Month: June 2020

Brought to you by the letter D

/ lovescienceandnat20s / Leave a comment

Hello.

It’s been a Time, let me tell you. Two weeks since I last wrote, and everything is happening so much.

Drugs. I’m not talking the ones that you were warned against in the fifth grade (aside: when we had D.A.R.E., it was before there were any mascots or anything, and all we had was this… “music video,” if you can even call it that, of what we were supposed to believe were police officers singing, “Dare! For keeping kids off drugs!” and then this guy in the background would radically wail, “KIIIIIDS OFFFFF DRUUUUUGS,” and I will tell you that I do not remember anything about the program besides that specific snippet), but the ones that you get prescribed from your doctor. 

When I went to my OB-GYN for my crisis of intrusive thoughts, he had me talk with a behavioral health specialist (which is the new name for a shrink), and said specialist both prescribed me counselling and called my primary care doctor to request an increase in my dosage of my current antidepressant, Effexor. I had been taking 75 mg (the lowest possible therapeutic dosage), so now I’m up to 112.5 mg, which means two little capsules every day instead of one. About a week after that, I had a psychiatric medication review with a nurse whose job is doing only that ever to see if I should continue with the Effexor or if I should switch to a different antidepressant and/or take something else as well. This was a lot like my therapy intake appointment, where you just go through alllll of your issues, realize how long they’ve been issues, and feel like somebody’s just peeled your emotional skin off for a minute. 

Like. Normal therapy gets into these issues, but it’s a slower and more gradual process. Intake appointments get to the heart of things all at once. No slow, gentle “so what was it like during that one specific afternoon when you were eleven and those five boys in your class called you ‘ugly’ while you waited for the school bus?” but more of an “OKAY SO YOU’VE EXPERIENCED INTRUSIVE THOUGHTS SINCE YOU WERE ELEVEN AND HAVE HAD SUICIDAL THOUGHTS SINCE YOU WERE A TEENAGER, SOUNDS LIKE CHRONIC SUICIDAL IDEATION, NEXT TOPIC.” 

Anyway, the nurse (who was excellent; very to-the-point, and also very practical) ended up prescribing me a sleep aid called Trazodone to theoretically cut down on my bedtime insomnia from 2ish hours to 0ish hours, and I’ve been on that for about a week. I want to say that it’s working (especially in conjunction with Kyle and my decision to start taking melatonin at bedtime every night in very tasty cherry gummy form), but I honestly don’t know. I’m forcing myself to be more well-rested, by which I mean that I’m refusing to take afternoon naps even when circumstances would allow me to (read: no appointments for anyone, either virtual or physical), but I can’t tell if anything is working well because Sam’s in an anxious streak and has woken us up one way or another basically every night for a couple of weeks now. 

(more on that in a minute)

So that’ll be fun to talk to my therapist about. Meanwhile, I’ve also had an appointment with an endocrinologist (not a reproductive endocrinologist, because while I’m 100% for snagging one more girl out of our freezies, we need to pay the $3500 to have them tested and have Kyle actually employed before we strike on down that path) to try and start getting my PCOS better under control. Last October, I spent a day in the ER with agonizing pain in my lower left abdomen, which the ER diagnosed as constipation (even though, and this is TMI, I was and am regular for basically the first time in my entire life) but which my OB-GYN figured was probably related to my PCOS. We went down a path there of trying progesterone-only hormonal birth control (review: too much breakthrough bleeding, too much depression, nowhere near enough pain reduction) because I’m prone to migraine with aura, which makes me a poor candidate for estrogen usage; and I got a referral to the endocrinologist to see if we could make my hormones start behaving. 

That appointment was supposed to happen in either February or March, but either I was sick as hell or it was during the Great Cancellation Of Things, so the appointment proper didn’t happen until this month. After we talked about my symptoms (I am quite fat, I have wonky periods, I am very hairy, acne is my constant companion, getting pregnant was a pain in the ass, and my ovaries have the distinct “string of pearls” cysts on them), my endocrinologist ordered about six sprillion blood tests to check how my hormones were doing overall. Everything is consistent with PCOS (absurdly high testosterone, which I wish I could donate to some trans men out there, and hallmarks of insulin resistance though not diabetes), so she’s starting me on metformin (500mg to start, gradually increasing to 2000mg/day) to combat the insulin resistance, and I’m adding that to my daily regimen.

Basically, I’ve reached a point in my life where everything is measured in various pills; and that’s not even counting my migraine meds (because I only really take those when I manage to catch a migraine starting). And honestly, I don’t mind it much. There’s some faux wisdom about blah blah blah, being medicated is bad, makes you conform, something something 5G Bill Gates QAnon bullshit (or, on the other side of things, “all you need is fresh air and a positive outlook, plus maybe some crystals and essential oils!” Or both. Silliness has no boundary), but it’s like. Maybe I like not feeling like garbage. Maybe I like it when I’m able to spend an afternoon writing a blog instead of sleeping. Maybe I want to treat my body’s hormonal wackiness. Maybe I want to have the ability to feel genuinely happy, because depression has stolen that from me, and if I need medication to get that back, I will literally take all the pills. 

Like not to feel happy all the time. That isn’t how things work. I just want to be able to look at the days and weeks to come and not feel like I’m drowning. 

BUT ANYWAY.

Dads. This weekend was both Father’s Day on Sunday and Kyle’s birthday on Monday. I’ve spent a decent amount of time, therefore, baking and also organizing gifts and cards and the like. 

The baking was the fun part. I love baking; it’s one of those things that, if you know a few tricks and are very precise with what you do, people will love you for it. Kyle’s cake, catering to the things he adores in a dessert, was a red velvet layer cake with a s’mores filling (marshmallow fluff mixed with crushed graham crackers and mini chocolate chips) and decorated with rich chocolate buttercream, marshmallows, graham crackers, and candy bars. I don’t like to say that I’ve outdone myself when I bake something, but this time, I absolutely outdid myself. 

I also outdid myself showering Kyle with multitudinous gifts, each designed to remind him of one of his kids when he used it. From Sammy, he got the game of Sorry, because we pretty much just play board games with Sammy (Sorry is… not anyone’s favorite right now because it’s really frustrating independent of anyone taking revenge on anyone else, and we’re all learning valuable lessons about not trying to stack the deck, because the game Knows). From Isaac, he got what’s called a dice tower; it’s basically a better way of rolling dice that resembles a marble game…

…and makes satisfying “click clack” noises as the colorful math rocks descend. Isaac loves putting things in things, especially if that act creates a Noise, so the idea of him giving a dice tower was just irresistible. And from Carrie, Kyle received some of those colorful math rocks, specifically a dice set with pink and purple butterflies because that’s just who she is. Sparkles, pink and purple, butterflies, rainbows… that may change in the coming years, but for now, she’s my girly girl. 

Lockdown has been easing in a good way here in Massachusetts–at least out in our neck of the woods, people have remained compliant with mask orders, so some things are somewhat back to normal, and we’ve felt comfortable enough the past couple of weekends to go and visit my parents at their house (even though our house is now visitable with its delightful couches, we wanted the twins to get some time at their grandparents’ house, since they haven’t had much time there at all). We went there for Father’s Day on Sunday and enjoyed some takeout from Outback Steakhouse and some good visiting. My dad and Kyle both got cards signed by all three kids (some more legibly than others), and I got my dad a book of Dad Jokes, because he is the absolute master of them. 

So it was a good weekend with a lot of normalcy, and that was really good for my mental state. Yesterday, for the first time in I don’t even know how long, I felt wide awake without having to go and take a nap when the twins did (I try not to nap when the twins do, but usually when that happens, I end up so tired throughout the afternoon that I can’t function; that I’ve been able to go several days without feeling like I need a nap–today excluded for being a migraine day–has been really nice). I also managed to go out and run some errands like the world was back to something resembling normalcy and not just. Chaotic.

Problems have even started being more normal, too, specifically where Sam is concerned. He’s had a loose tooth for several months, as you do when you are five, and it got really loose the other day, probably earlier than it should have. I guess he bit down too hard on a piece of bacon, and that pulled his tooth away from the gum and, apparently, exposed a nerve. The dentist told us there’s nothing for it except to give him Tylenol or Motrin and Orajel, because pulling it before it’s ready would cause more problems than it would solve.

The trouble is that this small adventure has caused a lot of anxiety for Sam. He’s understandably wary about eating now, because his tooth hurts–last night, despite us having his favorite noodles for dinner, he sobbed hysterically and refused to eat them because he was afraid. And then tonight, he sneaked down to snuggle with me when he was supposed to be in bed and told me, “I know I’m supposed to be happy about my loose tooth, but it hurts so much, and I’m really kind of mad at that bacon.”

I told him that the only way he’s supposed to feel is how he does feel–that it’s alright and even makes sense for him to be angry about this happening, because losing your first tooth should be exciting, fun, and painless, not scary and painful. 

And then he wanted to talk about spiders, because he’s six.

His pediatrician recommended us to a therapist to try and help him cope with anxiety better–I think his is worse than it should be because he’s got parents who are prone to anxiety, so there’s that natural tendency to pick up on it, and since the two of us are only just learning healthy coping skills, it’s hard for us to teach him. With any luck, speaking with a therapist will give him tools to use now so that he can grow up and have a handle on this instead of growing up like we Millennials do. 

So we’ll see where it all goes. But hopefully, it’ll go good places. Until then…

The Gremlins

/ lovescienceandnat20s / 1 Comment

Hey, guess what, here’s a TRIGGER WARNING, because I’m going to talk about my depression, and it’s going to be raw and real, so if you have a hard time reading about suicidal ideation or depressive psychosis, please click the little X on your tab. Please also click the little X on your tab if you’re the type of person to make “lol triggered” jokes because fuck you.

Right, so anyway.

I know I’ve talked about depression a lot, but not in a while, because for a really long time, I was doing really well. My meds (Effexor, specifically) were doing their job, I was feeling pretty good about life, even my hormones weren’t stopping me from being healthy. Ish. I still don’t have the high levels of serotonin required to make a cutesy Zoom video (and, in fact, the handful of video collabs I’ve been invited to participate in since quarantine started have whooshed right by me, for which I sorely apologize), and my energy levels have stayed steadily somewhere around “engages kids in play but only if it doesn’t require a lot of frolicking on my part.” I’d been mercifully free from downswings for years, even in the postpartum times, and I’ve been feeling genuinely optimistic, despite the world being a dumpster fire in a lot of ways. 

And then 2020 happened.

I felt the first hints of a downswing in January, when the president decided that starting World War III over Twitter was a great idea. It wasn’t anything severe at the time, more of a few nights panicking while trying to fall asleep and thinking, “Really. Fucking really. I cannot emphasize enough how little I and everyone else in existence want this, and yet it is happening, and it might result in massive casualties on all sides and nuclear winter. Yayyyyy.” 

But it passed. 

And I might’ve gotten through the year without a downswing, despite everything. The nonstop rush of everything happening so much that’s the modern newscycle has actually been good training for me at getting righteously angry while also being able to distance myself when I need a mental health break. We donated to help Australia recover from its wildfires, I spent most of the winter in bed because of bronchitis or norovirus, and once I’d recovered, I went into Sammy’s class twice to read him books. When I wasn’t sick, I went to the twins’ playgroup every week, and as exhausting as it was, it was good for me, because it was getting out of the house and doing a thing. 

But then Covid-19 came. 

And I hate talking about it as a catalyst for my depression getting worse, because it’s not like I’ve really suffered all that much from it. I have a dear college friend who’s an ICU nurse, and the fact that she’s not just rolling over into a ball of nope every day astounds me. I know people who’ve gotten sick themselves or lost friends and family members. By comparison with all of the above, I should be fine: I’m just homebound. That’s all. 

But depression doesn’t work that way. Instead, it sees patterns and recognizes those patterns as itself. For me, the pattern that pushes me into a downswing is monotony. If there’s little to no change in my day-to-day life, it gets hard for my brain to produce serotonin, no matter what good things are happening, like birthdays and new couches and D&D on the weekends. And I knew the second the Commonwealth started locking down that things were going to get ugly. I hoped that maybe, just maybe, the fact that I’m still on my antidepressant might keep things from getting too ugly, that maybe I might be able to come out of this with the lack of depression that makes sense for someone who’s not really suffering from the situation, just bearing emotional weight for the people around her.

I pushed through it as much as I could. I put off talking to someone as long as I could. What were they going to do, give me medication? Tell me that I could start therapy as soon as things were over? I didn’t leave the house because I’m prone to illness induced asthma and got bronchitis just a few months ago. My days fell into the same routine, even once Isaac’s ABA started and we had people coming into the house. The added pressure of keeping up with the twins’ Zoom call therapies didn’t help things at all, especially when I kept missing therapy sessions because I lost track of who was meeting when. Our poor services coordinator texts me at least once a week asking, “Are you still able to meet today?” when I’m 10 minutes late for our Zoom meeting because of basically no reason. 

I got through half of March. April passed by. We had Easter. We stayed in our routine. We were good. We didn’t leave the house to do anything but get groceries once a week. We washed our hands all the time. We made Isaac’s ABA therapists wash their hands the second they came into the house. We wore masks. Kyle worked twelve hour days, seven days a week, to keep up with a new project his old company was doing to help with Covid. 

And then, on April 30, he was laid off. 

Maybe that was the catalyst for the spiral; or maybe it’s that March, April, May, and June are usually my busiest months, spent obsessively organizing birthdays and anniversaries and holidays, and this year, I’m basically just sitting on my butt, doing nothing. I don’t really know. 

I just know that one night, I was sitting on my new couch, watching my kids play, and suddenly, it was like a little gremlin in the back of my head, saying, “Isn’t it a shame that you can’t want to die because of your kids?”

I should’ve seen it coming, probably. All of my previous hobbies have gotten kind of lackluster to me. I can’t disappear into writing anything anymore. None of my video games are fun anymore. I can’t make myself get up and read a book anymore. Even looking around at the mess in my house that needs cleaning makes me feel frustrated and empty, like why even bother when we can’t get it done while the kids are here anyway?

But there it was, that first intrusive thought, something I haven’t had since I started Effexor. More followed, usually late at night when I was trying to fall asleep. They really were like little gremlins sitting in the back of my head, saying things I didn’t like. “You know,” they said one night, “if you told Kyle you were going to take a nap, you could sneak up here and do it in a way you can’t sneak away any other time.” 

And the rest of my brain was screaming, “But I don’t want to die!”

Another time: “Let’s google ways of doing it painlessly, because pain isn’t fun.”

And the rest of my brain was screaming, “Dying in general isn’t fun either!”

I’m not a self-sacrificing idiot. I did some googling, not of painless ways to die, but rather of potential side effects of all the medications I’m taking. My birth control pill had listed under its name, “Contact your doctor if you experience new or worsening depression,” so that was the first step I took, calling my OB-GYN and saying, “hey, I don’t know if this is because of the progesterone or anything, but…”

And in a heartbeat, although Covid still mattered, it didn’t matter. Immediately, my doctor set up appointments for me to come in and see him. At the same time, he set up an emergency triage with the mental health department, which made the appointments kind of weird: I sat in his office having a pelvic exam, PAP smear, endometrial biopsy, and polyp removal (owwww), and then I went into another room and had a phone call with someone from behavioral health to make sure I wasn’t in any immediate danger.

And I wasn’t, because the gremlins aren’t terribly convincing, but they’re still present, so the mental health provider set me up with one of her colleagues, and we spoke on Friday.

The first appointment with any new doctor is an adventure, because you have to go through your medical history with a stranger and talk about how you’ve only ever smoked tobacco once and it was a pipe in college and it was terrible, and how having three kids and taking progesterone to help with PCOS means that your sex life is a craps shoot as to whether or not it exists and so on. 

The first appointment with a therapist, though, is basically an emotional debridement. You don’t just talk about your physical health and history, oh no. You have to go through the history of your mental health, which means delicately going into your background and realizing, as you talk things through, that maybe you haven’t been as okay all along as you previously thought. Like for example, your therapist asks, “How long have you had intrusive thoughts like these?” and you start to answer that it’s just been in the last couple of years, but no wait, you remember them in college, and no, they went back farther than that, and suddenly, you realize that you were having intrusive thoughts as a kid, and you were so scared of them because you grew up in a church that preached demonic possession and didn’t want your parents to think that you were possessed, so you kept it all to yourself. 

“What were they like as a kid?” the therapist asks, and at first you think you don’t remember, but then you do remember the thought of wouldn’t it be nice to get hit by a car or be sick in the hospital so that everyone would feel sorry for you. “What a weird thought!” you say laughingly, and the therapist says, “It sounds like you subconsciously wanted to ask for help but didn’t know how.” 

So you have to absorb that while also chatting about yes, things were better for a long time after you started meds, but now they inexplicably are not better anymore.

It’s a lot. And as you’re raw from letting this all sink in, the therapist remarks, “I think you’ve got severe depression and depressive psychosis, and also your meds don’t seem to be cutting it anymore. I’m ordering a medication review with your PCP and one of our prescribing RNs to see if we can’t find something that will work better for you. And you and I are going to talk again next week. In the meantime, here are some crisis numbers. Please make sure you’ve got them on hand and make sure your husband has them in case there’s ever an emergency.”

And you’re like, oh, I guess it’s worse than I thought.

I’ve got a lot to unpack over the coming weeks and months, on a lot of levels–judging by that, more than I probably realize. Having therapy to look forward to is helping in the short term, but in the long term… I don’t know. I just want to feel hopeful again, you know? 

Anyway. I didn’t write any of this as a ploy for sympathy or to try and divert attention from infinitely more important causes (and if we’re friends on Facebook, you know where my mind’s been this past week), but just because I want to be honest on this blog, as I always have wanted, and that means sometimes telling some hard stories. So there you go.