Making babies was never high in my priority list. When I was younger, it was for unashamedly selfish reasons. I wanted to travel, and having a kidlet in tow would cramp my backpacking style.
Things changed when mental illness came calling at age 27, in the form of depression. I was hospitalized and had multiple suicide attempts. As I’ve gotten older, my illness has just gotten harder and harder to treat.
Sometimes you hear tragic stories in the news about depressed women who killed themselves and their babies. And you know what? That could so easily be me. If postpartum depression can absolutely devastate women who have no history of mental illness, what would be likely to happen with me with my significant psychiatric history?
When I contemplate the possibility of getting pregnant, a significant episode of depression seems like a matter of when, not if. Am I exaggerating the risk? Possibly. But would I actually want to take that chance? When I’m really ill, I get suicidal. Sometimes I get psychotic. This is a clearly established pattern that isn’t likely to change for the better when you toss raging hormonal changes into the mix.
This subject isn’t talked about nearly enough. Some women who’ve suffered from postpartum depression do have the courage to speak up and share their stories with the world, but it’s less often that we hear from people with pre-existing mental illness about the difficult decisions that they face.
Medications are also a safety issue. One of the medications I take is known to increase the risk for a particular type of rare heart defect. It’s not a large increase, but it would be difficult to wrap my head around the idea of putting something in my body that could hurt my baby. Going off medications really wouldn’t be an option, though, because it’s almost certain that I would get ill. Most people would cringe at the idea of taking medication during pregnancy, but what about the very real and significant negative effects on the fetus from untreated mental illness during pregnancy?
Science still doesn’t know a lot about how susceptibility to mental illness is passed from generation to generation. Depression may be less heritable than some other mental illnesses, and there are genetic counselling services available to help better understand the level of risk, but I really would not want to put a child through what I’ve been through.
I’m 40 and single, so this is all a bit of a moot point right now. At the same time, though, I don’t know how much I would be prepared to let a partner’s voice sway me on this issue. Is anything worth the potential for suicide and/or infanticide? I’m not saying that other women should make the same choice, but with my history of suicidality and treatment-resistant illness, I’m not sure I’d ever be prepared to take that risk.