Q. I have made great strides in my recovery since beginning therapy a year ago. My therapist is amazed at the speed at which I have changed my self destructive ways.
I would probably classify myself as having mild BPD at this point.
I am now 6 months pregnant. I have had panic attacks in the past. But now I have persistent, debilitating anxiety. I know it has to effect the baby. I have had 15 bad days out of the last 20. I haven't self mutilated in 10 months, but I have become preoccupied with thoughts of hurting myself. I know its got to be physical. I have worked so hard at the mental.
The dilemma... I have no insurance. but can pay for meds. Although I do have Medicaid for pregnant
women, the Dr's. at my county mental health are not, shall I say up on the latest pharmacology. They seem to take great offense to any suggestion from me.
I am currently taking Wellbutrin 150 mg. I never responded well to SSRIs or Buspar I would really like to add Effexor to the Wellbutrin. My OB, sympathetic as she may be,
can't tell me if this is safe. This is an issue I must weigh on my own. I feel like
maybe if I had a consultation from an expert in the field knowledgeable about
BPD to help me weigh the pros and cons. For example, I live in NC, 2 hours from Duke Hospital.
In conclusion:
Issue #1. Pregnancy and risk to child
Issue #2. Resources and the exhaustion of local treatment
Do you have any suggestions? I am worried about the effect on my unborn child. with meds or without. Even more scary is the issue of postpartum depression. I need real help at this point. My entire family is suffering.
A. Most experienced OBs are minimally concerned about antidepressants during pregnancy. I can give you no guarantees, but have used Prozac, Zoloft, Serzone, and Effexor XR over all three trimesters in patients without any adverse events in the babies. There is a higher incidence of miscarriages and congenital malformations in depressed women, but the addition of an antidepressant (Prozac in the study) does not seem to effect the outcome. That is depressed women have more problems with or without Prozac, but not worse with Prozac than depression alone. This tells me you should not have to suffer. Taking medication does not seem to increase any risk to the child. Particularly since you are in your third trimester already.
Going to Duke sounds like a good idea if they have a doctor/program that addresses your needs. Call the psychiatry department, explain your situation, and ask if there is someone that can help.
