First trimester + panic disorder + low blood pressure

[Alear]

Jesus H Christ! Im just 6 weeks pregnant and I feel like everything is out of control.

Conext first:
Im medical doctor and during the pandemic I started having horrible panic attacks for which I have to take clonazepam 0.5 daily (klonopin/rivotril). Im also doing a lot of therapy, alternative practices like osteopathy, yoga, reiki. I also exercise frequently. But all this is, truly, palliative. I cant quit clonazepam because even if I lower my dose to 0.25 symptoms can be terrible. My psychiatrist that specializes in obstetrics is, tbh, quite ok with me taking clonazepam. She says my dose is very very low.

On the other hand I suffer from really low blood pressure which make me prone to feeling dizzy and not generally well. Something that has gotten even worse since I became pregnant. Which is fairly common but feeling dizzy triggers me to no end. I fear fainting with a passion.

And this has become a cycle of self loathing where feeling dizzy triggers my panic and ai have to double dose to calm down which makes me feel terrible for having to deal with this instead of enjoying my pregnancy. I feel like Im putting baby embryo at risk all the time either by being stressed or by taking the medication that keeps me from being stressed. Everybody tells you you just need to relax, but its becoming quite hard tbh.
Anyways, thank you for hearing me ramble. I just felt very alone in this and I didnt know who to talk to. My friends and family are very supportive but they just dont get it.

sending you hugs OP. I don’t have any advice about the panic attacks etc but I can empathise with the guilt… when I was pregnant I suffered from terrible migraines and although sometimes I suffered through without my meds, sometimes I just needed to take them to make the pain go away… so I’d take them and then feel super guilty about what I was doing to the baby. Then the worry would trigger another migraine and the cycle continued!

Please just know you are not on your own. It’s easy to say keep calm but that’s not so easy to do, so I wouldn’t stress yourself out stressing about stressing. Whenever stress hits, I’d maybe make a point of thinking of 3 things in either really grateful for right now or 3 things in super looking forward to!

wishing you all the best xxx

I’m, not in*

I don't have any advice but wanna send some love. ❤ I always have low BP and especially did in the first tri.. however I now have normal BP being in the third. Xx

In addition, my perinatal psychiatrist has just prescribed me benzos.. not ideal, but we have to do what we can to cope. Hope you feel better. X

@Alear what about starting sertraline? I had terrible anxiety before my first child and a fear of panic attacks and was taking beta blockers to cope. I didn't know how I was going to get through pregnancy without relying on the beta blockers by my GP told me this wasn't safe so she put me on sertraline. This addressed my general anxiety (pretty much took it away) so that I was no longer fearful of the panic attacks. And I didn't need to rely on the beta blockers at all throughout pregnancy.

I'm guessing seeing as you are working with a dr they have probably suggested this but just thought I'd add in case you hadn't .

Sorry to hear you're struggling, OP. Please don't feel you have to enjoy your pregnancy. Pregnancy is not enjoyable for a lot of people. Why would feeling ill for months on end be enjoyable? Obviously you can get excited about your new baby but you don't have to enjoy it.

At 6 weeks I am sorry to say things will probably get worse before they get better. I would recommend you try meditation/breathing techniques to help you alongside your medication.

I also suffer with low blood pressure and it's the second trimester that is worse for this. As soon as you feel it coming, sit down (even if it's in a shop/on the floor on the street/anywhere) and have salty snacks at the ready whenever you're out. If you're careful like this, you'll be fine. I am 18 weeks and was pretty much constantly in bed with loads of vomiting first trimester, second I've been in bed with low blood pressure and back pain but recently feeling better so getting my exercise done before it all gets awful again when I hit the third! Also had previous MMC so my anxiety has been insane.

Your baby will be fine despite your mental health problems and how much or little exercise you do. Try to tell yourself this when you're feeling guilty and remember you're not alone - we are struggling with you! It's okay to struggle and pregnancy IS very hard for some of us. Take things one day at a time. Wishing you all the best for the rest of your pregnancy.

Thank you all for your kind comments. They honestly made me feel better and not so alone. Im feeling a little bit more optimistic today and Im seeing my psychiatrist on Monday. She probably wont change my medication, but Im sure I will cry my eyes out and I feel like crying helps me get through anxiety a lot.
She once told me she has seen many many many women with sever psychiatriac disorders (including psychosis!) that are medicated heavily go on to have healthy babies so I shouldnt worry too much about taking a low dose of benzo.
I will keep you updated in case someone else goes through this in the future, so they know they are not the first and probably wont be the last.

As for the blood pressure, I will make sure to drink plenty of fluids, way more than I am. And I will try to eat more often, specially salty foods. Low BP is nasty but I guess it beats having high BP like my mom did hehe

Again, thank you all for your comments!

You are not alone! I am a psychiatrist and have taken zopiclone 7.5mg from my junior years as couldn’t deal with night shifts. I’m 8 weeks pregnant and am managing on 1/4 of a tablet but I too am crippled with guilt (made worse by the fact that I actually am no longer prescribed zopiclone and have a family member on same). As doctors we are not exempt from irrational worries. As a psychiatrist we also look at risk benefit and realistically a well mum is the most important thing.

Thats what my doc always says! She would rather have me taking clonazepam than having panic attacks when pregnant or living with fear of getting one. And that sounds totally reasonable and its the same advice I would give any of my patients (although im an internist). But I guess its a do as I say not as I do scenario :/

Hey. I have self medicated with clonazepam for the past 7/8 years - 2mg daily. When I fell pregnant last year I was terrified as I found out at about 10 weeks and had been taking daily until then. I then began to wean off as thought it would be dangerous to just stop after how long I'd been taking it. I tapered my use down massively and was taking 0.5 every few days by the end of my pregnancy. I didn't stop completely and I did feel really guilty throughout worrying something would happen but I was a mess without it as was also going through abusive relationship whilst pregnant. I saw a psych who obviously advised against self medicating and prescribed me sertraline which I was cautious of trying so didn't ever take it. Baby was born in June completely healthy and is thriving. wish you all the luck xxx

Thank you for sharing your story!
Quick update, went to my psych today. She switched me to lorazepam since it is apparently safer than clonazepam. She was by far more interested on how I was coping with the technical details of pregnancy (are you comfortable with your obgyn? When are you getting your first sean? Do you have a room ready for the baby? That sort of stuff).
She reinforced the idea that a mom on benzos is safer than a mom with panic attacks.
And she told me that I was doing really well.
And that totally broke me, in a good way.
She also told me to take a few days off of work if I felt to overwhelmed (I usually dont need to take benzos when Im off work).
All in all, I think I might just be able to pull through this :)
Loves and Hugs to all moms out there that are on some sort of psychiatric medication and feel terrible. You are not alone.
Fingers crossed lorazepam does its magic

Thanks for the update @Alear . I wanted to add- I actually found that my anxiety improved throughout my pregnancy and since becoming a mum. My panic attacks were strongly tied to my work and since becoming a mum I've come to expand my identity to other areas of my life, care less about work as what's really important to me is being a mum! I hope you get the same experience and I'm glad your psychiatrist gave you some reassurance.