In need of advice related to anxiety disorders, medication, and pregnancy.

I can’t speak to anxiety meds and pregnancy and I have heard that Xanax is very addictive. All I can say is that I use it occasionally to calm anxiety. Sometimes it works well, sometimes it has no effect but I have never upped the dosage or taken it long term.

I suspect the changes and worries of pregnancy may increase your anxious feelings so you might want to consider being on something deemed “harmless” throughout this period.

Pregnancy is quite the roller coaster of hormones and emotions. Then you add in risk of post-partum depression…

You sound really down on therapy. It isn’t really for the purpose of talking about your feelings. You can find a cognitive behavioral therapist who will help you work on very practical actions to take control of your anxiety over time.

Medication without therapy is far from ideal… but if you refuse therapy, it might be better than no medication at all.

I hesitate to write this, but as someone who has had anxiety and been on medication during my 3rd trimester to “ward off post-partum depression”, be prepared for anxiety that your anxiety medication will cause problems with your pregnancy/fetus/baby. If you ever watch TV, listen to the radio or open an internet browser, you will likely encounter an add for a class action suit against a pharmaceutical company related to mediation during pregnancy and birth defects. This is another reason to consider medication in consort with therapy.

@Cupcake I totally agree.

I don’t know anything about pregnancy, so someone else will have to address that component.

Can a gynecologist really prescribe antidepressants? That’s so odd.

I’m curious why you view daily medication so differently from as-needed medication. You say “I don’t want to depend on drugs to function normally” but it’s not like going on medication would decrease your ability to function without medication. If you’re not happy with how you function without medication, then medication could help make it better. If you’re not happy with how medication makes you feel, you can go off it and return to the way you feel now.

Personally, I have immense problems with anxiety and a daily SSRI has helped me a lot. I went off it for awhile and it didn’t take me long to see the difference, to remember why I had gone on it in the first place, and to start it again. I’m much happier with a little help with my anxiety.

Have you considered meditation? You might want to review some of the data on mindfulness meditation and anxiety. And this.

I have plenty of experience with anxiety and panic, as well as the treatments that worked (and didn’t work) for me. But you’ll need to find what works for you. The only suggestion I could make is that you may want to hit this from multiple approaches. You don’t need to consider the SSRI as permanent. But an SSRI combined with therapy can make a huge difference. Most people I know (including myself) have had the following experience:

- Xanax and benzos can provide some immediate relief, but are extremely addicting and can exacerbate anxiety once it wears off. I don’t recommend that anyone use these.
– SSRIs are a great way to kick-start your treatment, along with therapy.
– SSRIs can usually be dropped once the overall anxiety has come down, and therapy can continue.

One of the insidious features of anxiety is that it presents consciously as permanent. It’s not. It really isn’t. You can kick the shit out of it, and look back at your former anxious “self” with wonder. So, it may help to consider medication in this light. It’s temporary – as long as it is not the only thing you do.

Plus, I highly recommend developing a mindfulness mediation practice. Consider it to be going to the gym for you brain…and sanity.

@Cupcake “You sound really down on therapy.”

Hm…no. I have nothing against therapy, but I don’t think telling my boss I need to take off early, show up late, or take a long lunch on a weekly or even bi-weekly basis would bode very well. I work at a very busy law firm and I directly support two diva attorneys that someone else would have to take care of while I’m gone. They have their own attorneys to tend to. I asked my GP, who didn’t even mention therapy as an option, if many therapists/psychologists in the area did weekend visits and his response was, “probably not.”

@livelaughlove21 There are definitely therapists who see patients at night. I wouldn’t rely solely on your GP’s dismissive answer. It sure seems like it would be wise to get a handle on the potential disease anxiety before you have children.

@livelaughlove21: the therapists I know, and the ones I have been to, all have had some non-traditional hours for consults for people who work regular 9 -5 jobs. Do look into it, you might be pleasantly surprised.

I have panic disorder and it has been under control for quite a long time. I take a low dose of Paxil and have had lots of therapy. Personally I wouldn’t take any of the psych meds when trying to conceive or during pregnancy. I can only speak to my own experiences. So, there you are.

@livelaughlove21 Got it. I had to take off work weekly when my son was suicidal and his therapist only worked 9–5. Because they had an established relationship, I didn’t consider him switching therapists.

My husband and I saw a marriage and family therapist on Saturday afternoons. It worked out great for us. The therapist worked in schools during the week and had his own practice some evenings and all day Saturday. I hope you can find someone local to you who has flexibility, if you are interested.

I just want to comment on taking meds during pregnancy.

As you may know I was raped at 15 and had my first son at 16. I was extremely depressed and suffered from PTSD. It was a good day when I got out of bed and showered. I had panic attacks that the rapist would steal my baby if I left the house. I cried myself to sleep every night for over a year. Medication was essential. My son is now a well-functioning, intelligent, capable, normal, healthy adult.

When I got married later in life and was considering pregnancy again, my OB and I thought that it would be best, given my history, that I be on medication “to ward off depression and anxeity”. I worked hard on being in the present, being mindful, having control over my thoughts and feelings… as well as my reaction to them. Still, the thought that I was potentially doing my baby harm was present. Given my history, though, I think the medication was important.

For my last pregnancy, I refused medication. I had been pregnant just 2 years before and knew what to expect. I was healthy and happy and stable. It worked out splendidly.

Many, many babies are conceived and brought to term while the mother is taking medication. It is up to you and your physicians to determine what the risks and benefits are of each option.

@Cupcake Yes, I agree. One has to make a risk/benefit analysis and decide how best to cope for yourself and your baby.

I’d insist on the Xanax personally. It worked very well for me years ago during a crappy divorce and high stress job with a crazy boss. I took it on a regular basis for 2 years and then, just quit one day and had zero side effects or with drawl. These damn doctors would rather prescribe something that is going to totally screw with your brain chemistry rather than something mild like Xanax. I also asked for Xanax before an overseas 13–14 hour flight to Asia a few years ago and my doc gave me 10 for the trip, happily so, no questions asked.

Everyone is different but, I had zero issues with Xanax dependency but I had a horrible allergic reaction to Paxil. I do not agree with Prozac nation. Mild sedatives are waaay safer and better for most people not suffering from major brain chemistry issues. I will never touch another anti-depressent as long as I live.

@Coloma: “I’d insist on the Xanax personally. It worked very well for me years ago during a crappy divorce and high stress job with a crazy boss. I took it on a regular basis for 2 years and then, just quit one day and had zero side effects or with drawl.”

Personal anecdotes aside…please, OP – research this. Xanax and all benzos are no joke. This is the stuff hardcore addictions are made of. Not only is this considered one of the most addictive drugs – I have known people who have personally had to deal with addiction to Xanax. Also, it’s mechanism is quite the opposite of what you going for. You don’t want to be sedated. You need a way to keep see more clearly – and Xanax is not your friend in this area. SSRIs are a better option because you don’t have to deal with addiction, you’re not a sedated mess, and they complement therapy and other treatments.

@hominid I’d never want to be on Xanax on a regular basis. I was given two 2 mg pills from my mom when I was mid anxiety attack. I took ¼ of one, so .5 mg at that time, and I think I’ve taken two .5 mg doses since then and that was maybe three weeks ago. I try to mentally fight off my anxiety and just deal with it without medication, but those three times I took the Xanax were to ward off (or treat) an anxiety attack. I tried the Atarax in as prescribed and hated the effects – it felt like I took Benadryl for sleep, but no effect on anxiety. I don’t take the Xanax I have unless I’m mid-panic.

I just wanted something as needed. My sister has been addicted to narcotics for 8 years, so I’m very resistant to taking medications like this, which is why I’m having a hard time taking the doctor’s recommendation. I’m going to start taking Zoloft once daily beginning on Saturday, recheck with my doctor in two weeks, and just go from there.

@hominid I’m aware of the newer research but I still feel they are preferable than most anti-depressants, for SHORT term use. I did not take them daily for long, only as needed, but did “use” them over a 2 yr. period with no side effects or with drawl issues. Everyone is different. On the antidepressant end of things I know of someone who committed suicide on Paxil, a 70 yr. old man who had just told his family that the drug was making him want to die, he shot himself 3 days later.

It was prescribe after his wife died.
The connection between many of these drugs and increased suicide risk is strong and well documented.
I also have another friend who had a terrible, worsened, depression and suicidal thoughts from Nortriptyline, prescribed to help her with depression related to an MS diagnosis and issues of such.
I feel mild sedation is much preferable to these other psychiatric drugs.

I was fully functional at home and at work just took the edge off of my anxiety while the Paxil was a zombieland nightmare.

I know very little about which antidepressants, SSRI’s, and anti anxiety drugs are ok through pregnancy. I looked up Zoloft just know and the insert says Category C. I personally would much prefer a drug that has been specifically tested and cleared for pregnancy, although many many drugs are given that are Cat C just based on what seems to be not a problem in pregnancy in humans. Still, I like a drug in the Cat A or B column.

The first trimester is one of the most important. It is when the baby is first developing and forming. This is why doctors tell women who are trying to get pregnant to live like they are. If your a party girl (not you, I just mean in general) and getting drunk every weekend, and then finally find out your pregnant when you’re a week late, you’ve already been drinking during pregnancy. If you bleed a little during pregnancy you might not check for pregnancy for several weeks.

By the way, if you take Xanax again .25 is very effective for a lot of people. I’m afraid you are over drugging yourself unnecessarily. You should probably consult with a psychiatrist and let him really evaluate the best drug for you rather than swiping some from your mom. I’m not trying to lecture you about taking other people’s drugs, but I do worry that you don’t know enough about dosages and your mother is in no way someone who could give advice about it. Her perspective of dosing would be very skewed. I’m sure you know that already.

Moreover, it sounds like your doctors want to try to treat the underlying cause of your behavior, your obsessive thoughts. That’s why they suggest Zoloft or something similar. Xanax is the miracle for many people to take the edge off (although as you point out can be very addictive) but some of the antidepressants treat OCD and other conditions, which in turn mean the person has less anxiety.

I know you make the time to see doctors for your anxiety related to health, maybe forgo one of those redundant appointments and see a therapist. The therapist can help you decide whether to see psychiatrist for medication.

I think talk therapy would help you a lot. I really think you should give it a try. If the first person isn’t a good fit try another. Give at least two chances for it. It has really helped me in the past. I think about going back all the time with everything I am dealing with lately. My situation this time is much more complicated than other times in my life, and therapy isn’t a clear option for me right now. You would get a chance to talk through your fears with someone who is there to listen.

If I were you, I’d reluctantly go find a therapist. I’d take a day off from my weight lifting, and take care of my mind. I know that’s not a simple thing to do. When I started seeing a therapist, I was determined to not take anything that therapist had to say seriously.

But…within a few weeks, I changed my opinion. I finally had someone to lean on without risking to be too much of a strain on them. I had someone who was getting paid to deal with my problems. She would set help me set goals for myself, and remind me not to overdo it. It is not only helpful, it’s a luxury.

You sound like a smart person, and someone who is very independent. There are all kinds of therapists out there. Some will try to smother you, but the good ones will do everything in their power to act like the listener you need. If you see a very good one, that person will not only listen, but teach you how to see your emotions from a distance, and help you understand that putting other people’s needs before your own is not a long-term solution.

I had a mother who went through depression in my teenage years. Because her former support system – my dad – left her. I have a dad who probably still is depressed. For the sake of your future kid, take care of yourself, please.

Yes, many therapists do have weekend hours.

@JLeslie and @longgone Well said, both of you.
I agree, getting a handle on these issues should take precedence before proceeding with a pregnancy.
@livelaughlove21 No offense, but if you are already prone to anxiety about your health a pregnancy is going to really set you off. You will be calling your doctor every day with some new symptom or concern. Unborn fetuses are very sensitive in utero to the mothers anxiety and psychic vibes, you want to be as calm and as happy as possible.

@Coloma “I agree, getting a handle on these issues should take precedence before proceeding with a pregnancy.”

That’s what I’m trying to do. Not sure where I said otherwise. However, even if I get my anxiety under control now, there’s no telling when it can happen again. I’ll likely always have anxiety, even if I’m not always in need of medication for it. People with anxiety are capable of having children and being just fine. Happens all the time – anxiety disorders are very common.

And not that I’d take the chance, but I’ve spoken to many women whose anxiety calmed down during pregnancy, probably due to changing hormone levels. I’m not counting on it, but I wouldn’t say it’s a certainty that pregnancy will make me worse.

@livelaughlove21 I was agreeing with you, just concerned that given your rather hypochondriac tendencies a pregnancy might really be a challenge for your anxiety. Of course you will experience the normal concerns, hoping your baby is healthy and all, but you do want to try and not have major anxiety as it could lead to a hypersensitive and hard to soothe infant which causes more anxiety. haha

@Coloma “but you do want to try and not have major anxiety”

If only that were as easy as it sounds. If you know where the off switch is, please let me know.

@longgone “I’d take a day off from my weight lifting, and take care of my mind.”

What does one have to do with the other? I don’t lift all day…and I take all but four days per week off of it. Not sure what you’re getting at there. Working out is one of the few things that helps my anxiety and makes me feel good. Skipping workouts will only make me more anxious. I think I can lift and get help for my mental issues.

@livelaughlove21 If you can lift and get help, that’s ideal. When I decided to talk to a therapist, I had to give up time I had previously spent doing things I love. I was annoyed at that, but quickly found out it was worth it. That’s what I was trying to say.

@longgone Ah, well I lift between 4:30 and 6:00 in the morning, so it doesn’t interfere with much.

^ Okay, no – you won’t find a therapist willing to talk that early, I’m afraid ;)

Fingers crossed for you. Anxiety is hell.

I’m going to disagree a little with @Coloma and say don’t wait too long to try for a pregnancy if you want a baby. I think getting your anxiety down would be great, but if putting off a baby in any way contributes to your anxiety, go with your gut on it.

I’m projecting here, because I had health problems that caused me a lot of anxiety during my most fertile years and doctors, and even my spouse, voiced how they thought I was too anxious to have a baby. I regret listening to them. As you know I had fertility problems and now am 47 with no children.

You might get pregnant the first try and have a baby 9 months later, I’m not saying you will have fertility issues, I’m only saying trust what you think you know you can handle.

It seems to me that if talk therapy can help it’s really worth a try, especially if you want to be pregnant med free.

@JLeslie No worries, disagree away. haha
You make a valid point too, but my thinking was based on knowing that @livelaughlove21 is still really young, 23–24 I think, correct me if I’m wrong. She still has lots of time to conceive. If she was 30 something I’d agree with your take as well.

I am just concerned that extreme anxiety during a pregnancy can contribute to a hard to soothe and hypersensitive infant.The mother/fetus connection is really strong and babies are emotionally effected in utero. Something a lot of people are not aware of. They FEEL the anxiety in the mothers being. Infants also pick up on the parents vibes after birth and an anxious mother will pass on that anxiety to the infant, creating more anxiety for everyone.

@Coloma I don’t know if any of that is proven or just a hypothesis a lot of people believe. I do think the mother’s hormones, including things like adrenaline and cortisol might very well effect the fetus. However, I see babies born to mothers who dreaded being pregnant, were not happy to be having a baby, and at the same time in bad marriages, and the child is happy, outgoing, and smiling. So, I don’t know what to really think.

^^^ Yes, not saying it’s a given, just best to err on the side of caution. A pregnant women should, ideally, have good mental health as well as physical. A lot of it is temperament of the infant too, a more easy going baby will be more resilient over a more sensitive and high strung child. Luck of the DNA.

@Coloma Yeah, my son and I are arguing about nature vs. nurture now but in any case, he says it’s all our fault! lol

@janbb Haha…but of course!
My daughter is the perfect, computerized, blend of her dad and I. Has my humor, curiosity, creative and artistic side and her dads uber stubborn, know it all, hard nosed, let me pound my point home traits.
When her dads DNA rears it’s ugly head it transports me back to arguing with him. Gah! Sometimes it’s funny and amusing, others, I just want to smack her silly. lol