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How I Knew

For the record, I was never a Tom Cruise enthusiast, but I never in my life thought taking antidepressants would be for me.

For starts, I never suffered from depression.  Sure, I had the teenage angst years where I boo hoo'd over the boyfriend who dumped me, and the "what do I really want to do with my life" mindfuck when my graduate department admitted they had erred when they let in too many students ahead of me and there was to be no financial or professional assistance in the form of grants or jobs in my future.  Sure, I wrote overly-emotive poetry and listened to Pink Floyd's "The Wall."  I had a solid six-hour cry 18 months into my trying-to-conceive misadventure which was odd enough that my husband came home from work early to sit with me.  But I always felt a solid foundation going through these moments -- a sense that there was more to me than that.  I watched a friend crumble after failing her pre-lims, and realized she had wrapped her entire life -- her entire identity -- into this potential profession.  It hit me (as I passed the kleenex) that I was rather lucky:  I liked  this profession enough, but I had other stuff too.  I liked to cook, I liked to run, I liked to travel.  I had super friends, a fabulous boyfriend (who became my husband) and I figured if I had my wits about me, I could probably make money somehow.  Oh, and someday, I wanted a family.

Furthermore, and this is rather embarrassing, but I was never into mind-altering substances.  I  thought smoking was gross, and never even had the experimental attempt -- of either flavor.  Wouldn't know what drugs to take or where to get them, and I was not remotely interested, anyway.  I didn't realize beer tasted good until I moved to the midwest for grad school, and didn't like wine until I could afford something that didn't come in a box or with a black and white generic "Wine" label on it.

Finally, I liked having ultimate control of my body.  From very early on my life, I was a violinist and a soccer player.  So at a young age I figured out that if I practiced something for literally months on end, suddenly one day my fingers would click and lo, I could play the fingered octaves at the start of the Winiawski Violin Concerto.  I liked that if I did wind sprints around my block (two driveways on, two driveways rest) that come game time, I could throw my internal gear shift and move around someone.   I liked the way I could make my body do things, and there was no interest (no way, really) in allowing something to alter my mind that would mess this up.  I liked the control, not the fuzz.  I had no interest in being numb.  

What I failed to perceive, probably because of my immaturity, was that on some level my brain actually wanted to do these things.  That I liked doing these things.  It just seemed too easy that if I set my mind to a marathon, I could eventually make my legs follow.  And I did.  It all worked perfectly.

****

My husband and I joked (in the macabre way that you do, what with the terminal child in your arms) with each other during Maddy's brief week that we were going to need therapy.  But I think it really hit us, a week later without her, that we did indeed need something.  So we dutifully marched in, sat on the couch, and ground our way through the first awful few weeks of having so much to say and not wanting to say a word.

But I still didn't think I needed antidepressants.  Sure, I was depressed all right, my baby died!  Who wouldn't be?  This is just grief.  Everyone probably wants to crawl in a cave and stay there for 20 years.  I wasn't suicidal, I wasn't in denial.  I wasn't showering or eating much out of the coffee food group, but I was getting out of bed.

And there was Bella.  Two and half, still in diapers.  Not in daycare, because, you know, I was going to be home with the baby anyway.  She was my job, my responsibility.  She was my safety net, my bullet proof vest, and I strongly believe the candle which kept me from wanting to stay in my cave for eternity.  And for a good month or so, I could limp from my bed to her room, change a diaper, find her clean clothes, and start a day.  Probably one spent indoors, or sequestered in the yard, close to the door.  If we were lucky, a weepy trip to the grocery store.  Never the playground.  Never a playdate.  We let her activities lapse.

And one afternoon, Friday, about four weeks after Maddy died, she decided not to nap.

This was a completely unremarkable occurrence for a child who had never really napped in her lifetime, no different than any other day circa 1 p.m. where my tone of voice edges on exasperation.  But she would not acquiesce to quiet time, she would not stay in her room, she would not sit still and have me read to her.  And I was exhausted.  Of it all.  Of the grief, the loss, the aching, the trying, the getting up, changing diapers, putting my feet on the floor every morning with the realization that this was my life -- not some nightmare.  I collapsed on my bed, and could not get up.  I could not open my eyes.  I could not deal with my life.  I lay there glued to my sheets, with a toddler ambling about my house, and I could not call anyone on the phone, sequester her in the room with me.  Immobile.  Tired.  Comatose.

What stunned me was not so much that I couldn't get up, but that my mind ceased to ask for it.  My brain -- instead of screaming at me to lift my eyelids already -- shut down and concluded that this semi-conscious state was acceptable, regardless of the toddler who could possibly tumble down the stairs, walk out the front door, or figure out the safety latch under the kitchen sink.  My husband was at work, but I couldn't lift the phone.  Two neighbors had offered to come at a moment's notice if I needed a "time out," but I somehow forgot.  I could no longer rely on my mental faculties to prod me in the right direction and encourage the rest of me to move.  The part of my mind that once compelled me to run 26 miles now couldn't force me to lift my head.  It was . . . . frightening. Sorry Tom, if your brain doesn't send the signal to take vitamins or go for a jog, you ain't gonna.

First thing Monday morning, with resignation, I called my doctor for antidepressants.

A few of my friends had tidy little metaphors for exactly how ADs made them feel:  a tufted cushion to stand on; a buoy to keep their head above water.  I'm not really sure what my reigning metaphor was, but I can tell you this:  it slowed my brain way the hell down.  I went from racing from one deadbaby thought to another to actually being able to catch my breath between sobs.  It allowed me to sleep without tossing for two hours.  It allowed me to drive without breaking down in a (hazardous) blinding torrent of tears and shudders. It also diverted my attention from sticking on one ugly thought for too long:  going through the life support removal replay?  Mind quietly segues to lunch.

It allowed me to function.  I dare say, it helped me grieve.  I had a job to do, and it helped me do my job.  Although my brain never went to the place of endangering myself or Bella with weapons or whatnot, by having my body do nothing, it was in fact endangering us both.  The antidepressant did not make me numb, it did not make me miss Maddy any less.  It by no means made me happy.  It made me get up, it made me move when I needed to, it helped me pay attention.

After a few months, it became readily apparent to me that I had lost my short-term memory --  most likely from the shock of Maddy's death, but possibly abetted by the ADs.  I also noticed when I went to play the ABC -game ("Your name?  Gah.  Lessee:  A, Alice, Allison, Angie, B, Barbara, Betty . . . ") that my mind would not stay on task and focus long enough to get through the C's.  I'm guessing the ADs saw this as anxious fretting and tried to shut my brain down and think about puppies or daisies or something, but it became increasingly frustrating to the point that it made me overwhelmingly anxious.  Heart-racing, short-of-breath anxious.  Given that I felt a bit better all around anyway, I quit taking them at six months.  I haven't felt like I needed them since.

It probably bears repeating that I didn't feel I needed them until a good 4-5 weeks after Maddy died.  If I were to search around in med journals, I bet I might find some reason for this.  I don't think it's unreasonable to think that our body produces hormones and adrenaline after childbirth in order to get us through the first grueling sleepless weeks of our babies' lives.  I know the act of breastfeeding produces oxytocin, and I'm willing to bet letting down does a bit too.  All this conspires to both give us an amount of energy and simultaneously relax and think, perhaps, that we can do this just fine, thanks.  The first month or so many of us are also gently supported by the onslaught of cards, flowers, donations, email, phone calls, meals, and friends and family.  They too dry up about 4-6 weeks later.  I've seen a number of women here on the 'net crash weeks to months after the event.  It's not unusual.  And don't think if you haven't sought help by that point that somehow it's embarrassing if you do now.  It's not sliding backward, it's just what's happening now.

ADs are not to be taken lightly, in either direction:  you may not need them, but grow to rely on them.  Conversely, you may need them, but fear or not understand them.  Either scenario is dangerous in my estimation.  I can't tell you exactly when and if you need them, or when or if you should go off.  In my mind, it was crystal clear:  the day not only my body, but my mind stopped responding was the day I felt I needed them.  The day my mind began to rebel against their function I got off.  To quote every big-pharm commercial:  see a doctor, but please see one, if you think you might need additional help, or need a different dosage or flavor with less side effects, or or if you're ready to leave them behind.

I never, ever thought I'd need ADs.  I had seen them work for others, so I wasn't opposed to them as a rule, but just didn't think I was the type.  I had a foundation!  I was more than this death!  I had a life to live!  I've run a marathon, for Pete's sake!  But all that meant nothing when I realized I -- my mind -- had neglected Bella for an afternoon.  And not cared.  And there was no way I was going to let it do that to either of us again.

Posted on Monday, June 9, 2008 by Registered Commentertash in , , | Comments14 Comments

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Reader Comments (14)

Great post, tash! An important one, too, because I think so many people feel like it's a failure to take ADs. I know they're not for everyone, but I have found them helpful.

I had been on and off anti-depressants since my mother died in 2001. Probably, I had needed them for most of my adult life, as I have a tendency towards depression and a family history of it.

Maybe a week after delivering the boys I started back at small doses and after another week or so began to feel slightly less, well, run over. I no longer lingered over the bottle full of ambien, thinking about wanting all the pain to go away. Back at almost my regular dose, I was getting side effects, so I knew it was time to see the doctor again. That was almost three months out.

My therapist talks about it like this: You are still going to feel bad. Horrible, in fact. But you don't have to feel every *single* bump in the road if it will help you function a little better. And it did. Even at the very lowest dose, which I'm still taking.

So far, I'm feeling more functional. And honestly, my highs are higher, but my lows are very, very low. But it takes less for me to recover from the lows. And I can talk about the lows. We shall see, I guess.

This AD is a category B, so if/when we try again, there will be re-evaluation. For now, it's helping.

(sorry this is so long.)

June 9, 2008 | Unregistered CommenterSTE

Great post Tash, I think people need to understand it's OK. Tom is an idiot...

Anyways, for me, I fought hard against the looks, the check ins, the "is she depressed" worry that my friends and family and hell, even my coworkers dished out. Somedays I felt like I would have made them all a lot more comfortable if I had said, OK OK, I will take the AD's.

Of course I was depressed, ffs, my baby died. I ended up not needing them. Some days are bad, some are good, this is the path we follow.

June 9, 2008 | Unregistered Commenterg

I didn't think I was the type to need them either. But when I came home from work one day and laid on my bedroom floor sobbing for 2 hours because the landscaper had cut the lawn the same day we fertilized it, I realized that something was very wrong. They have given me a lift. After 4 weeks now, I can feel it, my husband sees it, and I believe others have noticed it too. But I am not sold on staying on them for long. I am not sure what I am going to do, but mine are Category C and I can't take the risk if I decide to TTC again. There's too many other risks to think about.

June 9, 2008 | Unregistered CommenterCLC

Great post, Tash. Thanks for the honesty and the sharing.
At one point I feared I had depression, but it seemed I managed to shake it off, somehow... everyone's brain chemistry works differently. we need open experiences like this so people do not feel like a freak or weakling for needing them.

June 9, 2008 | Registered Commenterjanis

Great post.
Oddly, I managed to not need them in the aftermath. I think if I didn't have the blogs, or if I didn't work flexible hours, or if I couldn't, last summer, take a bunch of time off from work altogether, I might have ended up with them again. I say again because I was on a heady cocktail of stuff about a decade ago for a major depressive episode triggered by my grandfather's death. It runs in my family, and every female on my mother's side has had to use these at one point or another. So I wasn't opposed to them last year either, Yet, amazingly, I ended up not needing them. I give a huge portion of the credit for it to Dr.Blogs.
I am glad, though, that you knew both when you needed them, and when you no longer did.
And Tom is a moron.

June 9, 2008 | Registered Commenterjulia

i wanted them, to be honest...but my best friend (a social worker, visiting from out of town four weeks later) told me i was experiencing normal grief and didn't need them. it has occurred to me since that i might have, erm, asked around a little more, especially since my friend, however lovely she is, has never known anyone else who's lost an infant and has no real frame of reference for normal in that particular situation. but i felt so chastised by her assessment of me as "just grieving" that i was reluctant to expose myself to anybody else and so i didn't. i shut up and grieved. i still think the ADs would have been good for me, to be honest.

but then, i even like the wine that comes in boxes, cause i've never been very discriminating like that. :)

June 9, 2008 | Registered Commenterbon

I probably could have used them. I can go back in my posts and tell you exactly when. But, I never did go get them. Fear of being one of those AD people kept me from them. It's stupid. Just dumb pride. And, surely, it would have been even more dumb had I not been able to shake off the depression. Somehow, I managed to. Somehow.

I think this is a wonderful post, Tash. I think it's something that needs to be talked about. I am glad you started the dialogue.

June 9, 2008 | Unregistered Commenterc.

I kept saying, "Of course I'll ask for a pill, the moment I feel like I need it..." and even though I had those multi-hour crying sessions and was unable to move from the couch, I resisted by always discounting how I felt to "normal" given the loss of a child (as if that somehow meant I didn't need ADs).

I wasn't quite in my right mind to figure it all out. And for a while I was a grief sadist, because this kept me connected to Liam, I thought, not all-too logically. And now I wonder if that ship has sailed.. but then, maybe not. I don't know.

Great, great post, tash.

June 9, 2008 | Unregistered Commenterkate

I'm glad you wrote about this too. I never took ADs, but my dr gave me some Ativan for the anxiety attacks I started having after our last planned IUI failed. I felt like it was a crutch, & I should be able to do this myself... but I was glad to have it for a while there. I actually wound up using very little of the bottle, but just carrying it in my purse & knowing it was there, just in case, like a security blanket, made me feel a whole lot better.

June 9, 2008 | Unregistered Commenterloribeth

I think practically everyone I know IRL takes ADs. Which says a lot about the circles I run in. Both literally and figuratively.

June 9, 2008 | Registered Commenterniobe

What an important post. Thank you for writing about this, and what happens "later." I'm glad you got the help you needed. I'm glad it helped you function. The pills are out there for a reason.

June 10, 2008 | Unregistered CommenterWhyMommy

Sometimes the best strength is knowing when you need a little help. Sounds like you've got that down pat.

June 10, 2008 | Unregistered Commenterthordora

I've been on AD since I was a teenager, and will probably (barring medical miracles) be on them the rest of my life. Just a quirky intersection of genetics and life experience (lucky me LOL!). I took them through both of my pregnancies (better to take a calculated risk than be completely non-functional). After my son died, my psychiatrist immediately raised my dosage significantly without even asking - he knows me well, knew that I would need extra help, and knew that I would have a hell of a time asking for it myself. And yes, they gave me just enough of a boost that I could cope - bathe, eat, move through and get through the day.

What was really interesting to me is that I knew when I needed to back down on the dosage...at a certain point the drugs started to interfere with my grieving. About 6 months after Griffin's death, I found that I couldn't *feel* the grief enough to work with it. The increased dosage went from helping to just numbing, and I knew that I was ready to start feeling the deeper parts. So for me, at least, I knew as clearly when I needed to back down as when I needed them increased originally.

June 10, 2008 | Unregistered CommenterDevani

this is a great post, tash, and very important, as others have said. I like especially how you trusted your own body to tell you when. and how you point out that what happens weeks later, after the attention stops, is normal rather than going backwards. it may even be progress...

your writing has always helped show how very difficult it is to go on parenting a living child through your own grief. this post elucidates that so clearly. thanks for sharing.


June 13, 2008 | Unregistered Commenterluna

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