It’s 1991. The internet is available for commercial use and the number of computers on the net reaches 1 million. The ice covering the Arctic has decreased by two percent in the last 10 years. And I’m pregnant!
I’m in love with my husband and over the moon about the family we are about to create—gotta love those hormones! I have nothing left but to get my baby birthed and enjoy the fruits of my labor (pun intended!).
Fast forward to bringing our little nugget home from the hospital. In just a matter of days of adjusting to “life with baby,” I started waking up in the middle of the night hyperventilating and in a physical state of complete panic. I felt intense fear. I was trembling, sweating, and crying.
Hey! This was decidedly different from the hormonal glow of pregnancy. That was clearly over, and a demon had invaded my body.
It took several hours each night to get back to sleep with hugs and lots of patience from my husband. Amazingly, the baby was sleeping six hours a night. I feared I would never feel normal again as the out-of-body state I was in at night invaded my waking hours.
My OB-GYN identified the cause of my acute anxiety as the abrupt changes in my hormones after childbirth. Simple! Six months on the medication, and I’d be good as new! Yes. Oh yes. I needed relief from this nightmare. Let the fairy tale new mother emerge; she must be in here somewhere!
When my OB-GYB referred me to a psychiatrist for postpartum symptoms, I admit it gave me a slight pause. Why a psychiatrist? I had plenty of experience at the feet of Big Pharma because psychiatry and psychiatric drugs regularly figured in my family life growing up.
In the late ’50s, early ’60s, Big Pharma had been powerful for over a century already in the U.S. My mother was a card-carrying member of the Mother’s Little Helper Club. While she seemed to resent her psychiatrist, she continued to be a patient with an intimate relationship with psychiatric medications until her death. I was effectively groomed to turn to pills at a young age and was never taught any coping skills besides swallowing pills.
Today, major depression is the fourth-ranked cause of disability and premature death in the United States. Women are diagnosed approximately twice as much as men, and it is acknowledged to be our hormones commencing with our menses and ending with menopause that are responsible for this high number.
The lack of appropriate research and development to bring hormonal treatment to market is due to the easy and big money Big Pharma makes on treating women’s hormones with antidepressants and anxiolytics without spending a dime on research and development. It adds a nice little market niche, doesn’t it?
I remember my first appointment in 1991 with the psychopharmacologist (a relatively new designation then) recommended by my OB-GYN. Sitting in his office on the Upper East Side of Manhattan, I described the panic-level anxiety that now accompanied me day and night—panic in the true physiological sense with all its accompanying symptoms revving up my thoughts and actions.
The rush of adrenaline, elevated heart rate, the amygdala taking over, and my central nervous system keyed up as if my life and my new son’s life were in danger, and I could do nothing to stop it. It was an utter nightmare.
And the truth of my situation was utterly incongruent to what I was feeling. I had a large and able support system, all willing to provide help, including my psychotherapist. Still, I didn’t believe anything except my bigger-than-life panic.
With approximately 4 million live births occurring each year in the United States, about 600,000 women receive postpartum depression diagnoses annually. This number excludes miscarriages or stillbirths where postpartum depression symptoms occurred, and those unreported or undiagnosed, so the number is likely larger.
Why is the first line of treatment still antidepressants 30 years later? It’s simple. Why bother researching new safe treatments when you can make millions off a product already on the market that women already take more than men by 50%?
Because of my family history with psychiatry, I was not unfamiliar with the psychiatrist’s office. So, my appointment with the psychopharmacologist in 1991 was not the first time I’d sat before one, and it wouldn’t be my last by a long shot. But I was naive and uneducated about the medication I was taking, just the way Big Pharma likes us.
The United States track record with women and psychiatry is paternalism at its worst, and we have generations of trauma to overcome. Think of Elizabeth Packard, whose husband committed her to an insane asylum just over 160 years ago for having her own opinion about religion different than her husband’s. A church pastor the one corroborating witness that she was insane, she fought her entire life to change that inhumane system.
The psychiatrist responded so compassionately to my story, something I desperately needed. He said, “It sounds like you are badly in need of some relief.” Those simple words meant the world to me. Suddenly, I felt like what I was feeling was okay, and I wasn’t a bad mother because of it. I just needed relief: prescription relief. Thus began my dubious membership with the Mental Health Industrial Complex. Huzzah!
I noticed a reduction in anxiety within a few weeks after starting clonazepam, and my desire to remain mentally healthy grew. I began to see the anxiety as a thing of the past and enjoyed outings with my son to Mommy and Me classes and made new friends.
I used the clonazepam on an as-needed basis. This seemed to me to be great progress! At about 12 weeks postpartum with my hormones still fluctuating, I returned to work. I continued to be anxiety-free with the help of clonazepam, if occasionally emotional.
One day my monthly psychiatric review coincided with an upsetting situation at work, and I did a good bit of crying about it during my appointment. He listened intently, compassionately, as I shared my day. At the end of our session, he suggested adding a different medication to address broader symptoms, such as those I experienced at work.
The psychiatrist’s job was not to help me adjust to being a new mom by providing coping strategies and ways to process normal feelings. His job was to identify what pill would eliminate them. Feeling weepy? Try antidepressants. I was still hesitant, but my early experience with clonazepam was successful. Why not address my emotional ups and downs, too?
I left with a script for Zoloft and clonazepam as needed. I was successfully upsold. Now I was taking two psychiatric medications I knew nothing about. I didn’t start reading inserts until I experienced withdrawal on my first attempt at stopping the medication to have a second child.
We kicked off our decision to have a second child with a family vacation with our two-year-old, and I stopped my medication. We found a cute little efficiency apartment near the beach and set ourselves up for a week of fun and sun.
It didn’t take long before I had very negative thoughts and feelings that I seemed to have little control over. I couldn’t stop myself from finding fault in everything and questioning why we were even there. It made the entire week extremely unpleasant and continued when we arrived home.
I was pretty sure it was from stopping my medication because these were not my original symptoms (remember postpartum anxiety?). I discussed this with my psychiatrist. He identified my experience as returning symptoms of depression and recommended we find a safe medication to remain on throughout my pregnancy.
This trope is a familiar response of psychiatrists heard worldwide by patients, and likely provided by the pharmaceutical companies. The result is that most of us go back on the medication rather than feel debilitated or being unable to work. And that is great for the pharmaceutical companies. They’ve got a solution to postpartum depression that generates dependencies and profits. But, in that blink of an eye I morphed from a postpartum anxiety sufferer to a depression sufferer and the label sticks to this day.
Two years into taking antidepressants, I was told by a psychiatrist that I wasn’t getting off them any time soon. “It’s time to face the facts,” he said. I would be on the medication for the rest of my life. Why feel negative about it? It’s like taking insulin for diabetes!
My psychiatrist provided me with a study on one of the older antidepressants that indicated it was safe during pregnancy. While I still held the belief that what I experienced was not symptoms of depression, I agreed. I certainly wasn’t willing to go through what I can only describe as psychotic-like experiences again.
I understood the implications that I would likely never get off the medication, but I kept scouring books and the internet looking for validation of what I had experienced. Why did I feel so horrible and experience symptoms unlike anything I’d experienced before?
If I count the Valium my mother began to give to me for anything from stomach pains to teen angst, as an adolescent into my twenties, I have been taking psychiatric medications marketed specifically to women for almost my entire life.
In the meantime, while disorders were “identified” and the DSM grew, medical justification for our ever-growing list of seemingly arbitrary disorders grew; the latest, the DSM 5, being criticized for dubious practices when including or excluding disorders. Imbalanced brain chemistry was peddled as gospel and psychiatrists morphed into prescribing machines.
The fact that I was taking antidepressants regularly for postpartum depression never sat well with me. Surely, years after having my baby, I’m no longer experiencing postpartum symptoms. Something in my gut felt it didn’t add up. Still, I couldn’t deny things were going well—until they weren’t.
I began to experience strange electrical shocks on my back and muscle tics in my legs and torso that become noticeable to people at work. On my first stop, I asked my psychiatrist about these symptoms because I had begun reading and knew they were not uncommon side effects.
His quip: “You may have an underlying neurological condition that the medication unmasked, but there is nothing you are taking that would cause what you are describing.” Second stop: the neurologist and tests. Results: negative. “I see nothing to cause what you are describing, but if you think it’s the antidepressant, then stop them.” Another quip, this time with a smirk.
I made an appointment with a psychotherapist to discuss getting her support to get off the medication. I told her I wanted to stop my medication, I didn’t like the side effects, and I wasn’t depressed. Her reply came in a flash of superiority. Why would I want to get off medication that was helping me? The insulin analogy again, and this—that none of her patients who tried to get off medication could because they all ended up having symptoms reappear and had to get back on. Sure, she said. She’d help me. But she could predict for me that I would end up right back on them like her other patients who tried to stop them. I declined to make another appointment.
Studies show my OB-GYN was correct. Most postpartum depression symptoms resolve within three to six months and are caused by a drop in progesterone. Why was I kept on a steady diet of antidepressants when my hormones were likely back to normal? Why were symptoms of depression returning when that was not my original diagnosis? My psychiatrist practically shrugged as if depression was a foregone conclusion. But I kept holding on to hope.
After my first attempt to get off them went so oddly, I discovered a book by a psychiatrist who, contrary to my psychiatrist and most others, had begun to question why his patients were unable to cease taking antidepressants when they wished to stop. He didn’t get the memo from Big Pharma or had a penchant for thinking for himself.
He described case after case of patients who took months to years to feel better after stopping. The reference notes that he provided suggested that psychiatric medication alters the brain. It doesn’t fix the mythical chemical imbalance, nor is it indicated for long-term use. Additionally, it causes problematic side effects and withdrawal symptoms. And Big Pharma knew it then, and they know it now.
Big Pharma has been systematically downplaying this vital information, benefiting from advertising to consumers, physicians, and other practitioners the wonderful effects of psychiatric drugs. Now I understand how they are willing to negate our human dignity for the almighty dollar.
I have experienced possibly permanent side effects from the medication that are embarrassing and could get progressively worse. And I have tried to stop the medication numerous times, only to be told I need a higher dose of antidepressants, an additional antidepressant, or an antipsychotic.
In 2017, after trying to stop again I learned that my dosage decreases needed to be much smaller. But I suffered for at least a year and then some with horrific and protracted withdrawal symptoms such as acute anxiety that started with the first light and accompanied me throughout my day, along with numbness in my hands and arms, paresthesia, and tardive dyskinesia.
It all became too much for me and I thought about suicide most of the time to end how horrible I felt, although I did not want to end my life. I knew no other way to feel better.
Our mental health system is deeply flawed. It lines the pockets of executives and shareholders and has wholly neglected the person taking its medications. It is paternalistic, medicalizing our emotions and misinforming us about psychiatric medication’s side effects. This is reckless and dangerous.
Patients should demand informed consent, referrals for appropriate physicals to rule out underlying causes for depression, a periodic evaluation of diagnoses with their physician or psychiatrist, plus education and access to alternative modalities.
Did I mention my first child is turning 30? In those almost 30 years, I have been unable to stop taking the psychiatric medicines that I should not have continued after at most a year.
The day I filled that prescription back in 1991 was when my postpartum anxiety diagnosis became subsumed by an arbitrary diagnosis of depression. And this diagnosis has followed me for 30 years and counting.
For now, I have a psychiatrist who is willing to help me reduce or eliminate the medications I have wanted to get off for a long, long time. I feel fortunate because such practitioners are few and far between. Yet, I can tell you: It will not be easy. I may not be able to completely get off all these medications because of how they adversely affect the central nervous system. But it is my journey to make.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.
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