Thursday, February 26, 2009

Depression Profile: Sue at Um, Thanks for Sharing

One of the best things about blogs is the discovery that you are not alone. My latest find: Sue! Sue is a warrior mommy--she's conquered perinatal and postpartum depression along with some generalized anxiety--with three kids and some truly insightful posts.

Confessions of an Anxiety Ridden Mother could have been my own story. I know what it's like to punch walls and yell at infants even when I know I shouldn't. I loved her honesty about how difficult it is to be a mom, a supportive wife, and a person in your own right. Be sure to look through the comments, too. Her post struck a nerve with several people. Here was one comment that really caught my eye:
Antidpressive meds were designed for the modern LDS woman! First of all, we all attempt to accomplish too much... and if you attend relief society on a regular basis, you try even harder. Calm down and realize that you are a wonderful person who is greatly loved and respected for all the tasks you accomplish.

I know Relief Society isn't meant to work this way, but sometimes it does. My personal solution? Just start admitting your flaws--the real ones, not just the cute quirky ones--when you make a comment. When one person gets real the rest seem to follow. I have to say, though, I'm not the first woman in our ward to do this. There are a couple sisters out there who really open themselves up and put themselves out there and I love it. (Nancy, Verna, De--you are ladies I so admire!) It is only when we are real with each other that I come close to understanding what the concept of Zion is all about.

Another post by Sue, If the Problem Gets Solved, Does it Really Matter How You Solved it?, is the story of how a nice girl with some solid biological issues ends up deciding to she needs medicine. It's a tough decision but Sue makes it deliberately and wisely.

One part I really appreciated was the description of her supportive husband:
I often think about how blessed I am to be married to Dan specifically because of his understanding and support about my treatment for depression. Not only does he have the scientific knowledge of depression, but he has also seen first-hand, from the time he was a little child, the effects of depression. And he knows that the meds work and that they are beneficial. When I started taking anti-depressants, I used them for about a year or so, then went off them during my pregnancy with Lily (not because they're unsafe, but because I was feeling pretty good and didn't think I needed them.) Then when she was about eight months old, I went through a bad time and Dan pointed out that he had watched the same cycle throughout our marriage, that I would fight and try to be positive for six or eight months, then I'd have a drawn out episode of depression that lasted for a couple months. It really caught my attention to hear him say there was a pattern to my behavior.

I was still feeling a little bit like I was weak for needing to take anti-depressants, that now that I was aware of my tendency for getting depressed, I should be able to combat it on my own with behavior modification, attitude adjustment, and lots of prayer. I worked with a counselor for 8 or 9 months and learned so much about my thought processes and emotional tendencies. But even with this knowledge, I still couldn't conquer the beast. I went on and off the meds two more times while Lily was a toddler. After hearing Dan tell me over and over that taking meds wasn't a sign of weakness, it was the same as a diabetic taking their insulin, I started accepting that for me, taking an anti-depressant wasn't a temporary solution to help me kick-start my system. It was something that my brain chemistry required regularly to stay balanced. I was a lifer.

Every depressed person needs someone like this in their life. Someone with knowledge and compassion. Someone who may not be living it but wants to be with you while you do. Someone who can reassure you when your resolve wavers. Sue is extremely lucky that this person is her husband. For me, that support has come through different people at different times. My sister has been there for me (thanks to our cell phones that we use more like walky-talkies!). My husband pulls me out of some sad, icky places when my mind is holding me hostage. Mommy friends,oh!, of course the mommy friends! Having someone to sit in the park/ice cream shop/coffee (except we only ever order steamers and sometimes a pastry) shop with and kvetch about the bad times, well, that's priceless. And, when I'm too afraid to tell anyone else how nuts I really feel, my therapist is there. She isn't fazed by anything.

Thanks, Sue, for your example and your courage. Telling your story is definitely blessing other people's lives. All us other But Not Unhappy Mommies are sending good vibes your way!

Wednesday, February 25, 2009

A New Psychological Movement: Pursuing Happiness

Turns out the Founding Fathers were right. It is the pursuit of happiness that matters, even for the depressed.

This article in the latest issue of Segullah, Harvesting Happiness, is written by practicing psychologist Wendy Ulrich and gives some good info about the new trend. She also offers some tips on exactly how to harvest happiness--some of them might surprise you! (Turns out not all service/volunteer-ing is good for you, only certain kinds.) I hope you all take a look at her article. After all, as Ulrich reminds us, President Hinckley did say, "In all of living have much of fun and laughter. Life is to be enjoyed, not just endured."

Monday, February 23, 2009

MIrthful Monday: I thought you might be able to use this one in FHE

A Sunday School teacher was teaching the importance of love in the home. She illustrated her point by referring to the commandment, "Honor thy father and thy mother." She then asked if there was a commandment which taught how to treat sisters and brothers. One little boy from a large family raised his hand quickly. Innocently he asked, "Thou shalt not kill?"

Thursday, February 19, 2009

Depressed (and sometimes angry) Mormon Mommy

A reader emailed me and mentioned something about anger and three kids and how did I start to deal with it. Well, boy howdy, I wrote her a dissertation! Actually it got so long I cut it out of the email and decided to post it here so all of you could have the joy of reading it. Hopefully it's helpful.

Dear Reader,

Having three kids is like running a marathon one day and waking up to run it again the next. It is SO HARD. I never knew I could feel so tired--physically, emotionally, and spiritually. Most days just keeping them alive feels like success. It's discouraging to set the bar so low, but, honestly, keeping three kids fed and dressed and out of harm's way is full time work. After my third was born I remember praying and praying that guardian angels were real because there was no way I could shepherd my children through one day, let alone the rest of their lives.

I say all this for one reason: don't short-change the enormity of the task you have taken on. It IS hard. For everyone. It means the world to me any time someone at Church points out the four year gap between their third and fourth child or when they shake their heads at the memories of how difficult it was or when they just reach out and say, "It does get better." I cling to those seldom uttered honesties. (I think I just made that word up. Oh well. Whatever.)

I used to scream uncontrollably at my kids. And that was when I only had two. Actually, I remember doing it when I only had one. I would unleash these wordless screams that would leave my throat burning and aching. Sometimes I would scream about how frustrated I was. Sometimes I threw things. Sometimes I broke stuff--a kitchen chair actually fell victim to my anger. It took a long time for me to start to take control of it and there are still days that I struggle. Here are some things that help:

*Yelling and uncontrollable/sudden anger is absolutely a sign of depression. For a long time I thought I was just sinning or that I had no self-control. The truth is that people react to depression different ways, one of which is anger. I think depression manifests that way a lot in women with small children because small children won't/can't leave you alone. If I had had the option I would have stayed in bed all day but my kids wouldn't let me. So I yelled and I broke things. Not too proud of those moments. When anger is linked to depression it is IMPOSSIBLE to change your anger until you have managed the depression. I am always surprised at how effective antidepressants are when it comes to cooling my anger.

*How we handle anger has everything to do with how we were taught to handle anger. When I was having my worst angry episodes I would have memory flashes of my mother screaming at us kids and throwing things. She looked exactly how I felt. (I think she was depressed when all us kids were little. She is definitely a warrior mommy who survived some very difficult times.) Anger is a natural, protective response. It is not a sin (most of the time). It is a warning signal and in order to get a handle on it you have to learn to understand the signals. And, as women, a lot of us were taught that we were not supposed to be angry. Repressing anger doesn't make it go away. It only puts it in a pressure cooker.

*Part of that last point bears repeating: Anger is not a sin. I know that in the scriptures Christ tells us not to be angry. President Hinckley even gave a talk about angry. Elder Bednar has covered it too. BUT that doesn't mean anger is a sin. Like all of our emotions, it is part of this this mortal life. Angry responses are strongly linked to bodily conditions. Hormones that we don't control (the fight or flight hormonal rush is just one example) trigger anger in our bodies. The problem is most of us don't notice those bodily responses (like tensing our jaws or our backs, grinding our teeth, clenching our fists, hunching our shoulders, pursing our lips, etc.) before the anger explodes. The Savior's injunction, and President Hinckley's and Elder Bednar's, are, I think, more about learning to work with and overcome the "natural" man. Anger turns into a sin when we refuse to acknowledge its problematic potential and when we let it propel us to hurt others. But feeling angry is not wrong. It simply is.

*One thing that helped me understand the roots of my anger was a really great book:
She's Gonna Blow!: Real Help for Real Moms Dealing With Anger by Julie Barnhill. Barnhill is a Christian who approaches anger from a no nonsense point of view. She is honest about how her anger hurt her family. Even how it led her to hurt her kids. She encourages the reader to be equally honest with themselves through journaling opportunities and scripture study (prompts are offered at the end of each chapter, if I recall correctly). Her book is also chock full of good information about anger. I wish I had bought this book so I could lend it out to people. It is so good.

*Of course, no discussion about my mental health would be complete without mentioning my therapist. Having a dispassionate, third-party guide can make all the difference. My therapist helped me identify the anger triggers and the warning signals that my body was trying to send me. She helped me increase my self awareness and develop coping mechanisms to stop the anger before it exploded. I think the word she used was "mindfulness". She is also an invaluable source of encouragement when I suffer a setback.

Anger is one of the most revealing things about our psyches. Understanding it is the journey of a lifetime and I wish you luck as you set out. You can do it!

Pay it Forward (the first But Not Unhappy give away!)

You know, I think I'm probably the only person in the universe who hasn't seen the movie but I do get the concept, although, besides Visiting Teaching, I have never actually seen the idea in action. So, in the name of good will, I'm going to give it a try. My sister-in-law, Heather, gave me the idea. She posted,
The first 3 people to leave a comment on this post will receive a hand made gift from me during this year. When and what will be a surprise. But, you have to post this on your blog then come back and leave a comment, telling me you're in. Fun, huh? Remember, only the first 3 comments receive the gift.

I totally signed up on Heather's blog because she sews super-cute stuff and I'm hoping I'll score a potholder or something. I personally DO NOT SEW. It gives me fits (read: anxiety attacks!) and I've decided that since sewing is optional these days I will abstain. I do, however, bake. YUM! So let's just say your hand made gift will probably be something from the baked goods section of my brain. Or pickled beets. Because I still have a bunch of jars left from the summer. They are rockin' good beets, but you can only eat so many at time (if you know what I mean!). I can send pickled beets through the mail, right?

If you don't end up being one of the first three to comment you can still pay it forward by checking out this site: KIDZ was started by a woman named Tara who was blessed with a special needs baby, Chloe. Tara is hoping her site will be a place for inspiration and comfort for other parents struggling with the similar issues. KIDZ is having it's grand kick-off party this week. Go over, check it out, comment (maybe you'll win a prize!), and pass on the good will by telling others about her site.

Another inspiring project to check out was put together by my husband's cousin, Heidi. Many of you probably remember Heidi's Angel Babies site and the heart-wrenching and touching story of her baby, Elizabeth. In honor of Elizabeth's birthday she decided to sew blankets and outfits and made bracelets for infant bereavement kits. Heidi's project is over for this year, but hopefully she'll comment here and tell a little more about the organization she was working with how the rest of can pitch in next time!

Oh, and thanks for being awesome and reading my blog and supporting me and challenging me to think more about the issues surrounding the many, many people with mood disorders. I have the best readers on the Internet :)

Tuesday, February 17, 2009

Depression Profiles Wanted! Share your story!

Hi friends, thanks to me being really tired (I've got a cold) and some wonderfully kind bloggers linking to me (Thanks Camarena Circus and Postpartum Progress!)I thought I would do a shout out for Depression Profiles. It's been quite a while since I posted one and they are so important!

What is a Depression Profile, you ask? Well, that is what I call the short interviews I post with other depressed people. In a Depression Profile you can share your story your own way, like Doc did, or you can just answer my questions and I'll post it in a Q&A format, like Annalee chose. You don't have to be a member of the LDS Church, like Courtney. I just want to know about you. Oh, and you can be totally anonymous if you want.

I want to reiterate how important these profiles are. Depression is a tricky illness and everybody (the media, well-meaning bishops/doctors/teachers/anyone in authority positions, spouses, children, parents, men, women . . .you get the idea) wants to simplify it. They want it to be easy to spot and easy to treat. But depression is a varied thing and the only way we can understand it is to share our experiences. So, please, if you feel like you can, share your story here. We all benefit from each other's wisdom and perspective!

If you would like to share your story, email me at lolapalooza AT hotmail DOT com. Please put "depression profile" in the subject line so I know you aren't a spammer :)

Oh, and if you like to take quizzes about yourself (and what red-blooded American doesn't?) try this one: What type of depression are you? The coding is bad/ugly, but it's interesting. I came out with cyclothymic disorder. Since the quiz is only five questions long, I took it twice just to be sure. Never heard of it before but it sounds interesting! Too bad I don't really have "episodes of hypomania", though. My therapist will love this *wink*.

Monday, February 16, 2009

Mirthful Monday: The Twelve Warning Signs of Good Health

(If several or more appear, you may rarely need to visit a doctor.)

1. Regular flare-ups of a supportive network of friends and family.
2. Chronic positive expectations.
3. Repeated episodes of gratitude and generosity.
4. Increased appetite for physical activity.
5. Marked tendency to identify and express feelings.
6. Compulsion to contribute to society.
7. Lingering sensitivity to the feelings of others.
8. Habitual behavior related to seeking new challenges.
9. Craving for peak experiences.
10. Tendency to adapt to changing conditions.
11. Feelings of spiritual involvement.
12. Persistent sense of humor.

Friday, February 13, 2009

"Private Practice" is put to shame!

Hey friends-
You'll notice in my post on ABC's Private Practice I didn't talk much about the show. Really I talked about myself. (Cause it's my blog and I can if I want to!) Anyway, Katherine Stone had a lot of BAD things to say about the show. I second her in absolutely every way. Read her post. The organization she works for, Postpartum Support International, was livid with how they were duped by ABC. Ms. Stone has asked that we PULL THE PLUG ON ABC's PRIVATE PRACTICE. As in quit watching--which shouldn't be hard to do because the show stinks anyway. I don't care how hot you think Tay Diggs is or that it's a soothing follow up to the drama of Gray's Anatomy. Turn it off. You'll be making a statement that will bless the lives of women every where because you'll be standing up for them--especially for the ones who can't stand up for themselves.

And, um, yeah, Amy Brenneman's character is the WORST therapist EVER. If I met her in real life I'd swat her with a rolled up magazine.

Thursday, February 12, 2009

Postpartum Drama is Private Practice

Thanks to Katherine Stone over at Postpartum Progress I watched ABC's "Private Practice". I usually don't watch it because it seems like every episode begins with lots of shots of people having sex or just having finished having sex and/or going for more sex. Not what I'm really into, ya know?

However, tonight they had a story line that was supposed to highlight postpartum psychosis. They even had a PSA on I watched the show. It was hard.

There was a new mom whose baby didn't sleep well so of course the mommy didn't sleep either. She was giving the baby a bath and the baby slipped under the water and instead of immediately pulling the baby out the mommy held her under for a moment--thinking that if the baby died she could finally get some sleep. The mommy was so freaked out by what she did that she went to see her pediatrician and the whole story came out. The postpartum psychosis story was regrettably overshadowed by the drama of one of the other character's unexpected pregnancy, but, well, it wouldn't be television if the didn't keep trying to one up itself.

My husband watched with me and he asked if I identified with the character. My first thought was, "Heck no! That girl looks too good." Her clothes were stylish and matching. Her thick, brown hair was so long it cascaded down her back; it had obviously been styled with a blow dryer AND curling iron. She had make-up on. Those are some of the first things to go when I'm in the dark places.

But I did identify with her babbling. If I had verbalized my PPD thoughts they would've sounded like hers: fast, disconnected, anxious, and overcompensating. She was clearly desperate. One thing that seemed to be missing from her rambling, though, was the guilt. During my bouts of PPD (which IS different from postpartum psychosis like the girl on the show had) my constant companion was guilt. Guilt for not eating enough to support breast milk production. Guilt for eating too much and not losing the baby weight. Guilt for not playing with the baby enough. Guilt for playing with her too much. Guilt for loving her too little and guilt for obsessing about her. Guilt for hating her crying. Guilt for not knowing how to make the crying stop. Guilt for wanting it to stop no matter what and guilt for feeling angry that it didn't. Guilt.

What I did like about the show was that the doctors were extremely supportive of the new mommy. Several of them got together to discuss her case and take care of her baby while the mommy was admitted to the hospital. It's a pipe dream, but if all offices could provide that level of attention fewer women would suffer in silence and fewer children would be harmed. The show worked hard to emphasize the two huge factors in postpartum issues: sleep and support.

After the birth of my second baby, E, the postpartum education nurse emphasized sleep. She said if I could find a way to get at least a five hour chunk of sleep my symptoms would lessen. E wouldn't take a bottle and I couldn't find a way to sleep. I actually enjoyed holding her close at night and slowly rocking her while looking at the moon. It was the only peace I could find.

After the birth of my third, J, I told my therapist that I didn't think my medicine was working and I might be slipping into the depression again. We did a couple diagnostic things and surprise: I wasn't depressed, I was tired. She prescribed 24 hours of sleep. Never did figure out a way to get that either. But that had a lot to do with the other big PPD issue, support. I could sleep for 24 hours, but WHO would watch my kids and feed my infant? My breasts would have exploded!

I've had all three of my kids with a minimum of support but with each successive birth, I found more people to lean on. Since my husband and I are alone out here with no family nearby we've had to create those emergency networks from scratch. With N I wandered around alone and sad for almost a year before I started bugging another Mormon who lived within walking distance. (I had no car.) Her husband hated me, but I was around a lot anyway.

With E I told the Relief Society president about my previous PPD but, in the same breath, also told her I didn't need any help. I had everything handled. At three weeks postpartum a friend came to babysit the kiddos so I could get my depression evaluated and start treatment. That friend did dishes and picked all the raisins out my carpet that N, who was two, had ground in. She even hung around the entire afternoon to just chat about whatever.

With J I told everyone about my PPD and how nervous I was about it and, thank you Jesus, people showed up. One friend watched my kids, cleaned my kitchen, and put away laundry when my husband picked me up from the hospital--even though she had family visiting. Another friend came and rocked my acid-reflux-y baby while I struggled to get the other two to sleep and my husband was working late. That same friend, who happened to be seven months pregnant with her fourth, accompanied me on a sweltering afternoon outing the county fair when J was only ten days old.(For that first little postpartum period I can't stand to be alone or be in the house too long. The curtains start looking like bars and I feel like I can't see straight and like all the noises are too loud. It's better if I get out, no matter how tired it makes me. I'm too anxious to be still and restful.) So many people brought meals that we had leftovers for more than a week.

PPD gets progressively worse. Every time I have a baby I need more intervention, more exercise, more help, and more drugs. But strangely, the more babies I have the better I am at asking for and finding help. The postpartum period with J was marked by PTSD type dreams, knife obsessions, and soul fatigue. But it was also full of surprising reminders that I wasn't alone. I felt better than I ever knew I could.

And that what this PSA is all about. (Amy Brenneman comes off a little cold, but hey, that's okay. She's trying to help). So, spread the word. Tell people if you struggle with this. Ask the pregnant women you know if they are depressed. Surprise someone with a meal or with a babysitting offer. If you are struggling, let someone fold your laundry and scrape the yuck out of your sink. (For more on meaningful service check out this Blog Segullah post, Seeing Past the Smile.)Over at Postpartum Progress, Katherine Stone calls us warrior moms. I like that. Let's fight this thing together.

Tuesday, February 10, 2009

Defining Recovery

I ought to clarify. In my post, That's It! I Quit!, I talked about possibly quitting my meds. Several of you were sweet enough to worry about me and I wanted to thank you. I appreciate all the support I get from my readers. It means a lot to me to know I'm not alone. So I wanted you to know: I didn't quit my medicine. I'm still popping my pill each morning. I figure I should wait until we are in a more settled place or until I have a real medical reason to stop or until I'm better.

Which brings me to my most recent quandary: what does it mean to be better? When talking about a possibly chronic mood disorder, is there a point where the sufferer knows that they are through the worst and will reach a full recovery?

I honestly don't know.

For me, this whole depression "adventure" has been a series of ups and downs. It's not that I'm manic or anything like that, it's just that whenever the good times are rolling there's a part of me that wonders how long it will be before I get a stick in my wheels.

Maybe I feel that way because my depression really took off as postpartum depression (I had anxiously depressed phases in high school but nothing I really perceived as chronic until the third trimester of my first pregnancy). Feeling bad and crazy is hopelessly entangled with mothering because the two happened together. It takes a lot of effort for me to tease apart what is the depression and what are my instincts as a mother and, as an Latter-day Saint, what is inspiration from God. Maybe as long as I'm mommy-ing I'll struggle with this.

Or maybe I feel like my depression is always lurking because I had three babies in four years. That's a lot of stress--a lot of ups and downs--even for normal women. There are a lot of benefits to having kids close together (they are such good buddies!), but there's no doubt that it is also hard.

Or maybe the ups and downs are just the nature of the illness.

The first time I started antidepressants, when my oldest was four months old, I thought that my antidepressant was basically like a supplement. You know, my body didn't produce a certain substance so I would take a pill that would give my body more of that substance. Eventually, I thought, my body would take over and start producing the correct amounts on its own.

Turns out antidepressants aren't that straightforward. Nobody is exactly sure how they work. All the stuff about serotonin (or any other neurotransmitter) being more available in the brain is true, but no one knows exactly what the brain does with the extra stuff. And nobody really knows why some brains don't produce the correct amounts in the first place. We know there's a relationship between hormones and neurotransmitters and we know there's a relationship between general health and mental health, but we don't know the exact nature of those relationships.

It's popular to compare the use of medicine to treat mood disorders to using insulin to treat diabetes. I like the comparison a lot and use it myself when talking with others but a recent conversation with a clinically depressed friend made that comparison even clearer to me. When I told her I wanted to quit my meds she said she'd been there too but she figured it was like diabetes. "A diabetic can't just wake up one morning and decide their to quit taking insulin," she said. "It's not like their diabetes is going to go away just because they learned to manage it. It's an illness and it's chronic. Depression is the same thing."

That was quite a blow for me. I had always looked at this depression thing as something I was going to overcome. I guess it was ridiculous but I really thought that maybe one morning I could wake up and know that I would never have to deal with the crazies again. But it's not like that. You don't get better from clinical depression. All my therapy, all my medicine, all my thinking and writing, is only managing the symptoms. None of it is fighting the illness at it's source because we don't know the source. Or maybe we do. The source is me. It's who I am. It is my life. It is my existence--my body, my soul, my mind, my everything--that feeds my depression.

So what does all that mean for recovery? When you have a cold you wait it out and eventually the symptoms pass. You wake up one morning and know you're not going to be blowing your way through a whole box of Kleenex. Not so with depression. The symptoms will always be cycling around. How do you recover from something like that? What does it mean to "get better"?

Maybe it doesn't mean anything at all.

Monday, February 9, 2009

Mirthful Monday: What the difference between a psychologist and a magician?

While a magician pulls rabbits out of hats, a psychologist pulls habits out of rats!

Thursday, February 5, 2009

Book Review: Your Child in the Balance by Dr. Kevin T. Kalikow

I'm pretty tired tonight. I've been trying to keep up on the housework this week. Yeah. I'll be giving that up pretty quick.


I have a book recommendation for you: Your Child in the Balance--an Insider's Guide for Parents to the Psychiatric Medicine Dilemma by Kevin T. Kalikow, MD. This was a great read for anyone on psychiatric medicine, anyone who is considering psychiatric medicine, and especially anyone considering medicine for their child.

Written by a prominent child psychiatrist, Your Child in the Balance comes at the issues from all sides. Dr. Kalikow approaches psychiatry from social, historical, economical and, of course, medical perspectives. He fills the book with anecdotes and examples that illustrate the many, many questions surrounding psychiatry and children. He avoids mincing words and doesn't give simple answers. What he does give is information. Lots of information. And even though that information is focused on children and psychiatric medicine it is easily applied to adults.

It was a frustrating book to read because it was frightening to realize how little we know about "psychopharmacology". Psychiatry is a relatively new specialization. Psychiatric drugs are even newer--Prozac was invented only 20 years ago. We know so little about the long-term effects. But it was also a great book to read because it was full of information. Considering how young the whole shebang is it seems that society as a whole and most doctors are being careful and learning from the research. There IS a fair amount that we know. The most important thing we know? Ask questions and work with your doctor.

Near the end of the book Dr. Kalikow gives what he calls
The Ten Commandments of Medicine:

1. Have your child (or yourself) appropriately evaluated by a trusted professional.

2. Before jumping to medicine as the answer, ask whether changing your child's (or your own) environment would be helpful. Understand whether psychotherapy would be helpful and how.

3. Never use medicine based simply on your neighbor's response to that medicine. Everyone is different. However, if closely related biological family members have responded to a specific medicine, inform your physician. Sharing similar genes might indicate a greater chance of success or side effects.

4. A diagnosis is not an excuse. Your child (or you) should understand that he or she is still responsible for his or her behavior.

5. Know what you're treating. Know whether you're treating a disorder or a symptom and if the medicine is FDA-approved to treat the disorder or if it's being used off-label.

6. Give the medicine time to work. Don't bail out early . . .Many side effects are mild, not severe or dangerous, and will disappear in time. Also, beware of polypharmacy (the use of many medicines or "cocktails").

7. Medicine must be monitored. Don't avoid your doctor. Make follow-up appointments.

8. Avoid the medicine rut, the use of medicine year after year without re-examining your decision.

9. Parents (or spouses) should be unified in the decision to take medicine. [To my mind, this is an ideal that may or may not be possible but it is certainly a good things to work for.]

10. Know when to quit your search for the medicine solution. Medicine is not the solution for every problem.

Tuesday, February 3, 2009

That's it! I quit!

(I posted last Friday but it looks like it got stuck back in December of 08 when I first started drafting it. For those of you who missed it you can read part three of my series on Support Where You Need it the Most.)

No, no, no, I'm not quitting blogging. I'm quitting my medicine. Well, maybe.

For those of you who have been reading for a long time now, you'll remember that last summer I had a Prozac poop-out. (I was on Lexapro, so technically it was a Lexapro poop-out, but you can't link to that term so what's a blogger supposed to do!) I met with a friend-of-the-family psychiatrist out in Utah during our family reunion. It was awkward but free so I went for it. She explained the Prozac poop-out phenomenon to me and recommended I switch to Cymbalta. She said it would do a better job at nipping my intrusive thoughts in the bud. I had reached the point where I was nervous to be alone with the kids so when I got home I dialed up our family practice doctor and she wrote me a prescription.

And it worked. It was a little rocky at first but it worked. I still get nauseous if I go too long without eating and I still nap 3 out of 5 days and since it's still winter I don't worry too much about my increased sweatiness--I just go without a coat--but most of the time I'm not depressed. That feels good.

Except for when it doesn't.

I have to admit those little blue and white pills are starting to annoy me. I hate having to remember them every morning. I hate having to call in for the refill. I hate how much they cost. I fantasize about how much I could get done if I didn't have to nap. I'd love to be able to lose my muffin top but the urge to snack is too strong. And, well, it's still winter now but it will be spring and summer soon enough and I don't want to have to carry around a pack of tissues just to soak up my extra perspiration. It's gross!

Of course, the real reason I want to quit my antidepressant is well, I want to quit being depressed. I want to quit having a mood disorder. I want to quit feeling less than normal because I have to take medicine every morning. I want to know if who I am now is who I really am. I think it is but how can I be sure when I'm popping this pill all the time? I'm just tired of being that girl.

I've gone off my meds before. I wean off them before getting pregnant. I tried to quit my Lexapro last summer (before it quit me. If I could argue with my medicine we'd totally have one of those "You can't fire me, I quit!" conversations). It's always ugly. My patience disappears and my anger comes back and then the guilt sets in. My intrusive thoughts get all noisy. I have to pray myself out of bed in the morning.

But this time is different. The first time I quit my meds I'd only been on an inadequate dose of Lexapro for three months--which research shows is too short a time and actually leads to worse depression. (I can't find a link to cite that last bit, but I know it's true. Ask your doctor!) The second time I weaned off was after eight months and a lot of the environmental factors of my depression hadn't changed.

So how is this time different? Well, I've been pursuing treatment that includes off-and-on therapy (the insurance only covers twenty visits a year so I've got to use them wisely) and SSRI/SNRI for over 18 months. I've actually been working with my therapist for over two years. Come to think of it, I should have sent her flowers for our anniversary last November!

I guess the big thing that hasn't changed is the environmental stresses. I still have three little ones, who are bizarrely unable to sleep through the night, and my husband is still in grad. school and working full time. He graduates in May so maybe I should hold on to those little pills until then.

It is such a wearying truce to strike. I'm so sick of having to act like I'm sick just to prevent the sickness, you know? It doesn't make sense to keep taking Nyquil just to make sure you don't get a cold. But depression isn't a cold. It's not something I can just get over. My body doesn't have a response system for this. Depression is a disorder that I will have to be aware of and manage for the rest of my life. That's what that pill means. And that's why I hate taking it.

Monday, February 2, 2009

Mirthful Monday: What Day Is It Today?

Over breakfast one morning, a woman said to her husband, "I?ll bet you don't know what day this is."

"Of course I do," he answered as if he was offended, and left for the office.

At 10:00 a.m., the doorbell rang and when the woman opened the door, she was handed a box of a dozen long stemmed red roses. At 1:00 p.m., a foil-wrapped, two-pound box of her favorite chocolates was delivered. Later, a boutique delivered a designer dress.

The woman couldn't wait for her husband to come home.

"First the flowers, then the chocolates and then the dress!" she exclaimed.

"I've never had a more wonderful Groundhog Day in my life!

That groundhog is definitely gonna see his shadow!