Right after my D + C procedure and right before Dashiell and I leave for our honeymoon, I have an appointment with Dr. Laser.
She’s a psychiatrist Dr. Betsy the OB thought I should see back when I was pregnant; she thought it would be a good idea to get a post-partum plan together should I slide into the madness once the baby’s on my tear and all my hormones have leached away.
After the ultrasounds revealed that the baby had stopped developing, Dr. Betsy still thought it would be smart to see Dr. Laser and talk about my mental problems. Why not? It has been a season of hiring and firing therapists, why not bring a psychiatrist into the mix?
Dr. Laser is sort of foxy, somewhere in her 30s, with long cherry-red hair and tall black boots. I’m both comforted and distraught by her apparent coolness -– it makes me feel like she’ll understand me, which is relieving, but it also makes me want to impress her, which is embarrassing.
Dr. Laser keeps a pretty solid therapy poker-face, asking me a series of questions that prompts me to reveal exactly how fucked up I’ve been, in how many different manners, for how long. I detail my family history of alcoholism and my own stunning achievements. Yes, I probably have had some dalliances with eating disorders –- OCD, too!
Awesome. Depression, anxiety. There was that time in my late teens where I couldn’t stop crying. There’s that whole deal with my stepfather. I started out on Lexapro, switched to Celexa and then hopped to Citalopran. Now I’m off everything, detoxing, no doubt, from the pregnancy hormones, natural and synthetic, that had been flooding my body for the past few months.
It just feels so lousy to have to detail the vagaries of your inherited mental health. I mean, if I’m hanging out with my similarly banged-up friends, making dark jokes and cracking up at one another’s gallows humor, it’s awesome. At a 12-Step meeting, such revelations seem almost sacred, meaningful, helpful -– and again, absurdly funny. But sitting in a tiny office while a medical professional makes notes on a computer feels overwhelming.
Dr. Laser has good news and bad. From my history with hormones –- getting PMS, having my Birth Control Pill meltdown at 18, flipping out on my Progesterone shots –- it is likely that I could suffer post-partum depression after childbirth.
(Let me interrupt this to note that it makes me SO HAPPY that all these doctors are treating me like I’m TOTALLY going to get pregnant again and not miscarriage again. Everyone is barreling ahead as if that is a given. This is amazing. It does not feel like a given to me right now. It feels like –- of course I miscarried. I would totally miscarry! My body can’t create life! But they’re all like –- of course you miscarried, it’s incredibly common. Anyone who’s anyone has miscarried! Now let’s get you pregnant so you can have that baby and then get super cuckoo!)
I’m not terribly disturbed by Dr. Laser’s prediction. Dashiell doesn’t like it one bit, but Dashiell is superstitious. She thinks that by saying something like, "You’ll probably experience some Post-Partum depression"’ dooms me to spending the first year of our offspring’s life cutting myself in the bathroom. But I feel like we’re just being real with each other, Dr. Laser and me.
My sister suffered from post-partum, and so did my mother and so did her mother. I feel very sensitive to the hormonal tides of my body. If we look at this thing honestly, we can get a plan together before I even have my next bun in the oven, which is what Dr. Laser would like to do.
The good news –- remember, I told you there was good news in here -– is that Dr. Laser thinks I take fabulously to anti-depressants. Many people struggle to find a pill that’s right for them, that doesn’t make them feel worse or give them diarrhea, and then they have to figure out the dosage, often through some gnarly trial and error.
Not me. I’ve hopped around a bunch of pills and have only had awesome responses. Because of this, she thinks I’d do well on Zoloft, which is the med that works best for mothers who need little helpers. Some women take Zoloft throughout their pregnancy, some take it while nursing –- a negligible amount gets passed over in the breast milk. At the very least I can take it for post-partum, but Dr. Laser thinks I should try some Zoloft now, so that we know for sure it sits well with me when I really need it.
I’m a little torn. Part of me would love to take the Zoloft right now. In fact, once I learned that the embryo inside me wasn’t living, I thought about digging my bottle of Citalopram out of the bathroom closet. It would be really nice to be on meds again, feel that balanced ease, not worry that a scroll through my Facebook feed could leave me ensnared in a virtual slapfest with a virtual "friend."
But then, the thought of having to titrate off of it (BTWs, I love the word "titrate" it sounds so snappy and elegant, like a purposeful young lady clicking around in a smart pair of Kate Spades, holding a clipboard) when I get pregnant again worries me –- am I just screwing myself up so hard coming on and off all these chemicals?
But what if this next round of IVF doesn’t even get me pregnant? It would be another two months to try again, that’s like three or four months I could have some chemical support up in here!
I decide to try the Zoloft. My plan is to take it until I’m actually pregnant, and then titrate off the stuff. (That makes me think of this Audrey Hepburn-ish woman walking down a very minimalist, white spiral staircase in a pair of kitten heels. I DON’T KNOW WHY.)
If some women safely stay on the pills throughout their whole pregnancy, then surely it won’t be very dangerous to have the stuff in my system for just a month or so. I decide against staying on for the whole nine months; I just don’t like the risks, however small, and I know I can handle my mood swings without it for that finite period of time. It’s after the pregnancy hormones blow away that I’m worried about, but then I’ll have a nice bottle of Zoloft waiting to help me out.
I tell Dr. Laser to call the prescription in for me, and I pick toss it into my toiletry bag with the prenatal vitamins I have to keep taking even though the iron is not helping my constipation, and the melatonin I can start taking again, and some of my natural Swiss Kriss laxatives, and the Ibuprofen I have to keep around in case the D+C cramping starts up again.
And I pack sunscreen and after-sun lotion and bathing suits and the new pieces I grabbed from the sale rack at Urban Outfitters that fit over my body, which still looks a little pregnant, though less so. It’s time for our honeymoon.