Prenatal or Antenatal Depression & Anxiety
Genevieve Tyrrell
The face of depression. This is a painting I did during a depression a couple of years ago.
So much of chronic illness for POTS patients is the unseen.
Pregnant women are supposed to be elated and actually I do feel excited about my baby. I didn’t really in the first trimester so much, but I do now. And yet, that doesn’t stop the depression and anxiety. 7 to 20 percent of pregnant women experience prenatal or antenatal depression. It's often a precursor to postpartum depression if not treated properly.
POTS patients already have a tendency towards anxiety disorders to begin with. There’s multiple reasons why. For some it may be a thyroid issue or some other imbalance that will never quite be resolved even with medication. Perhaps we all had a lot of stressful childhoods. Or it may be that having an autonomic nervous system that’s so easily stimulated or on overdrive day in and day out lends itself to anxiety. Maybe trauma of previous bad experiences relating to Dysautonomia/ POTS triggers underlying anxiety.
The thing is—it’s very real and exhausting. It can also create a cycle of feeling sick.
Before pregnancy, I had suffered at least four severe periods of depressions in my adult life, and also daily issues with anxiety. SSRIs usually made me sicker. Wellbutrin was a relief. However, it also increases heart rate. So the treatments for depression and anxiety can often exacerbate POTS symptoms like heart rate and blood pressure instability.
At this point in the pregnancy—almost 28 weeks—almost third trimester—it’s difficult not to worry about finances. I think that’s my biggest worry. On top of worrying about how to care for the baby and also maintaining a loving, romantic relationship with my fiancé. I still take 150mg of Wellbutrin XL, but often it’s just not enough. I really need a higher dose and perhaps a combination of a medication I’ve taken during depressions— Brintellix. But really, it’s better for the baby if I don’t do these things.
With depression and anxiety, my POTS and overall health deteriorates, which in turn gives me more depression and anxiety. And if I get upset enough I can feel it stressing out the baby, which is unhealthy for the baby, which in turn makes me feel awful. If only I could put her in a safe bubble outside of my chaotic body.
I have to make the difficult decision to go along with my doctor’s recommendation of disability leave, which will leave me without pay for two weeks definitely, and then potentially I could get 60 percent my old pay if my insurance doesn’t deny the claim. IF. IF. IF slides down my body in a wave of heat and shorter breaths. The thing that first gave me relief in the doctor’s office days ago—a way out—a way to get more rest and relax—have less work obligations—gives me stress just thinking about the financial repercussions.
I can’t win.
Or maybe I can some. Maybe if I have the rest I won’t be on this much of an edge. I don’t know. It’s exhausting even thinking about it. The dread is overwhelming. It can be suffocating. How will there ever be enough money on top of my student loan payments, my car payment, groceries, taxes, medical bills, and on and on and on. I dread being a burden on my partner. I consider myself a strong woman and yet it's all overwhelming.