Pregnancy & a severe anxiety disorder

July 25, 2010 3:12 PM

I'm a life-long sufferer of crippling anxiety/depression. Should I have a baby? Details inside.

I've dealt with severe anxiety & depression since I was seven years old. I've been through the gamut of treatments and psych docs. I've accepted my condition as chronic, and while everything's under control now, I know I'll continue to cycle the rest of my life.

My anxiety manifests physically. When I'm very anxious, I get physically ill to the point of dysfunction. (Dizzy, achy, deep fatigue, flu-like symptoms.)

While I've found the right combination of elements to control my anxiety, if those elements are disturbed for long periods of time, I have difficulty recovering. (Sleep, eating habits, exercise, etc.) I've been checked by several medical doctors, too. No apparent physical cause, so I've accepted this as a psychiatric condition.

Even at the worst of my anxiety and depression, I pay my bills, take care of my animals and plants, and get up in the morning. I'm a caretaker by nature. In these bad times, however, I'm unable to work or leave the house, and I'm in a perpetual state of mental despair and physical illness.

I'm 30-year-old, married, female with a wonderfully supportive husband and I'd like to have baby. Because of the way my anxiety manifests, I'm terrified that I will not be able to care for a child.

Though my condition doesn't keep me from caring for my animals and husband (if he's in need of caring), I'm scared the physical & mental stress of having a child, along with the hormonal changes, will leave me completely broken and unable to care for my child or myself, and will worsen my anxiety/depression. My anxiety/depression has cycled so badly in the past that the idea of reaching a low LOWER than those dips is unfathomable.

I feel like if I disturb the equilibrium I've achieved after years of crippling mental illness, I'll never be able to recover and will do inadvertent harm to my child and myself.

I've nearly resigned myself to being childless because I'm too afraid of the consequences. This breaks my heart as I love children, as does my husband. We want a family.

Have you gone through the same thing? Do you have advice on how to proceed? Though there's no way to predict hormonally what a pregnancy will do to an individual's body, did you have either crippling or surprising mental changes during/after pregnancy?

I'd like to stop waffling and either accept that it's best I go childless, or take the leap and attempt to conceive. My husband is supportive with whatever I decide is best. Our relationship is strong, and will continue whether we have a child or not.

Caveats:

a) I've read Dooce.

b) Medication. I've tried many, many combinations of different medication over the years. I've never found a combo where the side effects didn't outweigh the benefits. For the purpose of this question, please assume medication isn't an option right now, and trust that I've been down that road with professionals. I've accepted that if medication was the only choice, not putting my brain through another course/experiment in meds is more important than having a child.

c) I'm currently in therapy, and actively talking about this with my therapist. I've talked about this with my PCP, too. Their consensus has been that it's risky, but they don't believe I'll be harmful to myself or a child. Great to hear, but I'd love some first-hand anecdotes.

Thank you for your wisdom.

posted by Laura Macbeth to health & fitness (31 answers total)

I should mention that while the hormonal changes of pregnancy are worrisome to me, I'm also worried about how my condition will function with the changes/mental stress ANY child brings, adopted or biological. Thanks again for the advice!
posted by Laura Macbeth at 3:14 PM on July 25, 2010

Can you afford a nanny and/or housekeeper? That might help a lot.
posted by amtho at 3:26 PM on July 25, 2010

I don't have much expertise or insight on your question in general, but I'd just like to point out one concern: At times when you aren't able to leave the house, who's going to be free to take your child wherever s/he needs to go -- school, extracurriculars, doctor, lessons, friends, etc.? Someone's going to have to do those things, over and over and over, hundreds of times a year. Will your husband be OK with doing all that extra work? Or can you get someone else to do it?
posted by Jaltcoh at 3:37 PM on July 25, 2010 [1 favorite]

Hi there --

I am not an expert.....just a mother of two who has experienced anxiety/depression issues on and off for most of my life. My children are now 3 and 6 and turning into messy little hilarious humans I am very glad to know.

A few quick thoughts.

1.) Your post sounds remarkably self-aware and thoughtful. Good for you!

2.) Yes, there's no way to know how a new baby will affect your life and mental health. For me the sleep deprivation of the first few months was huge. Mind-blowing. Nightmarish. But we all made it through intact. (And I was waaaaay more clueless than you seem to be.)

3.) It sounds like you've got some support in place -- that's great, and more is good. It sounds like you have a supportive spouse and therapist. Any friends/support groups are great too, and nearby family (if they are helpful) could be good too. We had no nearby family, but I was fortunate to stumble into some amazingly supportive friends. Do you have friends who can take over if you need a day or so to just gather yourself?

4.) Parenthood tests your resources in ways you never expected, but you also find reserves of strength and patience you never knew you had. And sometimes those babies are just....awesome.

5.) Lower your standards. Dirty dishes, mounds of laundry, unanswered email....none of it matters when you NEED TO SLEEP.

6.) I've been on and off medication too in different combinations too. I haven't found anything "perfect" either and it sounds like you've been trying too. If you want to be unmedicated, it sounds like you've really thought it through.

If your anxiety and depression consistently manifested through wanting to harm yourself or others, I think it might be more worrisome, but that doesn't seem to be the case, and you sound like you have a good handle on what your mind is like.

I read Dooce too when my daughter was young (she's about 4 months younger than Leta) and that, in itself, was helpful.

You can do this. Find your tribe and let them help you.
posted by pantarei70 at 3:41 PM on July 25, 2010 [3 favorites]

Thanks for the answers so far!

Amtho - It's possible we could afford a housekeeper, but it would be tough. But it's a good suggestion.

Jaltcoh - Very true. My husband says he would be OK picking up the slack when I couldn't, but there isn't a way to know this unless we're in the situation.

Panterei - Thank you for this wonderful post! I have one close friend, and a smattering of acquaintances. I'm close with my family, but they live 3000 miles away. My anxiety has turned me into somewhat of a solitary person because I can be flaky. However, I love "find your tribe and let them help you!" Very encouraging.
posted by Laura Macbeth at 3:52 PM on July 25, 2010

I am bipolar and suffer from anxiety. Having a child has put a lot of things in perspective for me, and I find that I am much more calm with him and with life than I would've thought I could be.

I was lucky enough to get accepted into a study at Emory's Women's Mental Health program. The head of the study wrote the OBGYN manual for women with psychiatric issues and pregnancy. You should probably be able to find a copy somewhere or even through your OBGYN. It's scientific but a good handbook and read for women in our situation.

I stayed on medication throughout my entire pregnancy. I was put on Lamictal which is their top choice for pregnant women. For anxiety, I was given a low dose of Ativan. He asked me to go off it two weeks before my due date so that it would not leave myself and the baby under its effects during the labor process. (He came early so it wasn't possible, but it didn't seem to make a difference.)

I should note that I accidentally got pregnant after being with my husband for 8 years. We had just made the decision and told our families that due to my issues we were not ever going to have children in order to protect me from the challenges that we thought would destroy me and our lives. I'm not being a doting mother when I say that I have a VERY happy and well adjusted me and baby.

Good Luck.
posted by eggerspretty at 4:12 PM on July 25, 2010

I would not.

If you do, go in prepared for it to cripple you. Do everything in your power to preempt it, and have everything ready for if it happens.

You need social support, money, and information. Do you have family and friends around? You'll need them. Yes, hire a nanny or helper. Yes, if you can, hire a housekeeper. Consider group message boards and meetup/play groups. Be in therapy, right from the start. Learn what to expect with pregnancy and parenthood, so that you're less likely to feel lost or overwhelmed, so that you know how to meet it. Get sleep any time you can slip it in. Get sleep any time you can slip it in. Get any sleep any time you can slip it in.

And take care of yourself. Know how to keep your anxiety and depression at bay, have it down as a rock solid habit before you get pregnant.

This will be more work than you can imagine.

I'm sorry that I do not have a long, articulate personal story for you. I really don't have it in me to spill my history right now. I'll say that I'd not had an easy life previously, and that all of it pales next to the hell of postpartum depression. And there is nothing quite like the crushing guilt of feeling like I have not been a good enough mother. Like I have failed her in very important ways.
posted by moira at 4:16 PM on July 25, 2010 [1 favorite]

Having closely witnessed a parent with a similar condition raise a child, I'm going to say no, despite the fact that they have a generally good relationship. The heart ache and self doubt instilled in the child by having to deal with and sometimes take care of parent is heartbreaking. At times the child would manipulate the mother, simply because she figured out she could and felt as though she was "owed" for all the rough times. Though they're working on the dynamic and do generally have a good relationship, there has been damage, on both sides, that will probably be permanent, though I suspect they'll come to terms with it and continue having a good relationship.
posted by new brand day at 4:18 PM on July 25, 2010 [1 favorite]

Hire a housekeeper? Ugh.

Raising a child isn't like watering plants or caring for a pet. I'm sorry, but it's just not routine. The more you can establish routines, the better, for both child and parent, but it is full of surprises and changes, and is often unpredictable. You describe how your anxiety/depression manifests but not (besides upsetting your routine) what triggers it. Life is not routine.

At the same time, my experience has been that raising children is pretty easy work, but it is relentless. It goes on and on and on for years. There is never a break, even when there is a break. Right now you have a supportive husband, but what if that changed? What if trauma/disability or chronic illness affected one of you? Or the child? What about when the child is 3 and says "NO!" to everything you say? Or 12 and develops an attitude? What if your financial situation changed, or divorce or death entered the picture?

You also describe how you've been trying to imagine what having a child could do to your mental state, but I think you should give serious consideration to what it would be like for a child to grow up in a home with a mentally unstable mother. That old "Children Learn What they Live" poster is right, and any child you have is going to learn from you how to cope with stressors, how to navigate his moods, etc. I don't mean to sound negative about it -- I say this from my own experience. As my children have gotten older, I've begun to see where my personality traits (and anxiety/depression are among them) have shaped/affected their personalities. And of course those are the things I am most concerned about for them!

"[I]t's risky but they don't believe I'll be harmful to myself or a child" sounds like enough for a child to survive, but it doesn't sound like an environment where a child would thrive.

If you do decide to do it, I wish you well. I can't find the post now but someone posted once about raising a child being akin to building a brick wall, where each day you have one brick to lay. On any given day you can slack off or be impatient or mess up one way or another, but that day will always be there and will weaken the wall. Maybe not noticeably, and nobody's wall is perfect, but it's a good way of looking at it as the marathon it really is. It's not about losing sleep in the first few months; it's about a lifetime commitment to another creature whose needs trump your own.
posted by headnsouth at 4:35 PM on July 25, 2010 [7 favorites]

I think I would recommend thinking of this as a disability to try to get some of the emotion out of it -- to think more practically.

So basically, you have an illness which might be exacerbated by pregnancy and post-partum depression. Those are your two most vulnerable areas, really.

But you do want to have kids -- you do. There's no reason you shouldn't. People have kids despite LOTS of different challenges, physical and mental health, finances, etc. People have kids, good kids and successful families, in sub-optimal circumstances. All the time.

So the question becomes: what are the things that can help you manage the hormonal problems that will arise from your pregnancy and those that will arise, most likely, from PPD?

Can you trust your husband to tell you when you're not thinking straight? Can you believe him and just recognize maybe you have to go sit and read for a while?

How's your support system? How can it be better? How could you use it when you have PPD?

What are the signs people should look out for, and how can they help you if they see them?

What behavioral things can you put in place during and after pregnancy that can help? (Exercise, diet etc)

I am prone to all of the above and struggled mightily with PPD and just generalized weeping anxiety when I was pregnant. There are things I could have done better, so that's the standpoint I'm coming from here. Plan like crazy and communicate with your loved ones and care providers, is what I'm saying.
posted by A Terrible Llama at 4:43 PM on July 25, 2010

Step dad here. My acute anxiety has all but disappeared in the last ten years I've spent with my wife and boys. I will never be able to repay the kids for the strength and courage they've given me. It really just seems that my many triggers melt away when in the presence of my kids and children in general. My mind stops and everything is about them.

More importantly and hopefully more helpful, I would do more investigation about the effects of hormonal changes during pregnancy. This is pure hypothesis, but considering that anxiety and depression are comprised of parts that are emotional, psychological and chemical, that being pregnant may give you more miracles than just the baby.

Any mom will tell you that EVERYTHING changes with a baby. I think that might be good news for you.

Also, pantarei70's comment is right on the money.

Best of luck to you!
posted by snsranch at 4:45 PM on July 25, 2010

I'd suggest figuring out a way to afford a live-in nanny or mother's helper. Then you'll have a fallback person for if/when you're not as functional.
posted by Jacqueline at 5:22 PM on July 25, 2010

My husband says he would be OK picking up the slack when I couldn't, but there isn't a way to know this unless we're in the situation.

If you're going to do this, you're going to need more than you husband. You're going to need actual caring family members who are willing to help you. In that happens, you may have to be comfortable with idea that the child is not strictly yours, i.e. it'll have many parents who may be in conflict on who the final authority is.

A nanny could work, but actual family members (or friends) i.e. more than a single extra person would be best. Would it be possible to move closer to your family, like in the same city?
posted by new brand day at 5:34 PM on July 25, 2010

I'm in a similar position, and I've decided against having kids. Partly because I think it would be almost impossible for me emotional if i got hit hard with postpartum depression and partly because the odds that my children would be be bipolar or anxious are not insignificant and I don't think I could bear watching a child of mine go through what I went through as a child and young adult.
posted by mkuhnell at 5:40 PM on July 25, 2010 [1 favorite]

Thanks again for all this thoughtful advice on both sides of the issue. I knew I could count you. Though I mostly rambled about myself, I'm deeply, deeply concerned about how my illness will affect the child. It's just easier to imagine how it would affect me. I also didn't mean to imply caring for a child is like caring for pets/plants -- I just wanted to frame how my illness manifests.

New Brand Day - it's not possible for us to live closer to my family, but I should've mentioned my husband's family is close by. While I haven't been as close to them as I would've liked, they're loving, supportive people and would no doubt help if asked. We see them often. (His dad is an OB/GYN nurse, to boot.)

I do have people who would support me if I asked. It's difficult for me to ask, but I'm gleaning from these answers that support is #1.

Eggerspretty - thank you for the suggestion on re: the manual. I'll check that out.

Again, thank you. Hearing all sides is helping.
posted by Laura Macbeth at 5:43 PM on July 25, 2010

did you have either crippling or surprising mental changes during/after pregnancy?

I am generally a goofy, happy-go-lucky kind of person (which is sheer dumb luck on my part, because both bipolar disorder and OCD run in my family), and despite this, I have personally found that pregnancy hormones in the first trimester can be freakishly strong and scary.

I am currently knocked up with kid #2, and almost every night for about 6-8 weeks in the first trimester, I had a crazy, whacked out "worst case scenario"/"what if" brand of nightmare. That is, not only would I have dreams/nightmares strong enough to consistently wake me up at around 4-5 AM, but they would each be different variations on identifying potential physical or emotional dangers among my environment or people I knew, but veering off into the infinitesimally-unlikely type of threat-identification. And although the theme of "what if" was the same, it was a different dream/nightmare each time.

Here's an example: one of the panicked "what if" dreams I had was a "what if my husband and I got somehow thrown back in time to the early 1980's and we had to survive and somehow make a living and yet be unable to let on that we were really from the future, and we had to stay under the radar from the government, and we had no official papers or documentation, and do you think maybe he'd know enough about who won the World Series each year that we could surreptitiously bet on that outcome each year to earn enough money to live off of for the upcoming year, and maybe I could figure out what early tech stocks to buy (like Apple) and we could earn money that way, and we would have to be careful not to accidentally meet up with our contemporary selves or families so that we wouldn't destroy the timeline and cause a paradox, like in "Back to the Future"..."

Um, yeeeeah. Sure, it sounds koo-koo-for-Cocoa-Puffs now (but, I'm a bit proud to say, creative!), but I still woke up from my sleep with my heart pounding, and then I was stuck awake for another hour, because the anxiety from the hormones wouldn't let me get back to sleep, and that meant I was tired all day, which is when my other fun side effect from the pregnancy hormones, all-afternoon-long nausea, kicked in. And as I mentioned, these kinds of crazy crazy dreams like this, each one different and new, happened almost every night for almost two months of my first trimester. That's how crazy-making the hormones can be. Luckily, things leveled off after about week 14-15. Now I just wake up in the middle of the night from the much more mundane (but still desperate in its own way) need to pee.

So, do I, an Internet stranger with an overactive imagination, think that you should go ahead and try motherhood? Yes, I actually do. You just need to assume ahead of time that some parts of your pregnancy will be very, very weird (although almost every pregnant woman I know or know of agrees that the second trimester is pretty great, both physically and mentally), and that at a minimum, you will be a brain-dead zombie for most of your child's first six months, if not a year.

If you go into this adventure assuming zombiehood for at least six months to a year, you'll be much better off. Because then you don't have to spend all that nervous energy worrying about becoming a zombie mommy -- and that would only feed into your cycle of anxiety anyway! -- you can just expect it! And if you do have a good day in those first few months where you and your baby both get enough sleep and you have good energy levels and things are fun and sunny -- why, then, that will be an unexpected treat.

And if it means anything coming from a stranger on the Internet, I think you will make a very good mommy, because you care enough about parenthood to want to be good at it. That's so much more than many parents do. Best of luck to you and your husband!
posted by Asparagirl at 5:57 PM on July 25, 2010 [2 favorites]

And one more thing: children, especially once they get out of the newborn phase and more into the unique-person-with-a-distinct-personality phase (say, after three months old, but moreso after a year old), can be like a brilliant source of light and love and happiness and calm and joy that you never ever knew existed in the world. Yes, your life will revolve around them, but they just give so much to you, too. Watching a baby learn to recognize you and smile and laugh and giggle at the world is such the best thing ever.

Psychiatric meds may not have worked for you, but a toddling smiley happy little kiddo who thinks you're the best thing in their entire world might very well be a source of real strength and happiness for you, not just a potential stressor.
posted by Asparagirl at 6:05 PM on July 25, 2010 [1 favorite]

My Mom is fairly...ahem...'high-strung'. (She is unbelievably anxious). It rubbed off on me. I've spent most of my adult life trying to learn how not to be like her. I love her to death, but being around her pretty much gives me a panic attack, too. I wasn't abused as a child, and I'm basically a normally functioning adult, but I'm really jealous of everybody that had a 'normal' mother.
posted by Green Eyed Monster at 6:10 PM on July 25, 2010 [3 favorites]

[A few comments removed. One- and two-word answers aren't very helpful, please include some reason or context for your answer if you're going to try to contribute to the thread.]
posted by cortex at 6:38 PM on July 25, 2010

From a MeFite who would prefer to remain anonymous:

I was in a similar situation to you, except that meds worked pretty well for me. I stayed on depression meds (but went off anxiety meds) through my pregnancy and while breastfeeding (after consultation with GP, Ob/Gyn, and pede). I researched and chose a local ob/gyn with experience in depression in pregnancy, and made sure my child's pede was aware of my depression as well.

I also executed a legal document called a Declaration for Mental Health Treatment (called something similar in most states, if you're in the US) before I got pregnant. What this document did was allow me to state my preferences for treatment of my mental health for the next three years (in my state) in case I became too mentally ill to make good decisions about my own care. I was able to state that I was concerned about depression during pregnancy and post-partum depression and that I wanted my husband and/or my mother to have the power to have me medicated or committed if in their judgment and the judgment of my doctor I was not getting the care I needed. This took an ENORMOUS load off my mind, knowing that if my depression DID spiral out of control, the people who loved me would be able to get me help. Seriously, after I did it, I worried so much less about my mental health.

While this is obviously not true for everyone, and is just my personal experience, I found having a baby so incredibly grounding and centering and mentally healing. Once I got past the horrible "no sleep ever" phase, I got less upset, maintained my equilibrium, felt happy and mentally healthy. Scored better on depression inventories than I ever have since I got diagnosed. No post-partum depression. Actually tapered my meds because I was doing so well. I don't know how much of this to attribute to hormones, how much to the fact that my focus could no longer be myself so I don't really have TIME to get in spirals of bad thoughts, how much is just coincidence. But parenthood has provided me a type of healing no therapy or anything else ever did (which I almost hesitate to say, because having children to get better would be a terrible idea).

It may not be the same with my next child, and I'll execute another mental health declaration and so forth, and watch just as vigilantly for pre- and post-partum depression. And of course I don't know it'll be like this forever; I will always have to be vigilant about my mental health, moreso now that I have a child to depend on me. But it has gone so much better than any of us imagined.

posted by jessamyn at 6:38 PM on July 25, 2010 [4 favorites]

I have a children with my partner who has severe depression and anxiety.
I echo that you need a strong support system, from my personal experience I would not rely on in-laws but instead on my personal family and close friends. You would probably also benefit from a live-in nanny to relieve some of the burden.
It is unfair that you can't have a "normal" life, but, it is what it is. You may be unable to return to paid work (as looking after a child is a challenging job by itself) so plan financially for one income supporting all of you plus the caregiver.
posted by saucysault at 7:11 PM on July 25, 2010

Don't be afraid to do what works for you - people really create an atmosphere of anxiety around children (pregnancy and infants in particular). Everybody's got some damn advice and opinions about everything. But be ready to nod and smile and do what works for you. Baby in the bed lets everybody sleep? Great! Baby in her own room is better for everybody's sleep? Great! Breastfeeding works? Great! Formula-feeding works? Great!

If you decide to have children, the best thing you can do is take the pressure off yourself to have a perfect this or that (perfect birth, perfect feeding, perfect mother) and just focus on finding what works for your family. Even if that isn't typical for your social group or family.

I think the fact that you both actively want children and are being thoughtful in your approach is a huge plus here. Keep in mind too that even the "normal" moms have their own issues and challenges and failings.
posted by jeoc at 7:13 PM on July 25, 2010

If your symptoms of anxiety and depression are kept in check by routine and predictability, a child will make that extremely difficult. I had mild episodes of depression before I had my son. Four months postpartum, however, I'm still sometimes riding the postpartum depression train despite the veritable village of support that I have. And, it is a village: mostly full-time husband, daycare, friends, and at least one set of parents near by. I'm still exhausted at the end of the day.

Pregnancy itself, once I was out of the major miscarriage danger zone, was not a depressive trigger. It was after the baby was born and I was responsible for figuring out an infant who had exactly one cry (scream) and I couldn't give him back when things got hard that really threw me for a loop.

Knowing now what I know, I would have thought long and hard about whether I was strong enough to handle the enormity of parenting. It is all encompassing and engrossing, whether you want it to be or not. I love my son and the moments of joy are slowly outweighing the moments of sheer frustration, but these last four months have been the hardest of my life.

Good for you for thinking about this ahead of time. Whatever you choose, you will go into it with eyes wide open.
posted by Leezie at 7:36 PM on July 25, 2010

I read your question to my partner and we spent some time talking about it. It's a tricky one, and for us, even with hindsight the answers aren't clear. Parenting is unpredictable, and how it affects you is unpredictable. So is life. We adopted our third child, for instance, just before my 42nd birthday. It's hard to imagine life without her, and she is a delight and the light of our lives. And yet--had we known that within a year of her birth I'd enter Perimenopausal Hell, with frequent long, hard periods that brought migraines and anxiety bordering on panic attacks with them, and if we'd known she'd be orders of magnitude more high-energy and hard to keep up with than the first two--well, I'm just saying, it's been hard. Yet I wouldn't have not done it just because it's been hard.

You have some things going for you. One is that you are already skilled and knowledgeable about dealing with your anxiety and depression, and you have a therapist. After lifelong GAD, I fell into post-partum depression after the birth of #1. Fortunately, my partner and I had experience with the mental health system, and with recognizing early warning signs, and we got me help fast. In my case, that included meds, but it also included retuning to therapy and joining a PPD support group. I think having that prior history and knowledge made a huge difference in how quickly my PPD resolved, and how minimally it affected our lives.

Like moira above, I worry that I'm not doing a good enough job for my kids--I had 3 despite a history of anxiety and of chronic pain, and my 9yo and my 6yo know that I have good days and bad days; they help each other out if I have to nap when the youngest does, and they're very kind and solicitous to me. I don't want them to have too much responsibility, or be pushed into an adult role, or to feel that their mother is unreliable or unavailable. Sometimes I think they are--but is that true, or is it just my anxiety telling me it is? My partner says I, and the kids, are doing great, and I fret needlessly on this subject.

For me, being honest with the kids as they've gotten older has made a huge difference. We acknowledge that I have ups and downs, I admit it when my anxiety or pain makes me cranky, I am very skilled at apologizing for my failings. My two boys probably know more about women's reproductive systems than is good for them but it helps them understand why I am the way I am, and makes it easier for me to talk to them about what my doctors and I are doing to try to improve things. And as they've gotten a bit older, it seems sometimes like having a fallible mother has helped them deal with their own challenges.

I will say, that having birthed two and adopted one, I was really struck by how much easier it was to deal with the newborn stage when I wasn't also recovering from pregnancy and birth. Now, I had two horrible pregnancies, so maybe it's not like that for most women, but I dealt with the sleep deprivation etc much better when I wasn't also going through the hormonal swings that happen post-partum. I'm not recommending adoption necessarily, just tossing this tidbit into the mix. I am living proof right now of how hormones can kick your butt, and it is possible to opt out of that piece of things.

I don't know the answer for you. If we could have looked into a crystal ball to see what these last two years would be like, we might not have had #3--and yet I wouldn't be without her for the world. It's a big messy mixed bag. But I will say that I went ahead despite chronic daily pain and my history of anxiety in part because when these kinds of things are part of your life, you can either find a way to keep doing the things that are most important to you, or you can give them up. I wanted to be a mom, in such a deep way that it really mattered to do it despite the risks.
posted by not that girl at 7:53 PM on July 25, 2010

I know it's absolutely not PC to say "Don't have a baby if you really really want one," and I've probably said "have a baby" more than not on the Internet anyway, but man, I think you're right to have severe reservations about this. If you already have cycles of being too ill to leave the house, if you have to stay on a routine, if drugs haven't helped you worth a damn ever (though at least that rules out the argument about whether or not to be medicated while pregnant, I guess), hell, I'm scared for you. But even more, I'm well, worried for your child.

Yeah, I don't think you'll beat a child or go screaming nuts on one, but I can't help but think that:

(a) Depression is inheritable, apparently both by genetics and by growing up with someone who is depressed. Are you okay with passing this on to your child? To see your child go through the same things that you have since you were seven? Do you want a child with your husband badly enough to make him/her go through what you have? I hate to scaremonger, but it sounds pretty likely.

(b) Even if somehow your child doesn't pick up the depression, how well can you manage to "be there" for a small child needing mommy all the time when you are in the pit? That is definitely going to affect your kid because s/he may not feel loved because Mommy needs to hide in her room for 2 months (or whatever). I don't think you could physically harm the kid, but I do worry about the emotional effects of depression on a little kid just dealing with mom going through another cycle again.

To be honest, if it were me I think I would rather just play with other people's kids to get a kid fix.
posted by jenfullmoon at 8:19 PM on July 25, 2010 [1 favorite]

I have some horrible and long-standing sleep problems. I hoped a baby would be a sort of trial by fire/boot camp that would 'teach' me how to sleep; it didn't. I went back on sleeping pills, and things are well managed, but I still have the odd bad night.

When I am sleep deprived, I am anxiety-riddled, paranoid, a mess. Prior to having a child there is no way I would've left the house or even made telephone calls on those days.

But this is not an option with a kid. So I take a deep breath and put my coat on and stumble along and do whatever it is that needs to be done.

If there is no chance of your forcing yourself out the door during a bad patch and the kid is going to routinely miss his or her usual appointments with the outside world, even just the park -- I would lean towards not having a child, at least not without something like a very kind live-in nanny under contract for a decade.

Right now I am laid up a bit with a hip problem. I have a <3>
What would the plan be for times when you are "in a perpetual state of mental despair and physical illness"? Because there's just no way a young child is not going to require extensive emotional and physical care 24/7. How flexible is your husband's job?

However. +1 to Asparagirl's comment about children making one happy. And, has it crossed your mind that yours may not be a permanent condition? I was once suicidally depressed -- for years; I lost a big chunk of my life -- now? Tickety-boo.
posted by kmennie at 9:25 PM on July 25, 2010

Well, I couldn't tell you to have a baby or not have a baby -- that's such an incredibly personal decision, I don't think I could tell anybody that. But I can relate my own experience, and hopefully that will be helpful.

I grew up with a mother who was INCREDIBLY anxious. As in, completely unrestrained worrying. And yes, it did rub off on me. Some of it may be genetic -- I know that OCD can run in families. But I think a lot of it was her complete unawareness of her own tendencies. (and also there was my complicit, enabling father, but that's another story) So she would always worry worry worry, and urge me to do the same, and to act based on those worries. I'm not blaming my problems on her, but it's pretty clear where I get some of it. I am a catastrophic thinker, as she was, and it messes with me sometimes.

Now, you seem 1 million times more self aware than my mother was. The best thing I can say is that if you do have a kid, please hold on to this self awareness. Be aware of your own problems. Ask yourself the question, "Am I saying this to my child because it's the right thing to say, or am I only saying it because of my anxiety/depression?" Enlist your husband in this. Ask him to call you on it if you're letting your illness run away with you. My father was afraid of my mother, and never acted as a check on her worrying tendencies. He could have been a lot of help, but he wasn't.

I don't have kids and cannot offer parenting advice. But I would guess that people with anxiety/depression CAN be good parents -- as long as they watch themselves.
posted by Sloop John B at 9:51 PM on July 25, 2010 [1 favorite]

Thank you again for all these wonderful answers. I'm always wary about posting on MeFi, but this proves the community can be thoughtful & kind.

A couple of things -- depression/anxiety actually doesn't run in my family. I had some pretty terrible things happen to me as a kid, physically and mentally. While I think I do have some naturally wacky brain chemistry, I think those events at a young age gave me a double whammy. The rest of my family + my husband his family are some of the most well-balanced people I know, so while the "passing on the gene" thing does cross my mind, it doesn't worry me like it would if there was history.

As for not treating this as a permanent thing -- treating this as a chronic disability has been a coping mechanism for me. While, of course, I hold hope I'll someday be better, for practical reasons, it's better for me to proceed as if it I won't. (Which isn't to say I still don't try to push myself into new realms of wellness.)

Also, someone asked if I would be able to push myself out the door if I really, truly needed to. I think I could, and I have in emergencies, but when I'm in a bad state, the recovery from those particular pushes is long, which obviously doesn't work well with a child as recovery time wont be readily available.

My husband has a flexible job that pays pretty well, and we've been together for over a decade. He knows the ins and outs of my illness as well as I do, so he would be a terrific advocate & observer.

Thank you again for sharing your stories and advice. You have no idea how much this means to me. I have a lot to think about.
posted by Laura Macbeth at 10:35 PM on July 25, 2010

headnsouth: You also describe how you've been trying to imagine what having a child could do to your mental state, but I think you should give serious consideration to what it would be like for a child to grow up in a home with a mentally unstable mother. That old "Children Learn What they Live" poster is right, and any child you have is going to learn from you how to cope with stressors, how to navigate his moods,

The total and unrelenting horror I felt when I realised my 12 month old was pinching the skin of her palm when upset by too many people in the living room was mirroring what I do has only been matched by the choking incident.

It's terrifying. I worry a lot that I've given her my mental illnesses. That I've 'made' her like me. I worry about her dislike of loud noises and animals and her lack of affection for people other than me and the other anachronism. I get nervous when she stares intently into space for too long. I get anxious when she repeats actions.

Then I breathe, relax and realise I'm not that bad, as a person. That a lot of it is developmentally appropriate anyway. That she's got any number of non-mentally ill role models. That if she's anxious, or depressed, we can deal with it. It's okay. *I* am okay.

(Self loathing was always an overly large feature of my depression so coming to this point is incredible.)

For me pregnancy has been the only time I have had no depression. A smidgeon of anxiety (a single panic attack late in the pregnancy when some issues were cropping up and fucking up all our plans) but no depression. It was the most amazing thing. Then I had baby anachronism and it all paled in significance beside her.

I'm not 100% nowadays, but I'm better than I ever have been. I have bad days and good days and obsessive ones but in general having a child has made a very positive change in my mental health. From the purely practical (I may not have a minute-by-minute routine but I have a HUGE number of centering rituals throughout the day) to the more ephemeral (my life is so incredibly entwined with hers that I cannot even fathom the concept of suicide which is probably the biggest change). She is a constant reminder to not let myself spiral down and out.

That said I am SO much more vulnerable. I've gone from not crying unless drunk and provoked to tearing up at Pixar movies, newspaper articles and listening to the other anachronism talk to our baby when he thinks I'm not listening. It's hard to be this vulnerable after spending all of my life building walls to protect myself. Everything else has been simple (but not easy) to adjust to - the no sleep, the no space, the immediacy of it all. But I am no longer a solitary whole.
posted by geek anachronism at 4:22 AM on July 26, 2010 [2 favorites]

Lost part of my comment with a misplaced "<" -- sorry! Hip problem, small tot, difficult, etc. My advice would be to get your ducks in a row, support-wise, if you are going to do this. Even if it means moving to a new community. I am right now surrounded by helpful neighbours, in a place where people say hello to each other; I know the people on my street, and if another parent and child wander past our house I can catch a worry-free break while my daughter strolls down the block with them. Neighbouring mummies have been a tremendous help -- I can't push a swing right now but we are not lacking in swing-pushing volunteers.

Parenting in isolation is unnecessarily difficult for anyone, and it must be horrible with any sort of disability involved. Dad here is able to take a day off without too much bother, and my parents are nearby, and so we are getting by with me off my feet. If not for all that help -- I don't even want to think about it. "It takes a village," etc.
posted by kmennie at 5:22 AM on July 26, 2010

It's a complex question. My response is pretty personal. My Mom was (diagnosed by her kids as) bipolar. She was an alcoholic. There are strong genetic influences. My brother has been diagnosed as bipolar. One sister is (diagnosed by me) bipolar. I am on the milder end of the bipolar spectrum. My son is (diagnosed by me) bipolar. Of the grandkids, several have psychiatric diagnoses. My Mom's brother had serious mental illness and alcoholism.

So, how would you cope with a child who had a serious mental illness? What if it manifests pretty early? My son was a difficult child to parent.

My Mom was an intense parent. Sometimes really interesting, sometimes mean, detached, abusive, angry, fight-y, needy, yeah, I could go on. I have some issues, I am in some ways damaged. I'm also smart, funny, kind, interesting and complex. I feel sad for her because she never got the meds and therapy she needed. Effective therapy and meds didn't exist when she was young.

On the other hand, I'm glad she had me (she really didn't want more kids; the last 3, of 6, were unplanned, the last 2 definitely not wanted). I wish I hadn't gotten the bipolar genes, but I'm very happy to have the intelligence, humor and complexity. Would I have the good without the not-so-good?

Some kids are really resilient and will thrive in profoundly adverse environments. Some kids are really sensitive and will end up in therapy even in ideal circumstances. You have no idea what your child will be like. You could have a child with MD, CP, Down syndrome; can you deal with that? Get the best treatment you can; it keeps getting better.

Babies are awesome and amazing. Kids are so much fun. I coped with my depression because I had to. I was a pretty good parent the way I'm a pretty good person; good days, not-so-good days. Being conscious of my depression, being conscious of how I want to parent, has helped a lot. Having a supportive spouse would have been fantastic, for me and my son(spouse too, but that's another story). Every pregnancy is a crap shoot. Complexity makes the world better, I think.
posted by theora55 at 9:32 AM on July 27, 2010