Editor’s Note: Please consult a doctor or a mental health professional before beginning any treatments. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical or mental health condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this article.
When I decided to stay on Lexapro while trying to conceive, I felt a brewing thunderstorm in my brain clear up. Concern was replaced with calm, and fear with peace. I felt acceptance. I’d be remiss to not shout from the rooftops that what you do with your body is your choice. What I choose to do with my body may not be for you and vice versa. But here’s why staying on my medication is right for me.
A little backstory: I started taking Lexapro, a SSRI commonly used to treat depression and anxiety, when I was diagnosed with OCD.
According to a 2006 study published in The Journal of Clinical Psychiatry, it can take people about 17 years to get treatment for OCD after they start experiencing obsessive-compulsive symptoms. Hopefully, it’s shorter now with an increase in awareness and more trained professionals. But for me, 17 years sounds pretty accurate.
What it’s like having OCD
Here’s what I know about the disorder: it’s hard to sleep/think/work/read/talk/watch TV/breathe when smothered in all-consuming doubt and fear. It’s also hard on relationships when your brain is perpetually somewhere else, stuck in the deepest and darkest rabbit holes over and over again. OCD is very lonely.
For about two decades, I felt like my brain was fighting my being, doubting my every decision, morality, and purpose. It latched onto various obsessions, from calories to extreme fears about being recorded while saying something not nice, spontaneously losing control of my car, and doing something inadvertently that would harm someone. There were many times I wondered: will I ever think about anything besides this thought? This thought would linger loudly in the back of my brain nearly every minute of the day for years.
Finding healing in therapy and medication
I had assumed all of this was “just me” and even mildly positive traits—I was healthy, vigilant, a good person! Inside voice: but what if I’m actually a BAD person?
It took a public breakdown at a corner table in a coffee shop for me to finally get help. I was crying with bleeding fingers and picked skin, as a dear friend of mine listened carefully. She told me seven words that changed my life: It doesn’t have to be this way.
She was right, it didn’t.
Eventually, I was prescribed Lexapro and went to a new therapist specialized in OCD, where I started the hard work of Exposure and Response Prevention, along with drinking less coffee, going outside more, and exercising regularly.
Slowly, the waves of heaviness began to ebb. My ruminating thoughts didn’t go away, but they got quieter—and the way they affected me changed. About three months after getting help, I felt a lot better. A year later, I felt like myself for the first time: loved, loving, and whole.
Shifting my perspective on parenthood
Before getting professional help, I wasn’t sure I wanted to be a parent. I was so terrified by the what ifs. What if I’m not a good mom? What if I’m a terrible partner? What if I’m always like this? Every time I made a mistake or failed, it felt like validation of all the meanest things I ever said to myself.
Over many sessions of therapy, these questions shifted. What if my struggles and experiences will help me be an empathetic parent and a more understanding partner? What if I’d be an imperfect, good mom? And my relationship with mistakes and failures changed too. Rather than proof that I was a bad person, I saw them as inevitable (and even important!) parts of being a human.
Still, bringing a baby into the world wasn’t something I even considered until I was fully in “maintenance mode.” I knew I needed to be in a mental state that was as steady and strong as possible for the massively challenging new world of parenthood. I walked alongside women in my life as they experienced postpartum depression and other maternal mental health struggles. Their vulnerability and willingness to share their experiences gave me a glimpse of the exhausting, fulfilling, satisfying, and really, really hard work it takes to be a parent.
When I thought about how I could set myself up to be the mom I wanted to be, I knew going off medication wasn’t the right choice for me.
Navigating the decision to stay on antidepressants with doctors
Of course, I discussed staying on antidepressants during pregnancy with my therapist, my OB-GYN, a fertility specialist, and my primary care physician.
They walked me through the different risks associated with different antidepressants. Even with my now low dose of Lexapro, they explained that antidepressants have been associated with a slightly increased risk of miscarriages and the possibility for a baby to be born at a lower birth weight and to experience withdrawal symptoms that typically last two weeks.
We also discussed how untreated depression during pregnancy also is linked to physical and developmental issues for babies. Additionally, women with untreated depression are shown to be more at risk of developing postpartum depression, and suicidal ideation is associated with pregnant women who ruminate. As one of my doctors eloquently said, “babies need healthy people to care for them.”
So after a lot of time, research, and support from all my doctors and my husband, I have no plans to stop my medication anytime soon, and possibly, ever.
Self-care while trying to conceive
Medication is not a cure-all and it’s certainly not for everyone. Recent research shows that mindfulness can be as effective as Lexapro. But for me, it’s a major component of how I care for myself.
Do I wish it wasn’t this way? Sometimes. When I start to judge myself, I remember I want to do everything I can to protect my family—and that helps me appreciate this medication.
I often think of this New York Times headline from 2021: “Neglecting Yourself Doesn’t Make You A Better Mother.” While medication is not mentioned in the article, the sentiment of self-care as a necessary, valuable way to strengthen parenting spoke to me.
The author, Danna Lorch, wrote, “…I remind myself that self-care isn’t a reward that’s meted out once all the hard work is done. It’s what I need to keep inching forward right now, with a small child clinging to my back through a storm.”
The more I think about this powerful image, the more I find peace in my situation. I don’t think of it as flawed, shameful, or bad, but as one of resilience, intention, and authenticity—all of which I want to carry into this next chapter and beyond.