Shira Boxer is a certified school psychologist and DIR/Floortime practitioner specializing in early intervention planning, implementation and advocacy for children age five and younger.
I got pregnant as soon as we started trying. I was in my 20’s and had only been treated for general anxiety disorder and Attention Deficit Hyperactivity Disorder for two years of a very untreated life. I spoke to a reproductive psychiatrist who – without much information or data – recommended I go off all of my medications. Ten weeks into the pregnancy, I had a miscarriage. The process was drawn out and traumatizing. Because I had wanted to get pregnant again immediately, I didn’t go back on my meds. I wish I had someone telling me that it would be okay.
The fear of prolonged infertility and more miscarriages was terrifying. I suffered from situational anxiety, which isn’t great when your baseline anxiety is also there. It took me 14 months to get pregnant. Those 14 months would have been hard regardless. My SSRI would have made it more palatable.
When I did become pregnant again, I was happy and calm. The hormones did good things for me. This does not happen for everyone so I knew I was lucky. After delivery, I felt an instant shift. I was filled with fear and dread. I had a complicated birth, and both my baby and I were sick and hospitalized. With some time, we both recovered physically. The provider I was seeing did not prescribe medication while nursing. So again, I suffered. I had a touch of postpartum depression and postpartum anxiety. I didn’t want to be alone during the day and it took me years to admit the intrusive thoughts I sometimes experienced. These were symptoms that I knew were easily treated with the antidepressants I was on before.
I got pregnant again nine months later, and again went without my meds. The postpartum anxiety and depression didn’t last more than a few months and although not at my best, I wasn’t at my worst. Nursing didn’t work with my second child, so I was able to go back on all of my medications. It came at a good time – I had two babies under 19 months old. I was able to engage happily with my children, and remain focused, present, and calm.
Looking back, there weren’t enough resources for people like me. There weren’t many people openly discussing these struggles. I needed articles written by experts in the field and I needed peers who had gone through what I was going through.
“It took me years to admit the intrusive thoughts I sometimes experienced.”
I had always wanted a third child. I needed to recover for seven years from having two so close together. But I did want a third. I wasn’t sure I could have another baby, because I wasn’t willing to go another long period of time without my medication. I was older, I had two kids, and a career that required executive function, focus, and calm.
I’m forever grateful to Dr. Carly Snyder, a reproductive psychiatrist who managed my medication throughout my third pregnancy. I was able to stay on most of my medications without decreasing the doses or the frequency. With patience, warmth, and understanding, Dr. Snyder gave me all of the information that was available; anecdotes from her own experience and any scientific findings that were appropriate.
My third baby is happy, healthy and delicious. I was able to enjoy him fully because I was finally “at the top of my game” as a new mother. Seventeen months later, I’m still nursing and still on those same medications. Life, of course, isn’t perfect. I do, however, have the tools I need to face life’s challenges; in my work, with my family, and for myself.
I work as an early interventionist with infants, toddlers, and their families. What the children need, more than anything, is us, their parents. We need to be present and available in order for them to learn, grow, communicate, and connect.
Our bodies, minds, and hearts are not our own once we decide to have children. We have to be at our best so we can effectively share these parts of ourselves.
If I could give women like me advice, I’d say to talk to as many people as possible – anonymously or not – that have stayed on their medications. I find Facebook groups filled with other women who are happy to share their stories and experiences. I would find recommended providers who have the detailed knowledge appropriate to this particular subject. I recommend Dr. Snyder whenever I can. She made me feel safe, but more importantly, she gave me permission to confidently choose to take care of myself.