When “Eline” became pregnant, the message from the GP was clear: You must stop taking your ADHD medication while you are pregnant and breastfeeding. “Eline” stopped the medication immediately, and left it until she had finished breastfeeding. The child was then almost two years old. – It is overwhelming to be pregnant. Having ADHD and not using medication felt like the smallest challenge then and there. But it was the biggest. For the sake of the child, “Eline” does not want to come forward with her full name, but news has met her. – It is clear that it went beyond the child, she says. Thought it was hormones For “Eline”, these years without medication became a nightmare. The symptoms returned in full force and topped off the chaos as a pregnant and new mother. During the period without medication, no one should have raised the ADHD diagnosis with her. No advice or guidance. Neither from the GP, midwife or health centre, she says. “Eline” didn’t take it up herself either, and thought she was struggling with hormones. – I have never heard anything about what it is like to be pregnant and have ADHD. I’ve only heard that if you get pregnant and are going to breastfeed, you have to stop taking the medication. Great stress She describes everyday life with the child as overwhelming, chaotic and exhausting. Everything that required concentration became difficult. Often the roommate had to take over. When he could. If “Eline” could avoid acting, she did. If she could send the child with friends and family, she would prefer to do that too. Visitors had to remind her to eat and shower. Even simple decisions became difficult to make. She felt “extremely indecisive”. “Remember to say they can call mom.” “Remember to take medication.” Everything “Eline” needs to remember must be entered into the mobile phone as a notification. Photo: Philip Hofgaard / news – For example, what the child should wear, which nappies to buy, which food I should send to the nursery. I could spend an enormous amount of time on all such things. She could spend an hour finding clothes for the child. Lack of concentration “Eline” also experienced not getting important information, because she lacked concentration. – It was very challenging to get messages and to respond to them. Without remembering either the message, or having replied afterwards. She remembers it as particularly difficult at the health centre, where she also had to focus on the child. She developed an anxiety about not being a good enough mother. – I was always very concerned about how they assessed me as a carer and the interaction with the child. Whether I did well enough, or got everything. Better information General Secretary of ADHD Norway, Gry Lunde, believes that pregnant women with ADHD could have been better off with good training in the diagnosis, so-called psychoeducation, where one learns to live with the diagnosis. – Those who have the best effect from medication are those who also receive psychoeducation. But that offer is by no means offered everywhere, says Lunde. General Secretary Gry Lunde of ADHD Norway is critical that not everyone with an ADHD diagnosis receives good enough information. Photo: ADHD Norway Today, psychoeducation courses are only a recommendation in the Norwegian Directorate of Health’s national guidelines for the treatment and follow-up of people with ADHD. Lunde believes that information about medication during pregnancy should be a natural part of these courses. However, courses offered, and the content of the courses where these are offered, vary from place to place. – There are many people who simply break the national recommendations, says Gry Lunde. Balance between child and mother Senior doctor Mats Fredriksen, at the neuropsychiatric outpatient clinic at the Hospital in Vestfold, confirms that it is common to ask pregnant women to stop taking ADHD medication. The doctors are concerned about damage to the nervous system and malformations in the fetus. Senior doctor Mats Fredriksen at the neuropsychiatric outpatient clinic at Vestfold Hospital believes that more often consideration must be given to the mother when the medication is taken away. Photo: Randi Nørstebø / news For many it is fine to stop taking the medication, but not all. Fredriksen says ADHD can feel stronger than normal when you suddenly stop taking medication. – You become more unfocused, restless and impulsive. If the symptoms are severe, Fredriksen would let the mother keep the medication while she was breastfeeding. – At the start we were very restrictive. Now there is a trade-off between consideration for the child and consideration for the mother. For those with very severe ADHD symptoms, it may be appropriate to breastfeed even if one is taking medication. And that will also be the case for pregnant women, says Fredriksen. Many people with ADHD strive to keep an overview and have order in their everyday lives. The senior doctor thus has some advice for women who want to have children: – You should plan it so that too many other things do not happen during the period when you are pregnant. You must have time to be pregnant, says Fredriksen. GPs would like to help Deputy head of the Norwegian Association for General Medicine, Torgeir Hoff Skavøy, says GPs are in a good position to be able to select patients with ADHD who may need closer follow-up. Deputy chairman of the Norwegian Association for General Medicine, Torgeir Hoff Skavøy. Photo: Private – We will help these further in the system if there is a need for it. In cases where such a need is not identified, the information will unfortunately only be transferred on the paper-based health card. It will then be the pregnant woman’s own responsibility to bring this with her to check-ups, says Skavøy. He believes the time is overdue for the authorities to provide a digital transfer option of health information about the pregnant woman. Getting better The time without the ADHD medication was difficult for “Eline”. But now things are better. – I am able to be much more present now that I am using medication again, she says. She tells her story in the hope of being able to help others in the same situation to get help or ask for help, so that they and the children have a better time than she herself experienced.
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