Showing posts with label depression. Show all posts
Showing posts with label depression. Show all posts

Tuesday, September 1, 2015

Postpartum Anxiety


The fool says in his heart, "There is no God." 
They never call on God. 
But there they were overwhelmed with dread, 
where there was nothing to dread. 
Oh that salvation for Israel would come! 
Psalm 53 


"What does an unused prayer link look like? Anxiety. Instead of connecting with God, 
our spirits fly around like severed power lines, destroying everything they touch. 
A godlike stance without godlike character and ability is pure tension." Paul Miller


Allow me to start by saying that I'm hesitant to share this. The very last thing I want is for Noah to read this one day and feel like my postpartum anxiety/depression is somehow his fault, because it's not. Never for a second would I blame him! My inability to cope with the realities of motherhood, however, was a problem. No, scratch that. It was my reaction to my perceived inability. Mom-guilt and insecurity quickly turned into a fundamental shame in who I was as a person. That I was too much and not enough all at once. The shame was the straw that broke the camel's back. It was the tipping point in the perfect storm that had been brewing for, well, years according to my therapist. I went from extremely stressed, to anxious to the point of dread on a daily basis.

Walking around clinically depressed and anxious feels like staggering about, alone, on barren, deserted island. It can make you feel like you have no mooring; no place to throw an anchor; no shelter from the storm that tossed you ashore in the first place.

So in the end, I'm sharing. Because no new mom should feel ashamed when she's on the verge of tears and someone tells her to be grateful that she "only" has one kid and that it only gets harder from here on out. No new mom should be made to feel inadequate when someone tells her that they've never seen anyone else struggle so much with postpartum recovery. No new mom should feel the soul-crushing disappointment in herself when she's surprised by motherhood in all the wrong ways. When she's eating her pre-baby words and struggling to adapt to the role of motherhood, no new mom should feel ALONE.

This is the story of my pain, and maybe you will find in it an echo of your own story or that of someone you love. Consider taking the EPDS or reviewing this symptom checklist if anything henceforth sounds familiar to you.

.......


It all started when Noah started sleeping through the night consistently a few weeks after his first birthday. It seemed like suddenly I found myself at the beginning of July, after a month of rain, and I could see the sun for the first time in a LONG time. I had a few weeks of sleep under my belt, seemingly out of nowhere I had a toddler who could walk and talk and play, and life was so different than it had been just one or two months prior. I missed my baby, to be sure, and I still feel a familiar sadness when I think about all the sweet early moments I missed out on due to pain and anxiety, but mobility (and sleep) changed everything this summer and I couldn't deny that Noah was an awfully fun little guy to hang out with. Every stage is bittersweet, but I'm finding that each one is also progressively more fun as I get to know Noah better and better.

With the sun out at last, we could take playdates to the pool! We could take long walks every morning in the beautiful summer light! I had energy again! I could workout if I wanted to! I lost the last bit of baby weight and had a whole closet of clothes accessible to me again that I hadn't worn in almost two years! I could, and did, go to the farmer's market and start eating more vegetables after far too long of a hiatus. It's no secret summer is my favorite season. I felt like a new dawn was rising as I re-entered the land of the living and emerged from babyville. But it didn't take me long to realize I was not okay.

I was functioning. I was having fun! I was no longer having insomnia or heart palpitations, but I couldn't shake the feeling that I wasn't quite living either. At first I thought, okay, this is life as a mom. I will never be the same. And I WILL never be the same (thank God)! But I like to think that's because more has been added to my life and I've changed and grown into this new shape as I adjust. Not because the substance of my old self has been taken away.

This summer, Noah and I took daily morning walks and I started listening to sermon podcasts again. It was refreshing to just let truth wash over me. It's so easy for forget that I'm not the center of my life and that I'm certainly not in charge of it.

This summer, I realized I needed to change jobs. Again. But this time, the decision was not terribly debilitating. Now that I'm getting more settled into it, I'm relieved to find that my instincts were right, and this job is a great fit. But still, because of, or perhaps in spite of this decision, I was anxious. I was fearful. I had a certain peace that I was doing the right thing, that this was the best choice for my family, but I still wasn't okay.

This summer, Ross and I went to an amazing marriage conference once a week for 5 weeks. We started to reconnect and we were shocked and saddened at how far apart we'd grown in such a short time.

But the hardest thing was the thing that wasn't changing: the pain that I'd been having since I was 16 weeks pregnant. Ebbing and flowing with my hormones, but always there, always worse at the end of the day, was the pain. Somewhere in the haze of the early days of motherhood, my pelvic pain went from being a source of frustration to a source of concern to a trigger for hopelessness and despair. I'd been a compliant patient in physical therapy for 9 months by the time summer rolled around, and initially it was a life-saver. But the pain plateaud around March no matter what I did. In fact, certain aspects of it were starting to get worse again. It was so depressing. It was so painful. It was so discouraging. I was starting to feel like it would never ever go away. Like I would never feel normal again. Like I would never feel well enough to have another baby. Like I would never be able to love this baby the way I wanted to, because it hurt to lift him, it hurt to hold him, it hurt to rock him.

That kind of pain... I wouldn't wish it on anyone. By the end of most days, it was debilitating physically. I couldn't find it in me to stand and make dinner or tidy up. But emotionally? The pain was devastating. I felt like I was missing out on those "pay off" moments of parenting. Sure, having a toddler is chaotic. But people say, oh, when they snuggle up on your lap or fall asleep in your arms, it's so worth it. I felt like I didn't have that. I'd never been able to hold my crying or sleeping baby without my body screaming in pain. So I went back to my Midwife and thus began two months of constant appointments in August and September.

Back to the pain management OB, back to get another ultrasound, back to acupuncture, ramp up the physical therapy visits. Meanwhile, onto all of Noah's one-year appointments: pediatrician, shots, ENT, audiology... And then, I'm not sure if this was a cause or effect of additional stress and anxiety, but abdominal pain started waking me up at night. So I had an endoscopy. I had more labs drawn. More ultrasounds. More appointments. And more medical bills. And more hopelessness. Feeling like I was getting nowhere, and just spinning pointlessly in a cycle of pain and debt.

After Noah was born, I spent a very long time focusing on Noah's needs and putting him at the center of my life. This summer, I started to feel stifled by those expectations, and started feeling like it wasn't fair that I never got a break. Like I was physically worn out. Like I needed a spa day or a vacation or... something. Every time something else spun out of control, I thought: I'm terrible at this. I'm terrible at being a mother. I cannot balance this. I cannot manage this. Those were the sermons I preached to myself: I can't. I just can't.

And maybe I wasn't sharing enough, or maybe I cry wolf too much, or maybe it's simply that no one in my life was able to speak into that for me, to point out Satan's lies, to look me in the eye and remind that me that God CAN. To say, "Remember every other time you've reached the end of yourself and God drew you out of the muck and mire? He's still there. He's always there, but how gracious would it be for you to invite Him to partake in this moment with you? Into this embarrassing season of feeling hopeless as a mother and desperate for physical relief."

But it took me months to get to that realization. Until then, I was just in endless dialogue with myself: It wasn't supposed to be like this! I wanted kids! We prayed and planned. I take care of babies for a living! I loved Noah more than life, and I COULD NOT HANDLE the feeling that I was failing him day in and day out. In the isolation borne out of a long, dark, cold, anxiety-ridden, sleep-deprived winter, I had no one to bounce these thoughts off of, nor the mental clarity or inner confidence to do so. I had no barometer of 'normal.' Just occasional and seemingly benign comments here and there from people who didn't-- couldn't-- understand. Those words hurt. And made me feel more inadequate. And more abnormal.

Then, blessedly shortly before Noah's birthday, something clicked and I thought: what if this doesn't have to be normal? What if it's pain AND ... ? What if I'm depressed? What if my hormones are so out of whack that even though I'm a year out, I have had postpartum depression this whole time?

I truly don't know where this thought came from, but some freedom came with it, immediately. What if it's not my fault!? What if it's not just because I'm not trying hard enough or balancing well enough or doing things just the right way? So I got a referral and filled out the counselor's paperwork, and I was shocked. Shocked. At how many boxes I checked. How many symptoms I had.

Like many new moms, I was given a postpartum depression quiz shortly after Noah was born, when I was tired and sore, but also still riding the endorphin train. It's supposed to be hard at that point! I totally expected that! I did not expect to feel almost exactly the same, physically and mentally, a year later. I have no idea why I didn't think to take the survey again in the middle of December, when I dreaded going to bed only to be woken up every hour. When family obligations felt like a physical weight in my sleep-deprived state. When the long days started at 4am and I truly didn't know how I'd get through them in our drafty, unfinished house. (I don't know how I did, actually. I don't even remember.)

So in August, when the counselor tallied up my postpartum depression score, looked right at me, and said, "how did you get to this side of winter? How were alarm bells not going off everywhere?" I felt the weight start to lift. She said, "of course, the Scale is just a tool, and not necessarily diagnostic, but these scores suggest that you were terribly, frighteningly depressed. How did you get to the other side?!"

At those words, I wanted to cry tears of relief. Those feelings hadn't been normal! I wasn't inadequate for feeling like I was trapped and unable to talk myself out of it! But also, I saw God's hand. How had my depression score dropped from 24/30 to 11/30 in 4 months? Time helps. Sleep helps. Perspective helps (some of those extra-hard weeks really were just a phase). Sunlight helps. Exercise helps. A balanced diet helps. But really when it comes down to it, it's not hard for me to see that God was gracious and he removed me just far enough from the forest that I could see the trees again. I had been lost in a very dark place, and I couldn't recognize that because all I could see was this sleepless night, or that cranky day, or this extra-painful week. But once I could see the big picture, I could ask for help. More importantly, I could RECEIVE help for what it was, instead of a threat to my sense of capability.

When I think back to that symptom checklist, I think I was most shocked at the reality of the line I checked and starred near the end of the list: This is the worst that I have ever felt. When I saw that truth for what it was, and when I let it sink it, it hurt. Last winter was worse than being 15 and anorexic. It was worse than being depressed senior year of high school when I couldn't get out of bed and couldn't do school and cried about everything. It was worse than freshman year of college when all that unresolved depression left me unmoored and unable to recognize this girl who couldn't just sit down and study like she needed to. Worse than the bad breakups that haunted me. Worse than the hardest days of marriage.

The worst I'd ever felt... not only was that a bold statement in a season that I thought would signify that hard times were behind us, it was a disappointing realization in itself to feel this way during what I'd always envisioned to be one of the happiest times of my life. To be sure, the happiness did come in bits and pieces, slowly, and then all at once. Big love is winning over big heartache. Today, the exhausting is from keeping up with an active toddler and not from sleepless nights. And the joy... it overwhelms me at times. Our child is a delight, and I'm so grateful that he's ours, but there are a lot of things I would be tempted to change about the first year, if I could. (Things about myself, not about Noah.)

But I can't. Instead, this fall I started saying no to some things, but yes to others. No to the old job. No to a semester of Gospel Community. Yes to the support group, yes to MOPS, yes to spending allthemoney on acupuncture in a last-ditch effort to ease my physical pain.  Each of these steps would normally have felt very vulnerable, but for some reason they just weren't. I had nothing left to lose. What I was doing-- surviving-- wasn't working.

It was a breath of fresh air to sit at a table with other moms at my first MOPS meeting, toddlers safely tucked away in the childcare rooms, and to hear that God promises to send his people out in joy and lead them forth in peace (Isaiah 55). I thought, what a perfect way to end this summer. There IS more. There's joy to look forward to. There's peace regardless of circumstances.

Because now I see. Joy is not something to be attained. It's something to be received. A gift freely given, but often turned down in the pursuit of happiness. Here's the thing about reaching the end of yourself: depravity can be fruitful. God can plant the seeds for a harvest of plenty in the most barren soil. In our time of need, he loves to show us that he loves us. As a parent, I've garnered a new appreciation for the way God calls us to seek him for rest, comfort, reassurance, guidance. I can learn to give well as a parent when I, in, turn, receive these gifts as a beloved child.

I'm starting to get excited about motherhood as an opportunity to be enjoyed (as I first envisioned it) and not just an obligation to be feared (as I came to feel it). It's an opportunity to see God work in a new way. An opportunity to make new friends and have new eyes and, most of all, a new heart. A heart of freedom and not of burden.

I'm thankful for those uncomplicated moments this summer when I started to see myself in there again. After being buried for so long, it feels like catching a glimpse of a friend in the mirror when I say yes to the spontaneous outdoor concert, when I reach out to a neighbor and let our kids run around while we talk about everything we have in common, or when I'm running errands alone in the evening, car-dancing to CDs of music from high school. In those moments, I find a certain lightness of being, a simplicity, a reassurance, a whisper of hope. All is not lost. God can rebuild the years the locusts have eaten.




Saturday, January 25, 2014

Never Enough

(I wrote this a few weeks ago, and was too afraid to post it. Things are getting better, but these thoughts are still a legitimate part of this pregnancy and I want to remember it.)

Wondering why there's complete radio silence lately between my weekly pregnancy updates? I was prepared for the physical discomforts of pregnancy, but I'm having an immensely hard time dealing with the hormonal outbursts, irrational thinking, and anxiety, and I feel like I finally need to talk about it a little bit.

First of all, I'm sad that I'm sad, because I wanted pregnancy to be so blissful. Don't get me wrong, I love the weekly changes I notice taking place, and it's so completely surreal to be on this side of the exam table for once, but I'm grappling with a loss of expectations and I feel like it's something no one really talks about during pregnancy. For me, a lot of my anxiety and remorse centers around-- what else? Work. The axis around which it feels my life has revolved this past year. I miss the simple days of having one job. I had no idea how good I had it!

[The meat of this post may be a bit of a pity party. Please proceed with caution. And allow me to say that I know things could be SO SO much worse. This is simply a reality that I'm having a hard time with right now.]

My first 5 years as a nurse, I hoarded my PTO for an ever-elusive maternity leave. This time last year, dissatisfaction and a lingering feeling of restlessness drove me to leave my full-time day shift position for a Monday-Friday job in a high-risk OB clinic. By June, I was finally ready to admit that the clinic was a terrible fit for me. Of course, by then my day shift position was long-since filled and the NICU census was down, meaning they weren't hiring at all. So I left the clinic without a backup plan.

I searched for 2+ months, managed to find two jobs to cobble together an income, and got pregnant. On the one hand, I'm so grateful. Unemployment was much rougher than I had anticipated, and I'm very thankful that it only lasted two months. I do enjoy my current jobs and the variety that they provide, but it's hard to juggle two very different schedules. And so I still find myself where I started this whole mess: with a lingering sense of dissatisfaction. Without all the side perks of a job with benefits. It's a harsh reminder that the problem really lies within, not without, right? It's been an expensive lesson to learn.

When this baby comes, I'm looking at 8-12 weeks without a paycheck. No PTO to receive base pay for a month or two, no FMLA to receive partial pay for a few weeks after that, no free delivery at the hospital I worked at... It's entitled and bratty, I know. But truly, it's just not the picture-perfect scenario I imagined and planned on having in place for our first child. (Six years of neonatology and perinatology experience reminds me that there are an infinite number of things worse than no PTO for maternity leave. I do know that. But again, this is simply what I'm struggling with at the moment.)

I'm SO VERY GRATEFUL to have a baby on the way, and I'm so completely lucky that Ross has a stable job with benefits. We're blessed in many, many ways and we know we're able to live on one income if we have to... we've been doing that for roughly half of our marriage in one capacity or another. But to be honest? It's a really hard pill for me to swallow that I'm barely contributing now, and I'm going to be contributing even less in another 20 weeks. I'm used to being the provider. I'm used to having the backup plan and the job security and the good insurance. It's really humbling to know that I'm working my butt off on nights and weekends and home visits and I bring in less money than ever. Tax season has been a lovely reminder of that. It's really true when they say, "don't it always seem to go that you don't know what you've got 'til it's gone?" All those hours of unused vacation, all that planning... gone.

I know it's selfish, but this has been surprisingly hard for me to deal with. A large part of my emotional response to all of this is probably due to this time of the year, which is always rough for me. Pregnancy hormones and massive life changes on the way are definitely not helping. Then getting all 4 of my W-2s in the mail this month was a slap in the face. 2013 was an expensive lesson in what does and doesn't truly satisfy, and my tendency toward remorse and regret and anxiety has never been stronger.

You know what? A job will never satisfy or fulfill me. How many times have I said that and then turned back toward the work and tried to make it a tidier picture of what I want it to look like?

On a good day, I can still see that nothing is an accident. God has so precisely ordained every one of these circumstances. Even if my decisions were selfish or downright sinful, he is using them to show me more of His goodness and provision. But some days? I miss my old job so much I can practically taste it. I get bitter when I hear old co-workers complaining about the very job I was complaining about 12 short months ago-- they don't realize how lucky they are. Day shift! Insurance! PTO! I'm realizing I have a bit of a self-pity complex, and my problems always have to be bigger than everyone else's. That's not right and it's something big that I need to work though. (Then again I also tend to make reckless decisions that cause bigger problems with ever-rippling repurcussions! I need to work on that too.)

I don't know. This is all ugly, but I feel like I need to get it off my chest. Get it onto this page and turn to a new one. I desperately need God to break into my dark heart today and get past my stubbornness to once again remind me of his grace and truth. My mom and several sweet friends have been reminding me of this, but it's hard to hear through the tears. Some days, I feel like my bad decisions are bigger than God's provision and God's love, and that's just not true.

This sermon has been sitting with me all week and it couldn't have been timed better. (It really got pertinent for me starting at 20 minutes in, if you want to listen to it-- which you should!) There are so many truths in it that I needed to hear: Sometimes Jesus' delayed response isn't a contradiction of, but rather an expression of his love. I can't measure God's love by the absence of frustration and pain in my life. These are truths that I know deep down, but my pride has gotten in the way of my belief lately. I need these to wash over me again and sink in even deeper. Because a paycheck will NEVER be enough. The dream job will NEVER satisfy. And paid 'maternity leave'? Well... that's still a sore subject for now.

Monday, May 13, 2013

Hope Does Not Disappoint


Oh hey. What's that? Sunshine? Thank God.


So jeez. It's May. In with a few snowstorms, out with 90 degree weather, that's what I always say.


Oh man, I need a vacation.


Life. It's happening.


I have all these things I have wanted to blog about, but haven't. Why not? Exhibit A: my ridiculous schedule. (I keep thinking I can do everything. And I. Just. Can't.) Exhibit B: this. (Read it).

Depression is a sneaky little devil. I found myself blindsided with hopelessness this spring. Genuinely doubting that God was/is good. Truly believing that life was/is nothing but a struggle. Fearing God. And then slipping into a weird zone of self-preservation that hurt me more in the end. Like the aforementioned blog post says:

At first, though, the invulnerability that accompanied the detachment was exhilarating. At least as exhilarating as something can be without involving real emotions.

The beginning of my depression had been nothing but feelings, so the emotional deadening that followed was a welcome relief.  I had always wanted to not give a f*ck about anything. I viewed feelings as a weakness — annoying obstacles on my quest for total power over myself. And I finally didn't have to feel them anymore.

But my experiences slowly flattened and blended together until it became obvious that there's a huge difference between not giving a f*ck and not being able to give a f*ck. Cognitively, you might know that different things are happening to you, but they don't feel very different. 

Well, yes. I couldn't have said it better myself. So I found myself trying to climb out of this deep dark hole, and I couldn't. I just simply couldn't. I couldn't muster up the desire, the willpower, the energy, the optimism... nada. I'm slowly starting to see daylight, but I've needed an emergency airlift to get there.

See, while I think this author has eloquently yet humorously described depression to a t, I do respectfully disagree with her on one major point. She says, "And that's the most frustrating thing about depression. It isn't always something you can fight back against with hope." I would beg to differ. Indeed, hope is the only thing that can combat depression.

I mean yes, by all means, eat more vegetables. Start exercising: endorphins really do make you happier. Rekindle a beloved hobby or creative outlet. Yet one day, in the throes of it all, you may realize not even those things help. And in that terrible moment of realization, you also realize it doesn't hurt anymore. Nothing makes you happy, but nothing makes you want to cry your eyes out anymore, either. You're apathetic. Detached. Distancing yourself and putting up walls has removed you so far from the pain that you feel nothing. It's safer that way. Also, even more depressing.

{source}

If you get to that point, see a doctor who can evaluate your need for medication. But even then, medications can be a big band-aid if you don't address the root of the problem. (Please know I'm not bashing antidepressants. Been on them. Loved them. Currently loving life without them.)

Ummm my point is... hope. Hope placed in Jesus never disappoints. (I know, I know, you saw that coming. But hear me out.) Everything else will fail you. Has failed me. Everything else disappoints. Jesus it the only one who can keep every promise. The only one who can dry every tear from every eye. The only one who can give us the grace in which we stand and remind us of the hope of the glory of God.

Since Jesus suffered separation from God-- a true agony I never have to know since he bore it for me-- he can rightly encourage us to glory in our sufferings, because suffering produces perseverance; perseverance character; and character, hope. And hope does not put us to shame. (Romans 5:5). I don't have to hate or fear God every time I suffer, because God is actually good.

The Lord your God is with you, 
the Mighty Warrior who saves. 
He will take great delight in you; 
in his love he will no longer rebuke you, 
but will rejoice over you with singing.
(Zephaniah 3:17)

I'm not sure how to say that without sounding like a naive goody-two shoes. I just know in my heart of hearts that it's true. And if you've ever been paralyzed at the bottom looking up, maybe you feel it too. You need something bigger than yourself.

I don't have much to say besides that.  

Hope does not disappoint.

I'm re-learning who God is the good old fashioned-way: by reading my Bible.

And, you know, I guess I'm back to over-sharing on the world wide web :o)