Postpartum...Serotonin Syndrome?

I was fully expecting to get postpartum depression. I already had depression, I had a traumatic birth, I didn’t get to encapsulate my placenta like I’d planned to, it was my first baby, I was far from family… I felt like it was a recipe for postpartum depression. So, at 3.5 months when I started losing any and all motivation, I immediately called the midwives about upping my medication to try to get ahead of the PPD. Jokes on me though, that one decision would result in three months of crippling panic, excessive crying, and complete inability to think straight or function.

In addition to upping my medication I also contacted the counselor I’d been seeing right after the birth. She told me she would be going on maternity leave in a couple weeks, but she could do a couple appointments with me before she went on maternity leave. Surprise, surprise, the babies came early and so I couldn’t have any appointments with her.

The first week after upping my medication of sertraline (the off brand of Zoloft) from 50 mg to 100 mg, I felt plenty of motivation, but I was almost manic. I even joked with Jakob that if I didn’t know better, I would think I had bipolar disorder. That should have been my first sign, but I missed the red flag. The next week, the mania turned into panic. I’d wake up in the morning with my heart instantly racing and almost hyperventilating. I’d spend all morning trying not to cry and as soon as Jakob would be about to leave work, I’d break down sobbing. I literally would find myself sitting on the floor with Stella in my lap unable to move or even talk. I was so stuck in my head. My thoughts were so loud, it was like they were screaming.

Two weeks after upping my meds, about 3 days after the panic started, I was walking around my neighborhood sobbing on the phone with my mom and she told me I needed to call the midwives and get help. I called them and they asked if I had anywhere I could go so I wasn’t alone. I told them all my friends had children and I didn’t think I should be around any children in that state, it was bad enough I was around my own daughter. They told me to come into the office. Once I got there, I met with Valerie who delivered Stella. We talked about the birth trauma, and she told me she felt that was what was causing this. I told her how I had been told while in talk therapy right after the birth I needed to do EMDR to deal with the birth trauma but had been putting it off. I left there with plans to set up an appointment.

A friend of mine, turns out, had done EMDR and recommended me an EMDR therapist. I contacted her and scheduled an appointment. Two days before my appointment the therapist texted me saying that she had been contacted and would be deployed in a few weeks and so she would not be able to take me on as a client. I felt so defeated. I contacted another EMDR therapist my friend knew of. It turned out they didn’t take my insurance, but at this point I was so bad off I didn’t even have the mental capacity or the luxury of waiting to find another therapist. I’d already been let down by two (through no fault of their own) and I was terrified to deny one who could take me on.

I’m not even sure how long it had been at this point since my symptoms started, at least a month, and things were only getting worse. I was feeling hopeful though, I was finally starting therapy and felt like I could actually start crawling out of this hole.

I started the EMDR, read two books on the anxiety and depression, and did a ton of research about dealing with depression and anxiety. I read Change Your Brain, Change Your Life and The Food Mood Connection. I started meditating and exercising and completely changed my diet. Around 2 months after the onset of symptoms and upping my medication I was starting to feel a little bit better; I still wasn’t 100% though. I went to my appointment I had with a GP. I updated her on where I started and where I was now and we agreed that the best course of action would be to up my medication again, to 150 mg, then after I was back to normal and had been on the medication for 6 months we could start trying to go down on the dose since it concerned me what a high dose of medication it was.

Within like 3 days of upping the medication the panic came back. Waking up heart racing, hyperventilating, finding myself unable to move or speak just crying uncontrollably. I immediately contacted the doctor and asked what to do. She said we should immediately go back down to the 100 mg and take a blood test to see what antidepressants I metabolized best. I was terrified of switching medications, I knew the Zoloft was the safest for breastfeeding and pregnancy and Zoloft had always worked for me. I didn’t want to have to go through a bunch of medications with a million side effects each. While we waited for the blood test results to come back, I set up an appointment with a psychiatrist another friend of mine recommended.

Jakob and I did a lot of talking and reflecting and decided that it seemed that each time I upped the medication things got worse. I told the doctor this and she said we could go ahead and start tapering back on the medication because she didn’t believe it was helping my mood at this point at all, although I’m not sure she was convinced it was making it worse like I was.

Three days after going back down to 100 I went down to 75. The same day I went down to 75 I went on vacation with my family for Thanksgiving. Thanksgiving was great, I felt great. I still felt jittery, but nothing like before. When I got back from vacation it was a really hard transition. I was really depressed the first couple days, missing family. The depression subsided but I was still having the anxiety, so my doctor and I decided to go back down to 50, the original dose I was on. Soon after that I had my appointment with the psychiatrist. I told him what I had been experiencing and he said I was experiencing serotonin syndrome. This is when there’s too much serotonin in your brain. He said sometimes when you have a baby the baby causes your body to produce more serotonin in your brain naturally which results in too much. Basically, from the beginning I needed to go down on my medication but went up instead.

He had me go down to 25 and set up a follow up appointment for two weeks. After a week I was starting to get bad again, so I set up a sooner appointment with him. From my research it seemed I was experienced normal withdrawal symptoms as my body adjusted to the lower dose, but he didn’t agree. He told me that if I was feeling worse, I needed to go back up to 50. I told him that didn’t make sense we already knew that didn’t work for me. He decided to put me on a low dose of Abilify which is an antipsychotic. I had a lot of mixed feelings about going on that. For one, I didn’t want to go on an antipsychotic even if it was a low dose. Secondly, I didn’t want to go on more medication when I was trying to get off medication. Lastly, my research showed that Abilify wasn’t recommended during pregnancy, and I knew I wanted to get pregnant in the next 6 months. I really didn’t want to have to re-change medications when did. I decided to give it a chance and if it didn’t help, I would go off my medication and try that. I took it one day, and at the end of the day I felt really weird. I don’t know how to describe it, but I just didn’t feel right and decided to stop taking it and try going off of my medication first and if that didn’t work, I would explore other medications. I wanted to give myself a week without the Abilify before I went off the sertraline so that my body wasn’t going off two medications at once. I also wanted to go off of it right as I was going home so while my body was adjusting to no medication, I was at home with family distracted.

It’s been over a week now since I took that one dose of Abilify and I’m back to normal. As of this morning I stopped taking the sertraline all together. Even though I’m back to myself on 25, 25 is such a low dose I really think I can function without medication at all. I have always been easily overwhelmed, since I can remember, but I’ve also been on medication pretty much since I can remember so I’m wondering if that easily overwhelmed tendency is a side effect of the medication.

I meditate every night before going to sleep no matter what, I’ve kept up the running in the morning (although I haven’t been able to this week because it’s been hectic getting ready to come home). I take a bath with Epsom salt every night and read my book. I usually listen to the daily Catholic mass readings and do my bible study in the mornings, but I need to be more consistent with that. I also want to implement yoga daily. My eating is a lot better, but still not where I want it to be. Jakob and I are purchasing a blue life meal plan in the new year I’m really excited to start. I’ve also been journaling at night. Jakob and I also have an hour a night where we put away our phones and just spend time together. Whenever I am starting to feel overwhelmed or anxious, I stop and do a square breathing exercise. Four seconds in, hold for four seconds, six seconds out, hold for four seconds and repeat for a total of four times. I’m quitting vaping as soon as I finish the pack of pods I have, since vaping increases your risk for depression and anxiety.

I’m certainly not exactly where I want to be lifestyle wise. I’m not as consistent with all the above things as I want to be, but I’m so proud of how far I’ve come. Even though these past 3 months have been really rough, I’m thankful for them. I’m grateful because they reminded me how much I need God in my life, and they also pushed me to do research so that I can adjust my lifestyle to address the root cause of my depression and anxiety.

The moral of the story is if a therapist tells you to need EMDR therapy for a trauma, don’t put it off. Secondly, don’t automatically up your medication if you’re feeling off. Take the time to figure out what’s really going on. Don’t just try for a quick fix. And lastly, don’t just jump to medication in general. If you’re having mental health issues, assess your lifestyle and make changes as your first line of defense and use medication as a last resort.

There is absolutely nothing wrong with medication, when it’s needed, but it is so overused in our society. There’s a pill for everything and we think it’s an easy fix, but it doesn’t fix the root problem and opens up a can of worms for a whole bunch of other problems. Lastly, do your own research. Psychiatrists are great at their job, but their job is to prescribe medication. No psychiatrist, or I should say most psychiatrists, are not going to jump to go off your medication and sometimes that’s what you need. You know your body and what you’re feeling best of all, and sometimes that can be hard to articulate so doing your own research can make it easier to understand what’s happening.

*Disclaimer: I am NOT recommending you go off your medication or to make any medication changes without a doctor/psychiatrist’s guidance! You should always talk to your doctor/psychiatrist and make decisions but don’t be afraid to put your foot down and say this is what I want to do how do I do it safely.

Cover photo from: https://en.wikipedia.org/wiki/Serotonin