A Zolo PSA / Thoughts about my future practice

First of all, all of your loving comments yesterday make me all warm and happy and gushy. I love you guys!

Secondly, I want to write a quick post about Zo.loft. I am going to start weaning off of it now. I’m on 50 mg a day, and my OB says to start taking it every other day for two weeks, and then stop. I’m glad to be doing so, just so that there isn’t anything “extra” floating around in my system…

That said, I want to make a kind of PSA about this antidepressant. I have now heard from four very well-respected doctors that some women stay on 50 mg a day (the lowest dose), or even higher doses, throughout their entire pregnancies and after birth, with no complications. I’m making the decision that it is not necessary for me, but in many cases, the benefits of staying on it far outweigh the risks.

Anyone who is experiencing depression right now, reactive depression from infertility, I urge you strongly to consider talking to your doctors about going on an antidepressant, particularly Z, which is known to be one of the safest during TTC-time and pregnancy. So many things helped me get to a better place, mentally and physically, this time around—changing my diet, extracting stress from my life, art therapy, energy healing, and so on—but I’m not sure if I would have been able to make every one of those changes, or enjoy their benefits so readily, if I had not gone on good ol’ Zolo.

Yesterday, my therapist talked about why the drug was so important for my recovery. In a phrase: recurrent trauma. I started out with 100% serotonin in my brain. The neurons were talking to one another as they should, for the most part (although I might venture to say that there was still some residual damage going on from the divorce-era of my life). The first loss came, and let’s say my serotonin dipped down to 75% (these numbers are not scientifically accurate, obviously! But demonstrate a point). I rested for a couple of months and was able to bring that level of serotonin back up to, say, 85%. Then I had another loss. For this second loss, I was no longer handling it with 100% serotonin—I was weathering it with only 85%. But the second miscarriage damaged my serotonin just as much or more as the first miscarriage, bringing me down from 85% to %60. Perhaps I was able to repair to %70. But the third loss knocked me from 70% to 45%….

You see the pattern. With recurrent trauma, your poor brain is never able to fully repair, and each time you experience something devastating, you are facing that experience with less and less. Your neurons are not talking to one another in the way that they should. They are getting stuck and isolated. It is impossible to fully repair your brain on your own, at that point. Once you start taking an SSRI, you give your brain a chance to repair itself. I think, this past healing phase, I was able to repair my brain back to 100%, or close to it.

I would love to be able to conduct a study of women with infertility, looking at pregnancy outcomes both with and without antidepressants. I don’t think of zol.oft as a crutch; I think of it as one more tool in strengthening the mind-body connection, an east-meets-west approach.

PSA finit!

I am still glowing. Yesterday I was a blissed out mess. Today, I will go to the bookstore and get one of those pregnancy-through-birth planner thingies, because I have not allowed myself to “go there” yet. I’m realizing that I have to start making the transition to a more forward-thinking phase. I’ve been thwarted so many times that I have not allowed myself to even consider what I want to do this pregnancy—do I want to find out the sex? When do I want to visit family? When can I travel? What sort of birth do I want to have? What hospital? When are all of the important tests supposed to happen? How are we going to turn that “creative room” into a nursery? Should I take a prenatal yoga class now? I’ll figure it all out. I’m not anxious about it, just still having that slightly off feeling, like it’s too soon, like I’m not “one of them” or whatever. But whatever! It’s just a feeling. It can happen all it wants, and I can acknowledge it and move on.

I’ll be getting instructions from Dr. Shapiro today. My RBA nurse says that he will most likely be asking me to start decreasing my medications today. Oh, wow! Wow. That’s just—wow. Crazy. I’m kind of agog. Brand-new territory.

But I’ll be in the good hands of Dr. San Roman up until week 10. He said he usually sees patients only until week 8, but I’m a “special case” and he doesn’t want to let me go so soon. That’s all right. I really like it there and will actually be quite sad to leave. Those people have shown me what good medical care can be. I have a fantasy of being their staff social worker, with my own little office, there to counsel women if they receive bad or uncertain news. Wouldn’t that be amazing? But: we don’t want to stay in LI much longer. But maybe I can find a job like that in the next town where we live.

I’ve also thought of being a Skype counselor. Creating a partnership with fertility clinics and OB offices across the country. Having them give my card or brochure to women who are struggling, and particularly to women who are in crisis and need support and empathy and guidance right away. Maybe we could even do Facetime? I don’t know how it will shake out, but I definitely want women to be able to contact me immediately. I’m not sure how payment would work—perhaps pro bono at first, and then, if she wants to continue counseling, something like Paypal. I’m getting way ahead of myself! I don’t even know if I would be allowed to do such a thing yet. I’m a licensed clinical social worker—LMSW—but if I call myself a “coach” or “counselor,” is an LMSW all that is required? Or would I need my “C” (LCSW) which would require more years of supervised work experience?

Brainstorming. My mind, so preoccupied for so long, is starting to tip-toe into other territories, is starting to allow me to explore, and plan, other areas of my life.

Time for me and the little one to go the bookstore now…

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19 Comments

  1. So… Question for ya. If it’s too personal, don’t answer. But: I seriously considered going on Z because I struggled with postpartum depression, due to my birthing experience, lingering infertility emotional trauma, and my son’s health scares, etc. But I was scared when my midwife warned that many women lose the ability to have orgasms and experience decreased sex drive. Even at 50 mg. Do you have thoughts on this?

    Reply
    • Well, I have gone on it twice in my life now, and both times, the same thing happened: There is a period of about, I’d say, a month during which it was not impossible for me to have orgasms, BUT it took quite a bit longer to reach climax. I am unable to have genital orgasms—I have only clitoral-stimulation orgasms—whether or not I’m on medication, so it was not too much of a big deal for me. DH and I have fantastic sex (yay) so we’d just do our normal, I would get my usual very worked up, and then instead of him going down on me in order for me to “finish”, I would have to use a clitorial stimulator while he did other things to me. (Sorry if this is TMI–I’m very open about sex! Maybe more open than the average person.) During that same month, I experienced bazonkers fatigue for a period of about two weeks. Once I got through both of those phases—the longer-time-to-orgasm and crazy-fatigue phases—all side effects pretty much went away. Now, I can’t tell I’m on it any longer. So I always tell people who are interested: If you can just *hold on* through a few weeks of adjustment, you might get to a place of having zero side effects. As for my sex drive—it was 100% the same. In fact, I think I might have even been a little hornier, because I was feeling happier. If you’re still struggling, it might be worth a spin…x

      Reply
  2. I am so glad it is working for you. After reading this I kinda want to try it again. I took it years ago but I don’t remember the dosage. Whatever it was, I couldn’t handle it. Thanks for the info…

    Reply
  3. You know that I second this post! Huge fan of the Zoloft! I have no anxiety or depression diagnosis, but that stuff really helped me cope through IVF!!! I highly reccomend it!

    Reply
  4. AndiePants

     /  April 25, 2014

    I’ve been on anti-anxiety medications for years to manage debilitating panic attacks, and was terrified when we started TTC that I’d have to figure out life without it. We are lucky to have a great center on prenatal and maternal depression at a University Hospital here, and after consulting with a doc there I was able to find a drug that I could stay on throughout pregnancy without concern. I’m so very grateful. And I am grateful that you are being open about using zo.loft and your experience with it, because I think there is a weird culture where women feel like they have to completely eliminate medications and perhaps face some very dire consequences. Thanks for having this conversation openly.

    Reply
    • Absolutely! Thanks back. It’s important to destigmatize all of this, from diagnoses to medications. There’s no shame in our game. (: So great that you found excellent care and guidance, because yeah, there’s just no need for you to possibly have to face panic attacks throughout all of this. I totally agree with you that there is a culture of elimination—and guilt if you decide to prioritize your mental health over being medication-free, like you’re being selfish, threatening your baby’s health. It just doesn’t work like that. These medications help us make healthier, saner choices, help us maintain our relationships, and help our bodies calm the hell down and create a peaceful space for life to begin.

      Reply
  5. We had a telephone (option of Skype) counselling session before paying our gob of cash to our old clinic for the DE process (which was non-refundable but I console myself knowing a chunk of it went to said counselor, who was great). Pre-DE IVF counselling is mandatory where we live and is advised in other places. Her and her partner (another counsellor) have an entire established practice serving the infertile/donor conception/surrogacy/gestational carrier “community”. If you want more information or their website so you can get some ideas for your future career, e-mail me.

    Meanwhile… glad Dr. SR is keeping you in his clutches a little longer. I wanted a home birth but my guy barely stayed conscious at our hospital birth he was so stressed so it wasn’t an option (and then birth became a medical emergency so it wouldn’t have been an option even if I’d insisted previously). I hired two doulas – one for DH (so he wouldn’t crack his head open on the floor when he passed out – which he didn’t only becuase of his doula) and one for me. I loved my doula, will hire her again if we get a chance, and DH’s doula encapsulated my placenta (the 2 doulas are partners in their practice so get along really seamlessly). I’m throwing this out there as food for thought. You’re a long ways off from really having to worry about this but since you’re mulling… I’m sharing the small wealth on which I draw when I fantasize about having another successful pregnancy. Either that or I’m living vicariously? So happy you’re in the midst of just such a pregnancy. Yay, yay, yay!

    Reply
    • Thanks so much for the info! Oh, your DH! I’m glad he had his own doula. I’ve never heard of that, what a great idea. Yeah, I’m still tip-toeing in, but did buy one of those pregnancy-to-birth planners and am reading the lists of all the things and things and things. A tad bit overwhelming, but once I delve into it, I’m sure it will become my next all-consuming project, complete with binders, notebooks, dividers, etc. I’ll try to tame the chaos with organization like I usually do. (:

      Reply
  6. Former Z user

     /  April 25, 2014

    FYI I was on Z for ppd with my first. I weaned as you did–every other day for a couple weeks then stopped. I ended up feeling really dizzy and sick for about 2 wks after that.

    With my 2nd I also got ppd :(. I took Lex and this time I didn’t do the every other day thing–rather, I went from 10 to 5 every day for a month, then down to 2.5 every day for a few weeks. This time there was no dizziness or sickness.

    Maybe that reflects the differences in the drugs but I suspect it was the way I weaned.

    Reply
  7. Julia

     /  April 26, 2014

    I’ve waivered so many times on making the call to my doctor to get an antidepressant. Seasonal depression runs in my family. If next fall we’re still in the same place, I’m going to talk to my doctor about it.

    Thanks for the infomercial :)

    Reply
    • Ah, I’m glad you’re considering it. At least having a conversation about it with a doctor would be good.

      I know it’s not an idea you hear about much out there, but I just wonder if antidepressants and antianxiety meds—Zoloft is a great combination of these—actually *help* pregnancy by calming the systems of women who have experienced recurrent trauma. I wish there were some literature out there about it. It seems like all we hear are the possible negatives.

      Thinking of you always.

      Reply
  8. Good luck with lowering your dose. I actually tried to drop from 100mg of Zoloft a day to 50 but I wasn’t feeling so great, so back up to 100 now. Part of me feels like I failed, upping the dose. I want the best for my future children, but I’m slowly realizing I need to take care of me too.

    Reply
    • No shame! You are doing the best thing for your future children. I’m so glad to hear of your realization. Your good mental health will help you make good choices. I admire your strength in realizing what your mind and body need right now—it’s not easy, with all of the stigma. Hurrah for you!

      Reply
  9. Tess

     /  May 1, 2014

    You would be an awesome fertility therapist.

    I’ve been on Buspar, but this makes me wonder if I should try Zoloft! One of my friends went on it, and it helped her get through a miscarriage.

    Reply
    • Wopes, I somehow missed this comment—hey, thank you for saying I’d be an awesome fertility therapist! I hope so. Sometimes I wonder if the material is too close to me, but then I realize that with the passage of time, I will develop the proper distance.

      Reply
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