This blog is not FDA approved
I was three months pregnant with my first baby when I went cold-turkey off Lexapro—against the advice of my therapist and my OB/GYN. They both said that it was nothing to worry about, but in my ever-vigilant pregnant mind, everything was something to worry about.
My family physician had written the original prescription a few years before, when my late husband was in the end stages of cancer. When I told her that I was pregnant, she refused to refill it. Lexapro remained on the Class B list—fetal effects unknown. I left her office feeling ashamed that I had even asked her for it.
Like any conscientious pregnant woman, I listened to my doctor. Well, THAT doctor. So I quit.
I quit breathing. I quit eating. I quit sleeping. I lost five pounds in my fourth month, when I should have been growing. I, the me I love, began to disappear into the strangling thrum of anxiety.
My depression manifests as anxiety, the “teeming brain.” I recall the exact moment when I fell into the abyss. I had coughed for weeks, so that conscientious doctor who wouldn’t write me a Lexapro scrip prescribed codeine cough syrup. It was fine for pregnant women. Twenty minutes after the first dose, I begged my husband to come into the bedroom and sit with me, to hold me tethered to the earth. I hallucinated—not clowns jumping out of the closet, but faces blending into one another, strange thoughts bubbling up whenever I closed my eyes.
The drug finally knocked me out and I slept. At 4:16am, I woke up in a panic, strangling for breath from sleep so deep that I imagine I had died. And my baby along with me. She was dependent on me for everything—blood, bone, breath.
All of my fear—about being pregnant, being a mother, being a stepmother, being in the unknown—coalesced onto the single act of breathing. I became so obsessed with my breath that I could only drink through a straw for fear of choking. I couldn’t wash my face in the shower for fear of drowning. I chewed every bite over and over and over and still couldn’t swallow. Strangling. Choking. Drowning. I measured every breath as it came in and as it slipped out. I would get up and leave my husband and stepdaughter at the dinner table so I could walk outside where there was more air.
I ran out of prenatal yoga halfway through the class because I had a panic attack over not being able to BREATHE deeply enough.
How could I sleep? I might stop breathing. The anxiety ratcheted up throughout the day to a crisis point at bedtime. I never slept for more than 90 minutes at a stretch and I woke in panic four or five times a night. Sweating. Racing heart. Teeming brain. My baby could die if I let down my guard.
I developed a night-time ritual to coax sleep and peace back to me. Lavender oil on the sheets. A humidifier. Chamomile tea. White noise. Neti pot. Ayurvedic chanting. Yoga breathing. Cold wash cloths to the temples. Visualizations. Muscle relaxation exercises.
All that, yet still waking in panic that I might have slipped across the line from breathing into not breathing.
I never felt suicidal, like I needed to end my life, but the turning point came when I found myself feeling so empty that I was already gone. One morning after a sleepless night, I slumped on the edge of the bed and calmly concluded that my sister and her husband could raise my baby if my husband couldn’t do it alone. My fair creature, my beloved baby I had wished for on every birthday candle for a decade—I felt I would never relish that love. I had ceased to be.
As luck would have it, I bumped into my OB/GYN on the sidewalk that morning and we happened to be standing in front of a pharmacy–how’s that for a sign? I told him about the nightmare I was living. He took me by the shoulders and said, “TAKE THE LEXAPRO. My wife takes it and we are trying to get pregnant. Do you think I would let her do that if I didn’t think it was safe?”
I took one that night and slept 8 hours.
I carried the guilt through the rest of the pregnancy—guilt that I couldn’t get through life without meds like everyone else. I couldn’t do something as simple as breathing without pharmaceutical help. My therapist asked me, “If your body couldn’t process sugar, would you feel guilty for taking insulin? Your body doesn’t manage serotonin well, so you take a pill. It’s no reason to beat yourself up.”
I started taking Lexapro three weeks before my late husband died of leukemia. I couldn’t accept that I was depressed–I just couldn’t sleep. My mind had lost the ability to switch off. I had cared for him for 10 months, kept our household going, traveled back and forth to Baltimore every other week, 22 times. My therapist had recommended the SSRI to get my sleep back to normal. My brain had worn itself a groove, like a bare path that has been walked so many times that grass stops growing. The drugs helped my brain hop out of that groove and find rest.
But on a phone call between Baltimore and home, when I told my late husband that my doctor had given me these pills, he said, “Why do you need THAT?” He wasn’t a believer in any kind of…prop. I sat on the phone and cried silently. How do you tell a man who’s dying of cancer that you are struggling? He backpedaled as soon as he heard me crying, but I don’t think I ever got over that moment of shame. He faced cancer and never flinched. I lived and needed a pill.
Some of the shame lifted one summer afternoon when my daughter was two months old. I was back inside my life, nursing my perfectly healthy baby girl when a report came on the news that a Boston University study concluded Lexapro was not harmful to pregnant women or their babies. Tears rained down onto my breast and plinked onto my daughter’s face. It startled her, but she nuzzled closer and found what she needed, right there in me.
And finally–finally–I took a deep breath.