How did I get here, crying in my bathroom at three in the morning?
The answer is, one little word from my doctor during a med check: “Good.”
It was a simple enough question during the visit that led to the prescription my first ever anti-anxiety medication. “You’re not planning on having kids any time soon?”
“No,” I answered, still sniffling from breaking down and confessing how awful my quality of life currently was.
“Good. We’ll try Lexapro, 10 milligrams once a day.”
At the time, that “good” didn’t set off any alarm bells. And I genuinely meant what I said about not planning to have kids any time soon. I was such a mess at that point in my life, the idea of taking on the responsibility of growing and raising a tiny human was enough to set off yet another anxiety attack. I was so exhausted from trying to pretend everything was OK I was on the verge of a true breakdown. Kids were the last thing on my mind. I started taking medication, tolerated it shockingly well, had no side effects, quickly found a few coping skills that worked and never looked back.
It’s now six months later. I feel like a brand new person. On most days, I engage in zero compulsive behaviors and am able to turn off most obsessive thoughts. On worse days, I can turn the thoughts down and manage not to perseverate on them using cognitive behavioral therapy techniques. I am not picking my skin more than once a week, and have gotten at least six hours of sleep every night. My thoughts and emotions are mostly under control, and I feel like my life is back on track.
Until last night, when all of a sudden, I heard my doctor’s voice in my head say, “Good.”
And I couldn’t turn it off or push it back down. And I couldn’t fall asleep.
So I did the thing I tell all of my clients and their families not to do under any circumstances, which I am not at all proud of.
I rolled over, picked up my phone, went into the bathroom and shut the door… and Googled, “What anti-anxiety medications can you take while pregnant and breast feeding?”
At three in the morning, after four and a half hours of clicking on link after link after related link, I started to cry. Because the consensus of Internet-land is you really shouldn’t take any. Unless it’s a matter of life or death, and your obsessive compulsive disorder (OCD) or anxiety is so severe it cannot be managed without medication. And if you do take it, you will most likely be labeled a high-risk pregnancy. And in the third trimester especially, you can do unknown damage to your unborn child.
And then the obsessive thoughts began: Is my OCD and anxiety that severe? Do I want to be labeled high-risk? Will that limit my choice of doctors? Will this mean for sure I won’t be able to have a midwife and deliver in a birthing center and be stuck in a germ-infested hospital?
Because here’s the thing; having a child is something I do want. And I’m very much in favor of a natural pregnancy and delivery, vaginal birth and no epidural. Preferably in a nice clean birthing center with a midwife. And breastfeeding. And cloth diapers. And homemade baby food. You get the picture. Before I started taking Lexapro, I didn’t like to take medication at all. It had to be the worst migraine ever for me to even take Ibuprofin. My husband and I had said 30 was when we’d start trying to get pregnant. That’s in July for him, November for me.
But then life happened, and a lot of stressful events piled up on me at once.
One of my clients broke my foot in September. And we put in a bid on a house.
In October, my grandfather, who we lived with to help care for, was suddenly diagnosed with cancer and passed away two weeks later. He begged me to bring him home to die, which I did, and we started round the clock hospice care. My grandmother and mother were devastated and since my mom is an only child, I planned the funeral and did all of the hosting, etc.
In November, we closed on our house and adopted a kitten. And my brother and sister-in-law split up, and she took my nephew and moved back home to Florida. And I accepted a new client which added 10 hours to my caseload. I was burning the candle at both ends with moving, nesting and working. I drank more coffee and slept less. And started picking my skin again.
In December, I stopped sleeping abruptly. I was already unable to sit still for longer than 15 minutes without compulsively straightening and organizing. I paced all night to try to wear myself out and keep the obsessive thoughts at bay, anything from what if I got sick and died to what if the hot water heater breaks. I became forgetful and short-tempered. And we rescued another kitten. And one of the kids I worked with was constantly in crisis. And my psoriasis went from covering five percent of my body to 30. I tried to push back the little voice in the back of my head that said, “If a parent was describing these symptoms to you, you would recommend an evaluation.” I work with most of the psychologists in my area dealing with the kids I work with, and I was reluctant to mix business with personal.
All of this led to me sobbing in my primary care physician’s office. He’s known me since I was born, and has always checked in during routine appointments about my OCD.
And so, “You’re not planning on having kids any time soon? Good.”
I know I should give him a call and talk to him about this. Maybe call my OBGYN, too. But the truth is, I’m terrified they’ll say, “Well we can cut back the medication slowly and see what happens.” Or, “We really recommend coming off of it all together as soon as you start trying.” Because, since I’m already being so honest, I don’t just feel better than I did six months ago; I feel better than I have since sophomore year of college.
I have an appointment at the end of July, and I’m working up the courage to bring this all up. Maybe I’ll show him this article. Or if I can’t sleep again tonight, maybe I’ll call tomorrow.