As I prepare to work with another cohort of the Pregnant Athlete E-course, I’ve been wrestling with how to approach the topic of prenatal mental health. Most of us, by now, understand that many new parents struggle with postpartum depression and anxiety but we often don’t talk about mental health during pregnancy.
I had a significant bout with prenatal anxiety and, while I’m not yet ready to write about it, I wanted to share something on the topic. When Leia posted on her social media about her own work through prenatal anxiety I asked if she would pen her story for you, reader.
She DID and it is raw, beautiful, relatable, hopeful, and honest. Some of us use medicine, therapy, coping mechanisms, or other ways to manage our mental health; here’s to de-stigmatizing the decision to employ medicine as a means of supporting a healthy pregnancy.
PS: I care about your wellbeing. If you are having suicidal thoughts or are engaging in self-harm, please click the button below to find emergency support.
Prenatal Mental Health, by Leia Anderson
There are lots of ways that we can self-identify. I identify as a mom - with a three year old son and another boy on the way. I am a runner, which is a huge part of my identity as it branches into running coach, race director, and instructor. I am a wife, who has a spouse that supports me on my running and momming adventures. These are the identities that I latch onto. They’re positive and offer fulfilment. Unfortunately there’s also a large piece of me that struggles with anxiety. I do not enjoy identifying as a person with anxiety, but if I don’t own that piece, it risks the other positive identifiers that I claim.
Anxiety and depression are often hand holders. For me, anxiety is the largest struggle and it manifests in different ways. When I am at my worst, all of those positives, the things that I love, don’t make me feel good. I become what feels like a bad mom, a bad wife, and I stop enjoying running in the same way. I worry about everything. I over-analyze conversations and things that most people would never read into. I physically manifest symptoms like tightness in my chest. When I decided to seek out some help, it did not come naturally to me. Partially because I didn’t understand that the way I felt wasn't it normal. I’d always felt like that. I also listened to a lot of voices telling me that “nothing was actually wrong, and just stop worrying so much.”
About ten years ago I decided to start seeing a psychologist as a first step.Though even though it helped, it wasn’t quite enough. I had started running, and it became a great help, but also still not enough. After some time I was referred to a psychiatrist to discuss medicine. This is one of the hardest things for me to accept. I do not want this kind of help. I want to be ok on my own. I want to find coping mechanisms that I can hold on to and that will fix everything for me and make me feel better. However, I am a much better, mom, wife, and runner on medication and I have had to come to terms with that. I still incorporate talk therapy as I need to. It’s not a constant, but it’s helpful to have when I need a little extra.
A major struggle with medicine is determining whether or not to take it while you are pregnant and nursing. We talk a fair amount about postpartum depression, but we often don’t acknowledge how hard it is to actually just be pregnant. There are the hormonal changes that can cause moods to alter or stress to rise. Then you may have coping mechanisms in place that no longer work to ease your stress, depression, or anxiety. For my first pregnancy I chose to get off of the medicine that I was taking at the time (Citalopram). I had a comfortable pregnancy, was thrilled to be able to run and work out as much as I was able to, and managed fairly well. I even thought that I might be able to stay off of the medicine once I had the baby.
I was so in love with our little boy and managed for several months. Then I started to struggle again. I stopped enjoying things like running, particularly group runs, which are a big part of my life. I was worried about keeping up or taking time away from family in ways that were completely disproportionate to the concerns. I talked to my doctor and started taking Citalopram again. I felt better, like myself.
Fast forward three years and we are expecting again. One of the problems is that there really isn't a lot of research out there that clearly outlines SSRIs (Selective serotonin reuptake inhibitors) and their impacts on pregnancy. Google becomes a tool for stirring up emotions. I was struggling with the balance of how I felt being off medicine with how worried I was about being on it. Again I decided to get off of medicine.
It did not go well. Right before I got pregnant I ran a forty-eight hour race; it was one of the most successful races I have run and it was also the longest. So even though I was still running and strength training throughout this pregnancy, it was a huge let down from what I had been been doing right before this. I had a couple of stressful events happen and I was not handling things well. I was pregnant and not eating or sleeping enough, which was causing another layer of anxiety because I was worried about that too. I was sucking it up to teach classes and work with my clients, and was a mess at home. I started seeing my psychologist again, and though it helped, nothing was really making me feel truly better. At around five months pregnant I talked to my doctor about getting back on medicine. She was kind and empathetic (I could also go on and on about why it’s important to find a doctor who you truly trust and connect with during your pregnancy) and recommended Zoloft during pregnancy.
After a couple of weeks I started to feel better, and after about a month of being back on I was like my old self. I initially felt guilty for needing this. I know so many women who feel so broken asking for medicine. I totally understand. It’s the feeling that you are out of control or can’t manage on your own. For some people talk therapy and coping mechanisms are enough, but not everyone. When I am on my medicine, I feel like myself, or how I really identify.
I’m always amazed by how many people thank me for being open about this. I choose not to be ashamed, not to feel broken, but to feel stronger because I’ve asked for and gotten the help that I need. I’m far more excited about this pregnancy now that I’m in the third trimester because I feel better; I’m enjoying my family more and am okay with what I can manage on my runs. I’m glad that I didn’t try to wait until after I delivered to ask for the help that I needed. I believe I’m having a happier healthier pregnancy because of it.
Leia Anderson is a running coach and co-owner of Team Sparkle Productions in Kansas City. Team Sparkle coaches individual runners, has group training programs, workshops, and races. She’s passionate about helping people find their love of running and safely grow in the sport.
<— that is Leia during her forty-eight hour event!