This is the first time that I have actually told my story. I hope that it makes sense, but I think that just the act of writing it out may be very therapeutic to me. I will apologize now for the length of it....it's been a long ordeal.
I guess that a little background history is in order. I have a life-long history of depression, but I was never aware of it. It wasn't until a therapist pointed out the signs and symptoms of various points of my life, that these "black periods" were finally given a name. I was diagnosed with Dysthymia ( a chronic, low-grade depression) with episodes of clinical depression. This was a helluva bitter pill to swallow. Although I knew that a "hush-hush" family history of mental illness, paired with an extremely dysfunctional upbringing put me in a high risk group for depression, I had trouble seeing how I could possibly fit in this picture. Even though it stared me flat in the face, I still had that deeply rooted opinion that depression was only a form of extreme laziness and self-indulgence. If only these people could quit wallowing in self-pity, they could become normal ag ain. I can hardly believe how my feelings have changed today.
When my mid 30's hit, I decided that maybe I should get some 'semblance of order in my life. My husband and I had been having some growing pains within our marriage, and I was overwhelmed with the responsibilities of 2 young children. ( I did have PPD with my (then) youngest child...but I was the patient of an OB/GYN that handed out Zoloft like party favors. 3 months of 100mg, with ***NO*** supervision and I was considered "cured". ) These new emotions were branded as Dysthymic Disorder and Adjustment Disorder (with symptoms of depression and anxiety). Therapy wasn't an easy thing...I had many things to try come to terms with...but I didn't expect the hell just down the road.
Accidents happen, and in August of 2000, I found myself unexpectedly pregnant. Shock gave way to excitement...a chance to heal our marriage and ourselves. But this newfound joy was too-short lived. I lost my daughter to a late 1st trimester miscarriage. The experience of the loss, the surgery and the grief was intensely traumatic. Everywhere around me was the call..."Get pregnant again as soon as you can. It is the only way that you will heal." In my state of shock, I blindly agreed. But, what these idiots forgot to tell me was to allow yourself the chance to grieve first. I rushed headlong into a conception, confident that God would not forsake me again.
I found myself pregnant again within 3 months of my loss. But, amazingly, I didn't feel the joy that I felt before. The entire first trimester was spent in the bathroom, carefully checking toilet paper for smears of blood. I kept telling myself that once I got out of the first trimester...once I felt the baby move...I would regain that joy...that "glow". I kept giving myself pep-talks that my lack of enthusiasm was merely a symptom of fear; the fear of losing another baby. Surely a level 3 sonogram would allow me to see (and bond) with the "daughter" that I felt certain that I carried.
I will never forget that afternoon of my sonogram. With a painful bladder and bursting mind, I scoured the screen. The heart was beating. The spine lined up in form. Everything looked no short of perfect. Then the Dr said "It looks great...and you are carrying a healthy baby...boy." While I am sure that I am not the first woman to cry over news like that, I did my best to hold my composure. I explained that my few tears were the result of losing my daughter just months before. To this day...I don't know how I got out of that office. Once in my vehicle, I let the tears flow. I called my husband and choked out "It's healthy...and it's a boy." What strikes me now is my reaction on the drive home. I was crying so hard that I could barely see the road, and the only thought that occurred to me is "Why coul dn't I be killed in a car accident right now?"
In the weeks after, the small flicker of depression roared into a firebomb. I hated eating, or I would eat too much of the wrong stuff. Sleep dwindled down to 2 or 3 hours a night. I couldn't even concentrate enough to read the paper. By the time that I read the first sentence, I had forgotten the first. And when the baby kicked, I could barely acknowledge it. There were days that I could barely bring myself to touch my stomach (even though I was still a fanatic about examining myself for any signs of a potential loss). But, I hid all of this from those around me. I gave no sign of my mental turmoil. My therapist begged me to tell my OB about my deepening depression, and I finally relented. He was shocked to hear that I was depressed, since I seemed so calm and friendly on all my visits, but he agreed that a small dose of antidep ressants (Zoloft) would not do me or baby any harm.
On April 18, I took a dive down to the deepest depths. This would have been my daughter's due date. I know that this date would be a difficult one to go through, and I depended on my husband as my sole support. But even though I had warned him in advance of the difficulty that I may have on this date, I did not expect his reaction in his grief...of avoiding me so he would not have to deal with his emotions. When he finally came home, late that evening, he found me hysterical. Maybe it was because of my anguish that I was able to confess about the emotional turn that I had been having. Some nights I would wake up and have the unbearable urge to go into the kitchen and carve up my arms with one of our knives. The idea of allowing physical pain to take over some of the emotional pain was greatly appealing. My husband was shocked, as he had no idea just how deep my dep ression was...in fact, this was the first time that I had opened up and confessed to just how bad I was feeling. My husband and my therapist agreed that I needed more help than what I was currently getting. I was sent to a psychiatrist who specialized in women's mental disorders. Over the course of the next few months, my blood flowed with high levels of Zoloft, Wellbutrin, Trazadone and Restoril. When I expressed concern about exposing my unborn child to this prenatal cocktail, she sternly warned me that the risk of me being off of them was greater than the risk of me taking them...I more than likely would not be able to care for myself in a proper manner. That said...I was assured that I was well within safe borders, using the safest medications.
And, through this, my pregnancy progressed. I was resigned to the fact that I would be the mother of 3 boys and I would never have a daughter. I started to look forward to the thought of holding my child. But, oddly, I was strangely disconnected from my pregnancy. It didn't feel like it was my body that was carrying this baby...like I was watching another woman carry my child. I kept telling myself that once they put my crying son in my arms, I would relax and bond with him. My psychiatrist had lengthy meetings with me and my husband. She went over the signs and symptoms of PPD for him to look for. I was fairly certain that while my depression had evened out, I would nose-dive again, once the baby was born. I remember my husband asking if I was setting myself up for it: that I would make myself depressed if I expected that I would be depress ed. But, he was informed that it was no way possible to "think" yourself into depression. My chances were high and we had to be prepared. Then Danny was born.
Remember how I said that I wouldn't relax until someone handed me a crying infant? You got it. Danny didn't cry. His quick birth did not allow all of the amniotic fluid to be squeezed out of his lungs. The nurses worked over him for a good 10 minutes. And, a few hours later, a decision was made to take him into NICU for observation. It was there that I experienced my first dose of intolerance to depression. Danny's nurse had taken it upon herself to diagnose him...and I was to blame. She decided that all of his problems (low body temp and rapid breathing) were due to my taking antidepressants during pregnancy. I heard her make some phone calls and announce in a stage whisper, how "concerned" they were over the "amount of medications that 'the mother' had taken during her pregnancy." Just so I would not miss the point, she would s pell my last name. I sat by Danny's isolette, in tears of horror, and no one offered me so much as a tissue. I returned to my room in emotional hysterics. It took 2 pediatricians, 2 neonatologists, my OB/GYN and my psychiatrist to assure me that Danny's problems were in no way due to my medications, but instead was due to his hasty entrance. My psychiatrist, sensing trouble, immediately upped my antidepressants and started me on estrogen therapy. I think she could see it coming.
Upon our arrival home, we found ourselves surrounded by people. My parents were down from Oregon, and staying with us to help out for a few days. But, nothing brings 'round the people like a new baby. At one time, I counted 14 people in all, in our small home. I was engorged, in pain and completely overwhelmed. I started to try to isolate myself. The depression was full-blown again.
People left, and my husband went back to work. In spite of that rush of company, we have NO support system within the community we live. Our nearest relation is my 85 year-old grandmother who lives 100 miles away. This meant that I was completely alone with a newborn, and a 2 and 3 year old. I didn't have the luxury to wallow in bed and shut out the world. My children had to be attended to...fed and cared for. But, it was like watching a stranger do it. A robot in a mommy suit. I couldn't allow Danny out of my sight, even for me to use the bathroom. So determined to be near him, I refused to even put him in his own room for months, choosing to have him sleep beside me, instead. I would see wispy, white objects float by, just out of my peripheral vision, but when I turned to look at these things, they were gone. I would have "visi ons" of disturbing violence, like the time that I stood at the bathroom mirror and "watched" myself plunge a pair of scissors deep into my eye. My husband came home many times to find me sitting at the kitchen table with a far-off stare, barely able to communicate with him. For my part, I knew that he had entered the house and was standing in front of me, but I found myself feeling like I was miles away, and not caring enough to "come back".
Throughout it all, I kept in contact with my psychiatrist. I went up on Zoloft, and down. I tried Prozac. Antispychotics were added, then taken away when I could not tolerate their horrible side effects. And, my body felt 'out-of-wack' as double doses of estrogen patches were stuck to my stomach.
My thoughts grew more and more distorted. Once, I found myself wondering what it would be like to stick my head into a bucket of wet cement. The thought came to me with such clarity that I could "feel" the coldness of the cement around my ears. Then the day came that I went into the baby's room to check on him (as I did every few minutes when he was out of my sight.) Danny whimpered in his sleep and my first thought was "He is dreaming of me...of how horrible I am and how much pain that I have caused him." When it was time to feed him his bottle, Danny looked at me with that intense look that infants can sometimes have, and I thought "That's it. Look at his expression. He is thinking about how much he hates me." It was at this time that my Doctor said "I think it's time that we look into hospitalization."
Hospitalization was the best, and the worst, thing that has happened to me. Since I was admitted upon a Saturday night, there was no attending physician to evaluate me. I had my possessions taken away from me, I had an in-depth interview with a nurse, who then patted me down for contraband, then I was placed in the psychiatric ICU (known as "the locked ward"). When I was lead to my room, I found that most of my belongings had been taken away from me. Most stunning to me was that they confiscated my small ring-bound binder that contained pictures of my children...in case I should fashion the metal rings into an instrument to hurt myself. I have always considered myself very "together", and even at this low-point I was still very connected to the world around me, so I was horrified and terrified to be locked in a ward with people with severe psychosis. Breakfast the next morning was served from an "airplane" cart, without benefit of plastic knives in order to cut our food. At that point, I even began to doubt my own sanity. What if I really was this crazy? What if I truly belonged with all of these poor souls with true psychosis? While in this ward, I was even in the midst of a forcible removal to "the quiet room" of a woman experiencing a psychotic break. While other patients ran to watch this woman subdued, sedated and removed, I curled into a ball and faced the wall; unable to view this horror.
Thankfully, a medical professional was available to evaluate me the next day, and concluded that I was in no danger of a suicide or psychotic break. Some of my belongings were returned as I was transferred to the other unit (known as the "open" unit) but not all I was not allowed any shoestrings, glass or hard objects. I was still being monitored for my own safety. But I was so grateful for a small amount of personal choice (not to mention the excitement over being allowed to have a plastic knife!) that I accepted all terms.
I found that hospitalization involved a lot of therapy...an almost continual amount. While I appreciated the support and acceptance that I found among those in my group, I found that the content of the sessions to be no different from those that I had in my books at home. There were some sessions that were incredibly helpful...and other sessions that I got nothing from at all. I became very emphatic to those with many forms of mental illness, but I did not feel my own condition improving.
My hospitalization confused the dynamics of those around me. My husband desperately wanted to be supportive, but he was very confused how to go about this. I think that deep down, he hoped that being hospitalized would "cure" me....that somehow the right words and / or medication would bring his wife back to the status quo of being "normal". In addition, he took on the role of my "protector"...telling me what he thought that I could and could not do. This brought about feelings of indignation and resentment. How could I be "cured" but still have the need for someone to tell me what to do? With the exception of switching one antipsychotic for another, I left the hospital pretty much in the same condition that I had been admitted.
It has been 5 months since I was hospitalized. I have switched Doctors and have tried a few new medications. I am now on Effexor, Neurontin and Trazedone. I still cruise through the depths of depression. I now truly believe that this illness is biochemical in nature. I have tried desperately to look for triggers, but I cannot identify any. I liken it to being chained to the bottom of a swimming pool...looking up at the sun through the distortion of the water....knowing that you are down at the bottom, but you simply cannot remember sinking down there in the first place. "Thoughts" still come to me, just not in the bone-chilling clarity of before. And, I have become familiar with the specter of guilt...guilt that I should be a better wife...a better mother...guilt that I should be able to handle it all with a smile on my face; the contentment of th e stereotypical suburban Mom. Intellectually, I know that this can't be the case. Nature and nurture selected me to have depression, and I will never be the "Stepford Wife" that I envision. In reality, I need to let go of this fantasy and accept that I need medical intervention for severe clinical depression. My husband is learning to watch for signs that I am overloading (in my case, shaking, uncontrollable rocking and a despondent attitude). I am learning to accept that it is OK for me to request time alone in order to regroup my emotions. I am also learning to set and enforce boundaries...and it is healthy to do so.
So yes, I am still battling depression...some days worse than others. I am accepting that this may be a long journey...in my case, the depression that I have may be a life-long battle. I am enduring talk of continued therapy...continued medications...even ECT (electro-conductive therapy aka "shock therapy"). Everything I do is in the name of hope. I hope that one day I can laugh spontaneously. I hope to feel and enjoy the shining sun without looking in the horizon for a chance of rain. And I hope to offer hope to other women that may be like me.
Well, that is my story. Somewhere between a Reader's Digest version and a novel! I hope that this provided some insight to what it is like to go through a pregnancy while depressed. The diagnosis is PPD is still up for debate, but the actual depression was (and is) very real.
Thanks for sticking with this tale for this long!
Kimberly, age 35
mother of Matthew, Nicholas and Daniel