Saturday 18 October 2014

A less than easy topic~ Depression.


There are times in every persons life when things are stressful, complicated and far from fun.

Sometimes there is a reason for it, Other times it's happening in our brain chemistry; But when it becomes a way of life and not just the odd "down day" it's a problem. I am of course, talking about clinical depression.

First off I want to say the very worst thing a person can tell a depressed person is to "cheer up" or "there are so many things to be thankful for!" etc etc etc. If someone tells a depressed person to cheer up or "just don't be that way" I hope they throw a few well aimed punches and maybe a brick. And I hope they hurt.

True depression is an inability to produce serotonin and the depressed person has about as much control over this as a diabetic has over producing insulin. Depression is caused through many things. Trauma, isolation, hormonal just to name a few.

If you are depressed, I understand, I am sorry and I can't promise you an easy road to recovery. In fact I'm most certain that even years later I am still on the road myself. But I can promise you what you need. I promise to just love you anyway.

Now I am going to talk about my depression. Specifically about me. This has been a long time coming but the stigma needs to be removed and the only way to do that is to show people exactly how common it is and to remove ignorance surrounding what to do with a depressed person- people just plain don't know how to help! So they do things that make it worse and use cliche's that are maddeningly unhelpful.

I've had a struggle with depression on an almost grand scale since I can remember. I was a victim of sexual abuse as a child. There was an extra friendly neighbor. That is all I want to say on it. But that can probably be the beginning of the time line. I also went through school with chronic, merciless bullying. I couldn't help being so awkward. I had no confidence and the other kids could just smell the fear. Eventually I was home-schooled.

But it was manageable, things didn't become really unbearably bad until I gave birth to my first child. So this post includes a birth story!
*trigger warning, baby didn't die or anything totally awful but it isn't a terribly happy one so brace yourself or stop reading*

I labored at home really well and in the car I continued to progress, but as soon as we reached the hospital my fear of hospitals hit me like a ton of bricks and I shut down labor almost to a complete stand still; contractions where right on top of each other but I didn't progress from 4cm. I declined the c-section repeatedly making a deal with the staff that if his heart rate went bad they could cut me but not a second sooner. Sixty-four hours after being admitted I began to progress again and I was moved back into a "birthing suite. But the midwives crowded me, the lights where bright and I was asked by the on duty obstetrician if he could examine me. As soon as he did he declared me 8cm and then despite this progress and my birth plan saying I didn't want one he did a big stretch and sweep in the middle of an intense contraction without first asking if he could. He tore my cervix, then as I was telling him not to he broke my waters and then left me for the midwives to deal with. I got off the bed and tried to give myself some privacy but was never left alone for even a second. Feeling surgically raped and utterly defeated I dropped to my knees on the cold hard linoleum and didn't move, I couldn't take anymore. I was eventually moved to a bed for another examination and stayed there on my hands and knees.

After a few hours like this I felt our baby crown, it felt like I was being ripped in two, but I couldn't make a sound. As soon as his shoulders had been delivered the midwife attending me PULLED the rest of him out and cut and clamped the cord and handed the baby to my mother who was a bit confused at this. The midwife then yanked the severed umbilical cord to "see if the placenta had detached" it hadn't and this was the most painful thing that had happened yet; I begged for the needle I had just declined and the after birth came out very quickly along with about 300ml of blood.

As soon as it was delivered I was thrown into the shower while waiting family members cuddled our baby. I still had not even really seen him. I felt weird; kind of like I'd lost a leg and I sat sullenly in the hot water as the apprentice midwife showered me. (They put me in the shower so I wouldn't bleed everywhere) over an hour later they helped me dress, put me in a chair and the family members who had seen my baby before me put him in my arms and said "here's Edward" We had not decided on his name, but it was already filled in on the forms, someone else had bathed/cleaned him up and though I was now holding him he didn't feel like he belonged to Peter and I, he felt like a substitute. An impostor. I was numb to him and his cries and all the people congratulating us on a supposedly easy and very clean delivery- I didn't have so much as a scratch even though he was quite a bit bigger than the  average newborn.

On the same day of Edwards birth I got started on e.c. and I got to breastfeeding him really well, no one had to show me how to do these things and everyone who saw me took it as a sign I was doing great. People visited and no one had a clue what was going on in my head, except my friend Melinda who visited the day after and noticed I was acting like "just another day, oh and there's that thing in the clear plastic box feel free to hold it" which is pretty accurate really.

I had been so walked all over that I didn't even make the effort to say no to anyone who wanted to hold the fussy little creature in the "box" I sat and breastfed, I cared for his needs and I waited to feel something. We took Edward home on his third day of life and I continued to wait and pretend that I loved him, I was a good actress, no one noticed anything other than Melinda who said nothing until I shared my feelings with her. I simply waited, desperate to actually feel something, ANYTHING.

I should note that the depression I had felt when I was a teenager had been nothing BUT feelings. It was a relief to have finally shut down. Such a relief I didn't recognize it for what it was for a long time.

But not being overwhelmingly happy about my baby did bother me. I knew it could take a while so I gave myself six weeks as I had read somewhere that it takes about that long to get used to things. When he was six weeks old and nothing had changed I gave myself another six weeks. Then I got guilty and angry at myself. Or as angry as a person can be who isn't feeling much. I tried not to be depressed, but the effort of pretending was exhausting and I became worse.

Almost four months Later I still didn't even like Edward let alone love him. I knew I needed help. I was really concerned and guilt ridden as I called our community mid-wife Roxanne I was half choking, calling her for help was the hardest thing I think I had done at the time. I told her "I need help, I don't love my baby." she came over immediately, put her arms around me while I stood numb, cold and unfeeling. Some people say "I wish I was able to not care" and I was one of those people in my teens, but what I had realized in this moment was that there is a huge difference between "not caring" and "not being ABLE to care"

We worked closely for a long time and continue to do so today. She didn't do anything specific, she just listened, invited me for cups of tea, asked before she touched my baby, gave me space when I needed it and respected my wishes, boundaries and gave ideas for coping with people who usually walked all over me. She gave me the courage to tell them where to go or back off too, since after his birth I'd had so many people wanting to help- really, their intentions were good but I was already so traumatized by what had happened that constantly trying to remove my baby from me when I was so desperately trying to form an attachment was the worst thing they could have done because we, my baby and I gave up trying to bond at all!

This had lead to Edward developing a bit of attachment disorder, he was happy enough mostly but would go through stretches were he would cry, be irritable and would turn his head away from me- a stress reaction, whenever I held him, because he was reading that I wasn't exactly sympathetic to him, we were still breastfeeding (and continued beyond 2 years) but never once did I experience that supposedly ecstatic joy of a baby having some milk and then smiling up at me with a big cheeky, milky grin. Nope he was all business. Feed me then put me down lady!

He was way beyond "just a independent spirit. This wasn't normal. In his earliest days I couldn't rock him to sleep- he'd scream and turn purple, I couldn't hold him in my arms- he wanted the sling between us.

From 5 days old he slept all night in his bassinet with a pacifier. He was an EC champ. but there wasn't much of a relationship. I did my very best to meet all his needs, to smile at him and talk to him, I wore him and played with him as much as I could. perhaps it was because he was still so young that I didn't feel as though he liked me. I hope so, because that means I didn't screw him up. Only myself. Slowly, with help this began to change. He still slept on his own- his preference, and put all of his pees and poops in the potty but he started to seek interaction with me.

At six months old I looked at Edward and felt a tiny bit of happiness and while it wasn't love it was a step in that direction. By 10 months old I really did love him but not the way I thought I would, it was more like an adopted child than my own flesh and blood. (NOT to diminish adoption at all, just relating that it was more like getting an older baby and having to get to know them and the baby and myself both having separate baggage, it was wonderful to finally "meet" him) by this stage he had a total fixation on my hair and letting him hold it was a great way for him to find comfort in me.

Then not very long after I'd managed to form a relationship with Eddie, I found out that I was pregnant again.

I was terrified! I couldn't bear the idea of another hospital birth, the idea of not bonding with my baby or even liking them. I couldn't stand for this! I WOULDN'T! I decided to be pro-active about it.

Thanks to the help of  Rox and many a discussion we came up with some plans for Nicholas' birth. First of all, I was not going to be in the "luck of the draw" system getting whomever was on shift to deliver my baby. I was delivering with Roxanne. No matter where and no matter when. She did all my prenatal care except for the obligatory 2 visits with the OB. My "birth plan" was not the detailed one that had been completely ignored with Edwards birth. In fact it was VERY simple.

         Keep the OB away from me unless I need a cesarean section
         NO TALKING around me- I need quiet.
         NO TOUCHING ME without first asking specifically and then ONLY do what you have asked for nothing more.
         NO TOUCHING MY BABY at all. He is mine.
         VISITORS to wait at least 2 hours before they can see us.
         Baby not to leave mother once born

I had wanted to have my baby at home but there were constrictions with this and Peter was not overly thrilled with that idea and so eventually I conceded and agreed to a hospital birth on the condition that I had at least two hours alone with my new baby. NO VISITORS. And most importantly, no touching me. I felt I could do this because Rox knew me and the situation, she would be my advocate where as before I had none.

But I got my non-hospital birth wish anyway! because Nicholas was born in the car park. We never made it. And I am so happy we didn't. As soon as he was born I held him, he breastfed immediately. He never left my arms until I was settled into my bed by Rox and I was so exhausted she wrapped him up and placed him in the baby bed so I could sleep. When we woke up I fed him again and was able to concentrate on getting to know him. Relatives did come by, but no one else. It wasn't until the day after that I started accepting visitors. On day three I did begin to feel down. BUT because we were already aware of what could happen to me and so communication on how I was feeling was important. I did NOT develop depression. Though I felt a little guilty about Edward still but I reminded myself that I hadn't allowed it to happen again and Edward and I had bonded well though it had taken much longer.

I was SO relieved that I adored my newborn. And my relationship with Edward was helped too because I was happy, he could be too.

I have tried anti-depressants but they make me too sleepy and some actually made it worse so I try instead to manage my environment and avoid triggers being dropped on me by surprise.. and my nutrition is of utmost importance, If I eat well then I feel better. But the most important thing I have ever found for helping manage depression is ACTIONS and being able to be in CONTROL of myself and my experiences; it takes a mammoth effort to do so.

Part of the soloution (a major part of the solution) was taking the time to figure out my triggers so we could avoid them. Besides the fact that what had happened to me as a child was horrible, what my extra friendly neighbor also had done was control me; Then when I was in the incredibly vulnerable state of giving birth the pattern had repeated by my wishes being ignored and the OB controlling what happened then leaving me in excruciating pain after he was "done" with me for others to pick up the pieces. (a trigger we could avoid!)

For someone who needs to be in control of the situation labor really isn't a good situation to be in because everything is involuntary. You cannot control labor.

But, recognizing this I regained control by deciding to and committing to doing whatever my body wanted to do. I actually anticipated each and every contraction, chased them, felt them and got ready for the next wave. I didn't try to slow it down rather I beat it. Raced ahead and in the moments I felt out of control I spoke to myself "I am a leaf caught in a river current. I cannot control where the river takes me, the river is too powerful. But I don't HAVE to control it. It is okay to just go with it. I want this to get heavy, heavy means it's happening. It's almost over."

I couldn't control labor but I could control my mind. So that is what I did. And in controlling my mind and the way I viewed what was happening. I was able to relax even though I was in the car hurtling towards the hospital in a less than comfortable position, strapped into the passenger seat.

Labor was not painful, overwhelming at times. But painless. And I only had to get out of the car to have Nicholas birth himself. I felt his feet push at the top of my belly and then he was here.

The actions I took was to ensure I was not a victim and continuity of care was the key to this. My being in control of the situation was paramount. But I also used a one to one Midwife service that meant that I had a strong relationship with my care provider. I cannot recommend having a primary care provider enough. We were on a first name basis and had discussed in great detail all the options available and MY wishes no matter what they were, were respected and adhered to. I felt emotionally secure. I was kept physically secure. Roxanne took care of almost everything, was there at any time I needed her and while we were also close friends when she was being my midwife- she was very professional.
And I felt empowered.

If you are struggling with depression please find help. Find someone who will listen and not judge and who will take the time to find your own unique triggers so you can reflect on them, own them and take back control of whatever they are. Find the patterns and change them. They may be the only thing you can control and the road is long and often hard, but it's yours and you can do it. You're the only one who can.