After Crisis Mode, Waiting for “Better”

At first, I couldn’t figure out what felt different this weekend. And then I realized that I no longer felt like I was in “Crisis Mode.” I am not saying that there was a crisis, by the way, but I felt like I was in a problem-solving place. I was acting to avert crisis. I was making phone calls between sobbing attacks. But now the telling is over. Everyone has been told. I’ve taken my higher dose of meds every day at the right times. I’m doing ok. And waiting to do better than just ok.

I hate it. I’m not saying that I’d rather be terrified and feeling “in crisis.” But this just sucks in a whole new way. I am so. tired. Things that would normally feel sad feel really sad and I cry for what feels like forever. And it is all expected. This is my “normal” for now.

I can’t even begin to express my gratitude for all of the help offered (and accepted). I wish that it showed on my face. I can only hope that the friends and family who are helping me so much know how grateful I really do feel.

But feelings like gratitude are all buried underneath something; I can’t quite get at them, even when I know that they’re here and what they are.

Shame is happy to pop right up, though. When the sound of my baby’s cry makes me want to turn and run, I feel burning shame and guilt. I imagine that I’m supposed to want to run to him. I imagine what a “Good Mother” would do. And then I remind myself that she doesn’t exist. I am his mother, and whatever I have to give is going to be enough. His dad is going to help. I do not run away.

And so I keep putting one foot in front of the other.

I’ve discovered that my state does not have an official support group–there is no place I can go to see and hear other women talk about this in person. I have been brave and asked around. New York City and Massachusetts do so well at supporting moms who are struggling postpartum. I live almost next door to Yale University, for heaven’s sake. I am struggling just to get out of bed; I can’t start one. I hope that when I can see the other side of this, someone will show me how to start something for other women. Until then, I rely on Facebook and Twitter to connect me to women who understand what this feels like.

Those connections are my lifeline. Time will heal us.

Depression: Everything Is Harder

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My favorite portrait of a young Virginia Woolf, by George Charles Beresford. 1902.

You know those people who say that geniuses had to suffer to be geniuses? They are wrong. Case in point: I used to study Virginia Woolf in an English PhD program, and I came across a few fans of her work who thought that her suicide was terribly romantic. First, there is nothing romantic about suicide, ever. Second, she was not able to write the way she did because she was mentally ill. She wrote in spite of it. My heart breaks every time I think of her suicide note. Her husband, Leonard, wrote this, after her death in 1941:

 The words which she wrote are: ‘I feel certain that I am going mad again. I feel we can’t go through another of those terrible times. And I shan’t recover this time.’ She had a mental breakdown about twenty-five years ago; the old symptoms began to return about three weeks before she took her own life, and she thought that this time she would not recover.

Even in his grief, he felt compelled to write that to a newspaper after it tried to claim that she killed herself because World War II was coming–they quoted the letter as saying “these terrible times.” But as terrifying as the “times” were, she clearly meant that another bout of “madness” was too much to face. No one knows exactly what Virginia Woolf suffered from, but depression was certainly part of it. The poor woman also heard birds singing to her in Ancient Greek, so there was more to it than the kind of depression I have experienced. (Source: I’ve read tons of diaries and autobiographical writings and biographies, so it’s in those, and I’m not in grad school anymore, so I don’t need to find a page number. And yes, she did speak Ancient Greek, despite being self-educated.) Some of her characters experience things similar to what she remembered from being “mad,” but she did not write while it was happening. She couldn’t. Whenever I read that note, I think about what we might be able to read about her or by her if she had had more time. What I just quoted is just a few sentences, but “time” is everywhere. She could not face the time and energy it would take to live through another “terrible time.”

I do not compare my own writing to what Virginia Woolf wrote. My point is really that depression sucks time, energy and reality into its vortex and never gives it back. I had an idea for a post that I’ve forgotten. I don’t even remember when I had the idea, just that it was there and is now gone. But I keep hearing that it helps some of you out there to hear about what’s going on in my little world. And this is what is going on: no matter how hard I try, I am not able to think clearly. I run out of energy in the middle of things. I forget to eat. Hours go by like minutes sometimes, and at other time, minutes go by like hours. I have set alarms on my phone to remind me to take my meds and to eat, because I can’t trust my own sense of the passage of time. It is so hard to do anything that I am not sure I would keep writing here if I had not started this project before this bout of depression.

I learned, before I felt depressed, that writing here made me feel connected to people just like me. I learned that the act of writing and hitting that button that says “Publish” helped me feel like I had accomplished something. I know from my experience with anxiety that if I say my fears out loud, to the dog or to the air, they seem smaller. Outside my head, in the light of day, they are not as big. So it’s important not just to write, but to publish. I am thankful that the internet allows me to do that. To say all of this “out loud.” I have never been able to keep a journal going.

I know many people, many of them mothers, who have a hard time justifying to themselves a project that helps only them. That is not really ok, since self-care is so important for every human being to feel ok. But even though I know that writing here is good for me, I am working so hard to focus my scattered mind and write something today because I know it helps you. When I am too tired to get myself breakfast, I can still somehow get up to change my son or at the very least, feed him. I simply find it easier to do for others.

But this is one of the ways I can trick Depression and its Lies: if I tell myself that this is for the friend who will not talk to me over the phone or answer email but will read this blog, I write. And in writing, I help myself. I just wrote over 800 words that reminded me of the time I beat this at age 22. I remembered that I am smart, well-read and well-educated. I remembered that I have friends and family who wait for these posts because they love me, not because they need something from me. All of that gives me back the pieces of myself that Depression tries to tell me have disappeared.

In the middle of writing this, the baby decided that he was done with his swing. It’s hard to type while holding a baby, go figure. I put him in our Moby wrap, where he nursed and is now sleeping peacefully. Somewhere in that time, the doorbell rang. I was putting on (yoga) pants by the time I realized that I was about to actually DO IT: take the baby and the keys and go outside both locked doors to collect a package.

Friends, I put on my shoes, grabbed my keys, shut our apartment door behind me, shut the entryway door behind me and collected that package. I shook a little bit, terrified that I would lock us out again. But I looked down at the keys in my hand, and I told myself that it wasn’t possible. I felt the fear, but I did not believe the lie. I used my keys to unlock the first door, then the second, and here I am, sitting at this computer, writing the post that I told myself was only for you.

With depression, everything is harder. But it is not impossible. No matter how terrible times, we can always recover.

Depressed, Postpartum: A Short Update

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Feeling hopeful and enjoying these chubby cheeks.

I have plans to actually go do something for fun with a friend who lives here in Connecticut, and not far away, so I’m going to make this short. (Yes, I am incredibly proud of myself!)

I did not hear my doctor say “Postpartum Depression” yesterday. I have mixed feelings about this. What she did say is accurate and wonderfully helpful. The focus was, as it should have been, on what to do to help. I am to take Bendaryl as a sleep aid, since it works well, on a strict schedule. I am to take my meds on a strict schedule. I have been “compliant” with all of my medication, but my sleep has been so erratic that I don’t take them at the same time every day. That might help. I am also to take a higher dose of my SSRI (one kind of antidepressant), Effexor.

I immediately filled the new prescription and have started the new dose. I am much closer to following the new schedule. I took the Benadryl and slept. Walter, may God bless his tiny heart, put himself to sleep in his co-sleeper after filling up on milk. I hit snooze on my alarm for two hours, but it’s progress.

The mixed feelings I have about knowing that this could be much, much worse? I worry that I got everyone who reads this all worked up over nothing. If it’s just a phase, just a low-mood, might pass on its own but lets give the meds a boost anyway… do I have the right to be posting alongside women with “real” depression?

And then, the emails came. Two. They said “me too.” One, from a dear friend, said that me writing about my feelings so publicly gave her the courage to write and tell me about her PPD diagnosis. No one has said that I don’t feel terrible enough to be asking for help or to be writing about depression. Right in this moment, I feel the truth in that. I am depressed. I could be much more depressed. I could also be two inches shorter or taller. It’s neither here nor there.

Thank you for your support. Thank you for telling me that I have helped you. Thank you for asking me questions. Thank you for talking. Silence is the enemy, here. All monsters are very scary in the dark. Turn on the light, and they might not be so very big after all.

Help: Depression, Motherhood & Upside-Down-Me

When I saw the exoression on my face and dark circles under my eyes in this self-portrait of us, I was totally shocked.

When I saw the expression on my face and dark circles under my eyes in this self-portrait of us, I was totally shocked.

I am writing this well after my bedtime, because I don’t want to go to bed. I don’t want to go to bed, because if I go to bed, then tomorrow will get here faster. I know that this is untrue, and that being exhausted tomorrow will not make the day any better. But I have been staying awake to put off Tomorrow since I was a little girl.

What happens tomorrow? I meet with my psychiatrist. I am terrified. Not of her–she’s such a lovely person and so good at her job that my midwife started handing out the doctor’s card to local moms/moms-to-be who need help after speaking to her just once or twice. I am terrified of what she might say, and of what she might not say. It’s been a month since I saw her last, but it feels like six. Two weeks ago (again, feels like six) I told you about my anxiety attack after locking myself and my son out of our apartment. That blog entry is proof that I recognized what was happening and opened up my Anxiety Tool Kit to start dealing with those feelings right away. But they multiplied. I talked through it, but I kept crying. I felt foggy. I didn’t realize how terrified I felt about leaving the house until my therapist challenged me to leave with my son, walk out the front door of the apartment building, turn right around and open the two doors between us and home. I still haven’t done it. I can’t even do it with Nathan inside the apartment, ready to buzz us in. Since the point of the whole exercise is to prove to myself, to that doubting voice, that I can remember my keys, it’s unlikely that I would forget them. I can’t imagine it going wrong. I can imagine doing it. But I haven’t done it.

It took me awhile to realize how terrified I felt of going outside in general, because we were snowed in. As you may have heard, the East Coast, from New York to Boston (and us in between) got a lot of snow. I grew up in Minnesota, so a blizzard is not a scary event, and I can deal with snow. I know better than to drive during a blizzard, but I was not exactly panicked about the weather. In fact, I was thrilled. Thirty inches of snow fell in as many hours. It took days and days for a plow to get to our driveway. There are still major streets here that become one lane due to massive mountains of snow left behind by the plows. My husband, Nathan, couldn’t leave the house to do his grad school work; he usually leaves for a few hours every morning to work at Starbucks or the library.

Here’s the chronology: on Wednesday night, I locked us out. On Thursday, I had a therapy session about that over the phone because I felt too panicked to leave the house to go to therapy. On Friday, a blizzard dropped nearly three feet of snow on our heads. On Saturday, Sunday and Monday, the streets were too blocked to drived anywhere. But on Tuesday, he didn’t go in to school. He probably stayed home in part because of the snow; he had no idea how things looked up north on campus, and our car is notoriously bad in even a few inches of snow. He also stayed home because the thought of him leaving brought me to tears.

In under a week, I spiraled from Thriving all the way down to Crying At Random and shrieking “Take him!” whenever our baby fussed. I suddenly felt like a complete and utter failure whenever he wouldn’t be soothed by nursing or bouncing. I stopped sleeping at reasonable hours. I’d be awake at 3:00, 4:00, 5:30, hours after Walt had fallen asleep, playing games on my phone (and often crying). But this is where it gets weird, for me, because I didn’t feel my heart racing or recognize any anxious thoughts on a loop. I just felt… numb. Or sad. Once, I woke him up so that he could talk me out of self-harm; my urge that night was minor, in the scheme of such things and compared to what I felt in the past. But I have only ever felt those urges when I have also felt trapped and hopeless.

I felt depressed, obviously. But was this depression? Was this postpartum depression?

Obviously, the snow made going to therapy impossible, so I talked to my therapist over the phone. I told her about the crying (mine and my reaction to the baby’s), the fog, the feeling numb. I told her how surprised I was that the change had happened so quickly. I told her about my sleep and losing track of time.

I actually saw her today. Things are a little better, because I’ve been taking Benadryl to get to sleep. Yes, we co-sleep, and taking “something” to sleep isn’t safe for bed-sharing. But Walter is sleeping in his co-sleeper, now, if he must, so it’s safe for me to take something like Benadryl that makes me extra sleepy for a few hours. The sun is out, and I’ve gone outside to appointments (chiropractic! fun!) and even twice just to prove that I could (just not with Walter in tow). I’ve gone out for lunch and shopping with my mother-in-law. But I still feel all wrong.

There was a lovely moment today, with our gorgeous little family all snuggled up for a nap, when my husband told me that he was blissfully happy. The three of us, cuddling, was the best thing he could possibly wish for. He had never been happy like this before Us. I started to cry, because I saw but did not feel that joy. I knew that I should. I knew that I loved my family. I knew that a month ago, I would have felt the same rush of joy he was describing. But I cried today, because I could not feel the joy I had earned.

I’m crying now, as I type this. I’m doing everything I’m supposed to do, and I am not in any danger. I thank God that I have no intrusive thoughts about my son. Most of my smiles have been because of my Walt. He loves to smile up at me during breaks from nursing, and I get a special smile he saves just for me. I have fantasized about being far away, alone in a quiet hotel, because he is fussy almost every night around sunset, sometimes for over an hour, and hearing his cry hurts my heart. It hurt my heart a month ago, too, but I had perspective, then. Now, if I can’t comfort him, I can easily loose all perspective and start picturing a teenager who will hate me for every mistake I have made and will make. I have even wondered, at my lowest, how long it would take before my family realized that I was just weighing them down and left.

Part of me wants to hear my psychiatrist respond to this information with the words “Postpartum Depression.” I want those words as proof that it’s not my fault; a voice in my head has always told me that I am “faking it.” If I just tried a little harder… But do I need the diagnosis? Is it even possible to tell, yet? This could be a relapse of depression–Major Depressive Disorder is already in my history. My major depressive episode had prolonged and extreme triggers, and this just feels chemical. I feel like I got hit by a truck, or by a magic spell that erased my mental-illness-fighting powers. My therapist agreed today that, had I locked us out a month ago, I would have bounced back by now. She has a social work degree and does not diagnose things like PPD.

Something unfamiliar is happening. Suddenly, there’s a kind of distance between me and my own life. Underneath all the chatter in my head about diagnoses and justifications is one desire: find help. I just want to know that it’s going to be ok. I want to know that there is a path back. I want the mood swings to stop–I am scaring myself by feeling so full of rage and sadness that my face actually flushes hot and red. I don’t want to dissolve into tears every time my son cries. A month ago, I was pitching ideas to other blogs and excited about attending a conference, BlissDom, after winning a ticket in a contest. Tonight, I can hardly remember where this post started or where I wanted it to go. Hours go by without my noticing, or I feel like hours have passed after just one. My world is upside-down. I will do anything to make it right again.

The Stigma of Mental Illness: Three Stories from Readers

In exactly one week, I have received questions from three very different readers about three very different struggles. I love hearing from you. It keeps me writing, and it gives me a sense of purpose for this space. But I cannot begin to express how sad it makes me that these three women have come to me, each asking “Where do I even begin?” While I am a readily accessible voice happy to help, I believe that they are asking me because the stigma of mental illness, the reason so many of us end up feeling ashamed of our struggles, has made it difficult to find help in the “real” world.

I have some ideas specific to each question, but I want to take a minute to say this: if our culture did not stigmatize mental illness, maybe our daughters, sisters, wives and mothers would feel more comfortable talking to professionals. Asking for help in real life can trigger so much: what will friends and family think? What will it cost, financially? How do I find someone qualified to help me? If we were talking about something else, here, diabetes, for example, there would be no end to the resources available to help manage the issue. No one would call us weak for depending on insulin. No one would tell us to “tough it out” or “get over it.” But we say these things to people who admit to struggling with mental illness, so three women who each need a different kind of professional to guide them through very difficult decisions have come to me, a blogger with personal experience but no medical credentials.

I repeat: I love hearing from you. I am happy to help when I can. Overjoyed, really. But it should not be so hard.

Now. Please send your love to three souls in need of support:

Em is thirteen-years-old and at a loss. She has asked me what to do, because the panic attacks and other anxiety symptoms are overwhelming. She feels depressed. She wonders if maybe it would be easier if she were dead.

At 13, I felt every single thing Em described to me. I don’t know if she has “active” suicidal thoughts, but wondering if things would be easier for everybody if you died is called a “passive” suicidal thought. It’s a big step from feeling so tired that you want to give up to actively making plans to end your life. But it’s not a good way to live. It sucks.

In a strange way, being thirteen and anxious/depressed is a bit like being pregnant and anxious/depressed: no one knows what to do with you. It’s hard to find someone to give you a realistic picture of your options, because we are terrified of what the side effects medication might have on a fetus or on a child. There is a bigger risk, there. I truly believe that meds are just one of many tools, but being in a place where no one wants to touch that issue with a ten-foot pole? That sucks. If your doctor isn’t willing to discuss the risks, you may not be able to try something that has the potential to offer relief.

When anyone feels the way you feel, Em, we want relief. We want it NOW, especially when the work we are doing, like your work in counseling, doesn’t seem to help us at all. I am so truly sorry that you have to go through this. It gets better. I promise you that life is better on this side of thirteen-years-old. Please, do whatever it takes to get through this time. It is amazing, the amount of pain a human can feel and still keep going. One foot in front of the other. One day at a time. Just believe that it cannot last forever.

CC is forty-two-years-old and facing an unplanned pregnancy shortly after the death of her mother; she is not thrilled to be finding out this way that, despite feeling sure that she could not become pregnant, surprise! she can. And is. And there’s more. She writes,

“I was taking a boatload of everything and pretty much had some of my issues ironed out until this happened. Now I am told that, oops, that 3 mgs a day clopanpin a day you take could be the worst thing in the world for you. … do you know anyone who took that much clonapin in the early stages and had a healthy baby?”

I wrote back, immediately, of course, that those doctors are OH SO VERY WRONG! And here is where I get angrier than the Hulk. In this country, a woman has the legal right to terminate a pregnancy. But we are talking about a woman who wants to have a baby! CC sat at her computer at 4 am wondering who on earth to talk to, without a cell phone or money for a phone card, because she left a doctor’s office believing that she had to choose between her mental health and the physical safety of her fetus.

Just take a minute to let that soak in. An adult woman left the office of a licensed care provider with the idea that the medicine she considers a lifeline, her only path to sanity, would destroy the health of the fetus she is carrying.

I don’t even know where to begin, there is so much wrong with CC’s experience at her doctor’s office. I reread her letter so many times, wondering if it was possible that she had misinterpreted a responsible doctor’s explanation that there is a risk in taking meds to mean “meds will definitely hurt this fetus.” But she did not leave that office thinking that medication in general is terrible during pregnancy, a myth that many people believe. She left thinking that only one of several medications she takes is basically poison. It takes a special kind of incompetence to so severely misinform a patient.

I don’t know the end of CC’s story. I hope that, whatever she has decided, she is doing ok. Obviously, I told her that she deserves a care provider who can show her enough respect to at least do an internet search on her meds before telling her which to stay on and which stop taking. I also told her that I took four mg of Klonopin every day of my pregnancy and had a healthy baby, but that this did not mean that everyone taking the drug would enjoy the same outcome. But the specifics just don’t matter, here. At the root of this woman’s encounter with a medical professional is the idea that she can just go without the medicine and that she should, because she is pregnant. Did you know that asthma inhalers pose risks to a growing fetus? Did you know that some women end up hospitalized because they try to go without their inhalers? Do you know what doctors tell them? They say, “Use your inhaler! You are breathing for both you and the baby, and neither of you can do without oxygen!” CC told me that she is afraid that she will become suicidal again without her medication. She is also afraid that she will become suicidal if she terminates this pregnancy. If she were not pregnant, every doctor would see the risk of relapse after stopping a medication like Klonopin. But as soon as there’s a fetus involved, most stop seeing that risk to the woman and only see potential birth defects. The worst part is that most of them don’t even know the actual probability of that happening.

And this brings me to the last letter, written by a woman very much like me. Laura put off thinking about the potential conflict between her desire to have children and the use of medication to manage her anxiety and depression. Now that she and her husband of three years want to have a baby, she has no idea where to begin trying to understand her options. She wants to stay healthy, mentally and physically. She wants to have a healthy baby. She went looking for “resources” on this topic and found nothing.

I started this blog in summer, 2010, because I couldn’t find any sort of guide to help me understand my choices. In the eighteen-plus months since I went looking, not much has changed. There are articles about individual studies that have come out since then. There is more information in the world about pregnancy and mental health. But it’s not any easier to find.

I’m simply not qualified to create that resource guide, nor do I have the time and energy to do it. Maybe it should be done. Or maybe our doctors should look up the medical research that exists on databases that are readily available to physicians and, at the very least, translate what they have read for their patients from medical jargon into English. Maybe medical schools should look into training obstetricians to prepare for the fact that this is going to come up, given that, as the Mayo Clinic website reports, “About 1 in 5 women develop depression at some point in life.” You know how I learned that? I did a Google search for “percent of women with depression.”

Somebody. Please. Tell me why it is too much to ask that doctors who exclusively treat women prepare themselves for the possibility that some of us will have such a common illness? Why do we just accept it when a doctor is uneducated or, worse, misinformed, about something that happens all the time.

The only answer I can come up with is the thread that connects these three letters, for me: as a society, we send the message that depression and anxiety are not “real” problems. In a thousand ways, we imply that medical treatment for depression and anxiety is optional. Those of us who struggle with mental illness learn quickly that others become uncomfortable when the topic arises. We learn to hide it. We learn shame. Even if we manage not to feel shame, we hide it for the sake of convenience. We learn to justify taking medicine, going to therapy, seeing a psychiatrist, because our culture still promotes the absurd idea that, unlike a heart condition or diabetes, mental illness can be willed away. It is not a “real” illness; it is more like a weakness.

Just get out of bed.

Just stop crying.

Just go for a walk.

Just talk to someone.

Just go off the meds for the pregnancy.

It’s been weeks/months/years, aren’t you past this, yet?

Are you going to have to take that stuff forever?

It’s all socially acceptable, even for doctors. It’s all wrong. I love that my little corner of the internet is a place where we refuse to accept that kind of nonsense. I have carefully crafted this blog so that it will show up in search engine results for the very specific problems I encountered (“klonopin and pregnancy” is quite common). But my heart aches, because for this one safe space, there are a hundred hostile environments. Em, CC, Laura and all the rest of us deserve better.