Beyond post-partum depression: part 2, Stepladder
I’ve suffered post partum depression. This is how I came out on the other end of the tunnel, or at least to a place where I can see the light. This will be a play in 3 acts:
1) Falling down the pit (warning, a bit depressing)
2) Getting on a stepladder (the salvation part, more pragmatic)
3) Get up and stay up (sorry, probably nauseatingly cheerful)
Well, if you read the previous post, you know I basically fell down the pit of misery after childbirth, including severe injury. It’s about how depression feels, and how it can grow on you, even if you think you should be happy. If you didn’t read that one, maybe this won’t make much sense.
It got really bad after a year and a half. Or maybe it just didn’t get any better and real life knocked on the door, with new work responsibilities and the stress related to that. I never slept a full night. Baby boy didn’t eat at nights anymore, but still needed a lot of comforting. Starting life at day care came with a variety of sniffles and the occasional nightmare. When he fell back asleep I was still wide awake for hours, filled with dark thoughts of horror and despair. Me, in my safe life, with my kind and caring family healthy and all. It was ridiculous, but knowing that didn’t help. I spent a lot of 4 o’clock-in-the-morning-time convincing myself the horrors could be true.
I was so anxious about things that I got sick. Dizzy, fainting, trembling like a leaf at every raised voice anywhere, I wasn’t able to concentrate or remember things I should. Unorganized and sad, sad to the point that I didn’t want to live anymore, I finally went to a doctor.
Finding a stepladder out of the pit
There are a number of things with healing powers. Things that help us feel a little better. Maybe there isn’t one simple cure, or maybe one single medicine isn’t enough. Maybe you need something to start up with, and something else to stay on course. Here are some real life experience on:
The healing power…
My doctor, a kindhearted person, pointed out to me that sleep deprivation alone causes depression, at some point. You can use medication, try exercising, try being the superhuman that we all think a mother should be – but we have needs of our own, and they need to be attended to. Sleep, for example.
I got anti-depressive medicines. More than anything they made me tired, and helped me sleep. I really needed that. I also got something to keep a possible anxiety attack down.
I’m not going to say that everything changed, but it did help. Not at once, but a few weeks in. It was a bit like being gently tucked into a soft cloud where nothing seemed to upset you much anymore. It was all okay. With that, I actually could sleep. I still woke up when Baby Boy did, but I was gently tucked back into the soft cloud of nothingness and fell asleep fast again.
– but also the side effects
So I used meds, I did for a year. I was much better from it. I was all okay. Not happy, mind you, but okay. Nothing upset me anymore, I was constantly tired and mildly content, steady as a rock. Hard to get going, hard to engage into anything, but there, constantly chewing on something.
The medicines made me hungry. Really hungry. All the time. As they also made me so tired, I didn’t exercise. The usual walks turned shorter and slower. Everything slowed down.
So I turned fat as a cow, gaining a lot of weight during that time. It didn’t help my self confidence much.
I think I needed that time to pick up on all the sleep I had missed out on, heal that brain of mine that had been working overtime for so long. But it wasn’t much of a life I had. I don’t even remember most of it. I can look at pictures of myself from that time – fat and dizzy looking – and wonder where I really was? In the last post I mentioned the lack of sex drive while breastfeeding. Now there was none. All I wanted was to eat and sleep. Very sexy.
I know the constant crying stopped, and so did most of the mood swings. But it was still there somehow, behind the soft fog of ignorance. I was aware of the troublesome feeling of not caring much about anything, my slow reflexes and constant tiredness. I didn’t dare to drive a car. I was afraid something would happen to my child because I was too slow to catch him when needed. But it was sort of drowned out by the tiredness.
So, sleeping it all out was probably necessary. But the tiredness and slowness of it all flipped the coin to the other side of depression, the passivity. It’s a symptom, yes, but it is also what keeps you down. Shake it off and a big part of your problems will be gone (see below, on anxiety vs passivity).
…of therapy or counselling
Talking about it may help untangle the real problem from the fake ones, and help you find better thinking patterns or even solutions.
Now, to me, it didn’t. I got a counselor with no specific orientation, who went straight to asking me about my mother, and I just got turned off. I felt my mother had nothing to do with it. Maybe I could spend years in therapy and find out exactly how and when my mother may have hurt me, but still that wouldn’t help against the depression. (Also, I love my mother and don’t want to try and mend something that isn’t broken.) I wanted to think differently, to get better.
New thoughts, new habits and little by little lifestyle changes is mostly gained through cognitive behavioral therapy.
…of a healthy diet and / or supplements
So, what happened next? I was a big fat cow on meds that kept me nice and calm, but without any energy or real hope. I stood without counselor. Well, I think meds helped as far as they could. I could start thinking again. I went to a masseur who told me I had to change diet and eat less acidic food. I took one look at his paper with dietary suggestions and gave up immediately. No way I would go without coffee, or fresh fruit, or chocolate?!? Oh my, what did he really think of me?
But I did think about it, and read about it, and made some references to dietary recommendations during pregnancy and came to the conclusion that maybe I was in desperate need of more calcium? Now calcium is really important for all our body’s functions, it takes part in neurological activities and muscle tension, and it’s needed for our skeletons to grow. Even the baby’s skeleton. We need quite a lot of it daily, and when pregnant or breastfeeding, we need more (around 1000 mg). There is a lot of it in the milk we produce, and if there’s not enough in our diet, it’s taken from our bones. This may be why so many women suffer from osteoporosis, and I expect a variety of other conditions could be related to this deficiency.
Considering my diet through pregnancy (being constantly sick and actually hardly eating at all) and how much I had been breastfeeding (every other hour or so), and for how long (almost a year), also remembering the cravings I had for cheese and ice cream, it all made sense to me. So I started having calcium supplements, including vitamin-D, that helps the body absorb the calcium and also is needed during cold winters with a lack of sun.
I felt a lot better, rather quickly too. The dry skin I had was suddenly better. The cramps in the legs and the acidic stomach I used to have was gone. Within a few weeks I quit the meds! (Yes, I did the fading out, but a bit quicker than recommended) I haven’t used any for 5 years.
– but also the side effects
The difference is, I felt more, again. Yes, sadness, at times. Yes, anxiety too, at times. But also happiness, anger, excitement and all those other feelings that we have, that I believe needs to be there. I can get all worked up and intense and sometimes slightly neurotic, or a bit maniac. I can play pirate and sword fight with my son (yes, using soft swords of course). I can climb trees, and swim, and laugh, feel more lust again. I also got the sex drive back. And soon I was pregnant again and had another son.
This time, I asked for help. I was promised a c-section (after a whole lot of crying and administrative trouble with localizing the old journal from my first delivery). Before it was clear, I was pretty stressed, admittedly.
I lost weight, about 40 pounds actually, during pregnancy and breastfeeding. So I was back in shape and very content about that, even if it was not the preferred time to diet, and neither a method of choice (to throw up by the smell of food alone – morning sickness hit me hard both pregnancies). I was a tired and boring mum, very much a passive one, those couple of months, but I was better again.
I was remitted to physical therapy and got helpful advice on exercise for those damn lazy pelvic floor muscles that didn’t want to cooperate with common techniques. I also got hope back, concerning my body. Little tips and advice that helped. Like peeing before I went for a long walk, or using tampons while jogging. I got exercises for my belly that was not going to push anything down anywhere it shouldn’t.
Sunlight also helps. I spent a lot of time outside. Exercising was not for this pregnant mom, but there was moving around a bit and feeling lighter (possibly because of weight loss).
The next baby
The c-section, in my humble opinion, is indeed a civilized method to deliver a child. Giving the going-to-be-mother time to sleep before delivery time, get full anesthesia and recover on drugs. I’m for it. Yes, it hurts a bit, mainly the first 24 hours. But it hurts on your belly, on the front part of it. I’m fine with that. Compared to my first delivery this was a piece of cake.
I was again a little crazy defensive with my baby, Tiger Mom rising again and saving my baby from stupid syringes, fighting off good nurses, but then again, head nurse embraced me for it.
I finally got to talk to a specialist on post-partum depression after delivery. She could kindly tell me I was fine now actually, and completely normal, and I didn’t need her. Hug and smile. Thank you. What a relief! A professional opinion! I chose to listen to her more than my own doubts.
But there is constant work to be done. Finding balance in life, between personal needs and those of others. Balancing the need to rest and the need for action.
Anxiety vs passivity
I think it’s basically 2 sides of the same depressive coin: the anxiety and the passivity – locked together by unreleased stress. Strictly physiologically, stress lies behind it all, causing tension. When tension is not released anywhere by some kind of action, we turn kind of stiff, paralyzed in mind and body.
Anxiety is related to depression, as a common symptom. Anxiety makes us nervous, worry about things, sometimes getting fixated on fearsome thoughts. This makes us more stressed, naturally, causing nightmares and trouble sleeping, but also affects our ability to concentrate, and our memory. One time, I couldn’t remember my own phone number. It was bad, people!
Sometimes the stress causes heart arytmia, dizziness, hairloss, gastritis and other physical problems too. It makes us sensitive to stimuli, easily overwhealmed. Anxious people will avoid crowds and social gatherings, new experiences and places if possible – as it stresses us out. We need a quiet place to rest and be able to focus.
When we are better, meaning not depressed anymore, we can get our curiosity and formerly known selves back. But we may be a bit more sensitive, with a need for peace and quiet time between events. Collecting ourselves. This is not necessarily a bad thing. It gives us time to reflect upon things, analyse things, learn from them and grow a bit.
Passivity is the major sign of depression. It’s really a kind of defense mechanism: you want to protect yourself and enter a bubble of inner peace. Or faint (I’ve done that too, from fright alone). Problem is, it gets cramped inside.
Passivity is a constant feeling of exhaustion. Of not having energy to refill yourself from the smallest of efforts. Stepping out of bed could be enough, at one point.
It’s a feeling of being strangled by your own anxiety or tied down by the depression, patronizing you with dire statements, in a rumbling, thunderous voice of doom. Depression tells you – falsely – that you are basically worthless, you can’t do anything right and you will never get better because you don’t have the strength. Just look at you, how miserable are you? And the more you try and hide from it, the worse it gets.
The hardest thing you need to do is realize this: you are worth more. You are ill, that’s all. There is a way out. But you need help, and determination.
Out in the sunlight, you can call that voice of depression out. Put the spotlight on it and it diminishes. You’ll realize it’s pathetic, scared and weak. More importantly, it knows nothing of the real you. It knows only what you thought about yourself, there, for a while. Perhaps it’s really the memory of the voice of a stupid bully from the playground of your childhood. Listen to other voices, real ones. Voices from the people that matter to you now, people who know you and like you, or at least someone you think of as wise, a therapist maybe.
One way of putting the spotlight on the problem is in therapy. Psychotherapy helps in many cases. Modern therapy is all about goal orientation and that is surprisingly effective, going straight to the case: Where do we want to go? How do we get there? Where do we start? How do we know we succeeded with our first step?
I’ll admit it’s like a fast-food ordeal in therapy. It’s for a limited time and oriented to solve specific problems. It won’t solve profound traumas, but it will find ways to deal with things, and, sometimes, that’s good enough.
Another is to challenge it by action: by simply going against it. If the voice tells you you are too tired to go out, you go out anyway. If it tells you something is too hard, you take a small step every day to make it happen. Prove it wrong – little by little, and you will see yourself differently one day. Because you will be different. You will not be held down anymore.
Of course it takes time. Of course it takes a lot of hard work: calling on those negative thoughts, demanding new interpretations out of your brain. Forcing yourself to create new – by your conscious mind approved – chains of thought, making new associations, trying out new habits and routines.
To feel exhausted from hard work is way more satisfying. Admittedly, as depressed or after suffering depression, you might get exhausted much, much earlier than before. A sensitivity to stress, noise and crowds may be there, that wasn’t there before. But we mustn’t be afraid of pushing ourselves to tiredness sometimes. As long as we also allow ourselves the rest we will need afterwards.
What we need to do is balance things: the need to rest, and the need for activity. Because activity will make you tired, but it refills you somehow with more energy after. You feel better and can do more things, making you tired again. We do need to respect our needs and manage stress by saying no, restraining ourselves from overdoing things and making realistic schedules including time to breathe, plan ahead and evaluate things. It’s important not to stretch yourself too far again. But there is a need for some action too, just to break the bonds of passivity, with all the negative thoughts coming along with it.
The problem is, of course, that we don’t shake them off that easily. The power of thought is strong. Your own beliefs can hold you back OR carry you anywhere you want to go. Here is where we might need step-by-step programs, not to be overwhelmed and give it up before we even started.