I love that Dr P. is the specialist I’m working with because she is very good at her job, but I kind of wish that we had met in other circumstances; namely, circumstances in which we could be best friends and drink hot chocolate together. Because when she laughs, I laugh, and we spend much more time laughing than really feels proper for a psychiatry session. The time flies. And I have fun. And then I remember that it’s a psychiatry appointment, and I think wow, am I lucky! This is a little weird, but I’m so lucky that this is fun! (We’re talking about babies! And how awesome my husband is! And cracking jokes!) But you want news. Here is my news:
First, Ativan. I am possibly Ativan’s biggest fan. I can feel it kick in in no time, but it doesn’t leave my system in a rush. I can practically feel it slow down my thoughts, as though it is returning the speed of my thoughts to “normal” down from “super fast” and I finally sound like myself, instead of a chipmunk version of myself. (You know, like when sound gets played too fast and everyone sounds like chipmunks!) In other words, the “cross-taper” is going well. I am having no trouble saying good-bye to Klonopin, which will be gone completely by Tuesday.
Second, Dr. P. asked me a very important question. How ready am I to start trying? Well, you know what I said. She asked me how I know. Well, folks, it is quite simple: I know in my heart that our baby is waiting to be loved and known and to meet us. We’re all just waiting for the right time. But we’re already family. This baby is already out there. If that sounds crazy, then I guess that’s fair. But she says she hears things like that a lot. I realized that we already love our baby. What better time could there possibly be?
Finally, Effexor. Dr. P. is a sort of fresh pair of eyes for my case, the only new psychiatrist to talk with me since, well, since I was admitted as an inpatient in early 2007. A lot has changed since then. I have not been worried about depression in a long time. Dr. P. wonders if, perhaps, I might do well not taking any anti-depressant at all. It’s true that I only talk about anxiety. I only feel anxiety. Ativan seems to treat that anxiety. Could we, perhaps, get me off of Effexor? Apparently, this is done while taking Prozac, because Effexor leaves the body so quickly that patients feel withdrawal no matter what. More importantly, it can be done in about six weeks. I thought that it would take months. I’m going to talk to my primary psychiatrist and make the final decision later.
It’s an interesting idea, though, this realization that depression no longer lurks in the background of my mind. Anxiety is jumping up and down like my brain is a damn trampoline, but depression? I looked in all the dark and scary, cobwebby corners today and found no brooding, lethargic, unhappy mess, anywhere. I love my job. I love my husband. I’m active, physically and otherwise. I’m seeing a therapist twice a week. It is entirely possible that the daily battle with anxiety is my only remaining battle. It’s a tough fight, but if I don’t need the other medication, then by all means, let’s get it out of my body and see what happens!
If I do need Effexor but can wait to go back on it until after the first trimester of pregnancy, I can prevent exposing myself to the risk SSRI’s pose for early miscarriage, something I don’t remember and maybe the baby developing Autism, although the study that linked first-trimester SSRI use with slightly higher rates of autism is by no means definitive.
All agree that the fewer drugs I use to achieve “normal,” happy, stable moods, the better. If we can use one drug instead of two, a big factor disappears: the two drugs interacting. You see, it’s very difficult to parse out even one set of data about women and babies when just one drug is used during pregnancy. Throw more medication into the mix and everything gets even less predictable. The development of zygote, embryo, fetus, baby is incredibly complicated, obviously, and there is so much we don’t know.
Now all I have to do is try not to get my hopes up too high or set unreasonable expectations for myself (oh, say, for example, only taking one medication and never ever taking two again under any circumstances or else I will be a failure and terrible mother!–things like that). Simple, right?
The new timeline still has us TTC around February/March. Assuming my psychiatrist agrees that going off Effexor is a good idea. If he thinks that’s too risky, I totally trust his assessment. And if we decide not to go off Effexor? Well… then it’s time to buy some ovulation predictor kits!