether this will settle? I will also speak to my GP on Monday. I just so want this to work for me.

I meant to also thank you all again - your support was so helpful at a really low point. Thank you.

Have you ever had antidepressants before?

In certain people antidepressants can trigger moods to rapidly shift from depression into hypomania/mania. I'm bipolar and I am sensitive to antidepressants and they can send me manic in hours

Mention it to people you live with to keep an eye on you and reach out to professionals on Monday or via A&E if things get out of control.

I'm so glad they are starting to work for you!
It may be the effects are due to the stimulant effects of the antidepressants which is a positive sign they are working for you( waking up the brain, if you like)
That will lessen and disappear once the side effects wear off which they will
Do seek advice from your GP as they will keep an eye on your progress
Take care of yourself