Friday, August 8, 2008

Don't Rock the Boat

The first six weeks of my medication came and went. There was improvement, but I was still fighting desperately to get anything done so my dosage was increased. That made a world of difference. After being on the medication for about 5 months I was feeling wonderful. Thoughts of weaning myself became more and more tempting, but with an upcoming move I new that might be risky.

As I mentioned in my Learning Limits post, it is all about balance. For me, and I believe others with most mental illnesses, the balance is SO precarious. I think I feel like I'm always in a high stress situation (even when I'm feeling wonderfully) and then if something happens that would be considered stressful to someone feeling emotionally healthy, it TOTALLY knocks me off balance...moving is ALWAYS stressful.

I was prepared for this (well as much as you can truly be prepared for anything) and I know my doctor was SO thankful I didn't try to wean myself. I think he was just happy he didn't have to try to convince me that it would be a dumb idea to come off right before a major life change.

So as I anticipated the move from Greenville, NC to Durham, NC (about 1 hour and 45 minutes away) was hard. The boat had been rocked, and I almost fell out. I also knew that my time in Durham would be limited to only 12 months...about the time it takes to truly feel comfortable and integrated into a new area (or at least it seems to be about that long for me).

Totally an aside, but year long internships should not be allowed. BLAH! It's just long enough to become attached, but not nearly enough time to feel at home...evil...they're just plain evil.

I came crashing into Durham. We had a wonderful ward* that quickly welcomed us, I preferred the location (lots more to do in Durham), but still I crashed. Again, even preparing for it, it never makes it easier. Sometimes I feel like a person can only handle so many ups and downs and so my body was starting to really feel the effects of this most recent change.

I tried my best to become active in my ward; I started a preschool with some other ladies in our ward, I attended weekly Music Makers classes, taught Daily Dose English classes , joined our ward's book group, and just plain tried to get involved as much as I could. That helped, at least for the most part, but I also realized I was pushing too hard.

Weight has ALWAYS been my fight. Between children I've been on and off the LA Weight Loss Program with varying levels of success and in retrospect I realize, largely based on my emotional state. So by the time Braeden was a year old, I was getting frustrated that despite my best efforts, the weight was hanging on. Thankfully by this time I just finished nursing and so my medication choices were now wide open and I changed from Zoloft (one of the 2 antidepressants recommended for pregnant and nursing mothers) to Lexapro.

Both Zoloft and Lexapro are SSRI (Selective serotonin reuptake inhibitors). This is a specific type of anti-depressant. Usually most people make the transition from one SSRI to another relatively smoothly. Obviously you wean off one as you're slowly starting and then increasing the other, but that didn't seem to work for me.

The boat had been rocked again, but this time I was already nearly overboard before it was rocked and so in I fell. Like in the beginning, I was very low. Thankfully, not as low as I had been, but low none the less.

For the first time during the entire ordeal I contemplated suicide.

An aside, something that I have been SO grateful for during my entire fight, is that I have never felt the urge to hurt my children. You hear about women with post-partum depression killing their children and the thought of that terrified me. On many occasions I have found myself on my knees thanking the Lord that, although this has been a tremendous process, I have never wanted to hurt my children. Quite the contrary, they have been one of my greatest motivating factors.

Thankfully it was not a compulsion or nagging thought, but it scared me SO bad. I wasn't sure I could handle having to fight that. I think what was most scary about it was how reasonable and normal the thought seemed. It didn't come to me in a moment of utter despair, but during a normal everyday moment. For the normal person those ideas would seem weird and unimaginable, but it seemed as normal as my realizing it was night time and I needed to brush my teeth. I immediately set up an appointment with my doctor.

Again, this was a medication switch and not the beginning. I just didn't anticipate the drop. In talking to my doctor they assessed the level I was at (at the time of the appointment, I wasn't feeling suicidal anymore...thankfully!) and informed me that there really wasn't much that could be done until I had been on the medication for at least 6 weeks (I was at about week 2).

Another problem had surfaced with the Lexapro. Even with the excellent insurance Ryan received through is internship, I was still paying $50/month.

It would have been worth it if Lexapro had been wonderful and if I didn't know we'd be making a job and therefore an insurance change in the near future. So I opted to make another change and then changed my medication to generic Celexa (Citalopram) another SSRI that is derived from the same isotope as Lexapro (I think that's the right way of describing it, in layman's terms, they are based one the same thing).

Thankfully, I was prepared for another dip and so the boat only shook during this transition.

I leveled off on the citalopram and things were at least better in the weight loss department, but I still had to reevaluate my abilities and priorities and decide what was too much, and what I just couldn't afford not to do. I survived, but largely with the prospect of Ryan completing school and actually starting a real job...a big mistake!

I think to a certain extent we all cling to and look forward to a future event. For many of us that is what gets us through each week. If I can just make it to the weekend. or Christmas is just around the corner. or It will all be better once my child exits such-and-such phase.

There's nothing wrong with healthy anticipation, but my anticipation was NOT healthy.

I knew the move (especially cross country) would be hard, but I figured after that Ryan would just have so much more time, I would just feel so much better, and we'd finally be living the American Dream (i.e. real job, 2 cute kids, home owners, etc.). Obviously this wasn't the reality.

Again, my boat was rocked and I fell out. And in many ways I wasn't resurfacing. I'd flail my way to the surface only to grab a breath and be pulled under again.

I'd try to muster up the energy to unpack a box or play with my boys in the backyard that we finally had, but that was usually very short lived and often we spent our days inside with TV or GameCube.

The tiniest things would make me frustrated and down. I'd often be found crying. My days were limited to about 1/2 of my previous energy level. I would be completely tapped after feeding my family, exercising, and showering. On good days I'd weed the garden or go shopping, but still my energy level was far from normal. Here I was living the American Dream and I felt like I was in a nightmare.

Something had to change...

*Ward: Within the Church of Jesus Christ of Latter-day Saints (LDS Church), the congregations are broken up geographically. Instead of choosing to attend a specific service based on the preacher, members of the LDS Church attend a specific service (or ward) based on where we live.

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