Saturday, August 27, 2011

Hesitation

Six months. Give or take. That's how long it took to convince me that I ought to at least try anti-depressant medication.

What was I afraid of?

Well. Small amounts of the drugs can pass into breast milk and I was worried about the effect these would have on my wee babby. (She was two months old when I was diagnosed with depression.) I later learnt that when the literature says 'small amounts', it really does mean that. According to the studies I've read, only a small proportion actually makes it through to breastmilk. And the baby's system is usually able to deal with that. At least, my baby coped. At introduction, her tummy was unsettled for about 48 hours. After that, I noticed no ill-effects during use, nor when I ceased breastfeeding her four months later, on her first birthday. I did nothing suddenly, and always followed the advice of my GP, maternal and child health nurse, and various other advisors with experience in the area of breastfeeding. [Southern Health  in Melbourne has a phone number you can call to discuss breastfeeding while on medication. Also in Australia, the National Prescribing Service is able to provide over-the-phone information for the cost of a local call.]

I can't give people advice on whether or not it is safe for them to breastfeed while on medication. But I can suggest that you get some good advice, from sources you trust, and find the best compromise for you and your family. And I can beg you not to be as stubborn as I was in thinking that breastfeeding and medication are mutually exclusive. The agonies I went through, thinking that it wasn't an option for me because I so badly wanted to breastfeed my baby, I would happily see others forgo.

Here we see, perhaps, a glimpse of how Post-Natal Depression (PND) is sometimes a little more complicated than some other forms of depression. Ante-Natal Depression (depression during pregnancy) is even more fraught as far as treatments are concerned. But that subject arises much, much later in my story.

What else stopped me from trying out 'happy pills'? Just this: the glib attitude I had that anti-depressants were just plain cheating. Honestly, sometimes I want to rewind and shake some sense into myself. Cheating?! Where did I ever get the idea that using a therapeutic tool was 'cheating', and that I had to tough it out with more 'natural' ways of getting through? Probably from that same place in deluded-brain-land that told me I should never feed my kids in the car, because the crumbs would make a mess.

The plain fact of the matter is, for the first six months of my depression I had no idea how dangerous a condition it can be. Things had to get a lot scarier for me to realise that.


Because I was sleep-deprived, and caring for two kids under two years, I really couldn't think very clearly at all. I didn't realise that the depression was also contributing to the tiredness and the lack of clarity.

But the day I drove home from the library with the girls in the back of the car, and thought about driving in front of a train - that was the day I realised the danger. I was so tired. So despairing. I had tried, like a good mummy, to take the girls to the library and borrow some books. It had been an unmitigated disaster. There were queues, fines, no money to pay them, a screaming baby leaking poo in the pram, a toddler throwing such a tantrum that I was physically struggling to strap her into her seat. It still stands out as The Worst Outing in My History of Motherhood, five years later. Driving home, I just wanted all the struggle and humiliation to end. I did not want to be responsible for these children. I felt that I could not. I was not doing them any good. They were not doing me any good. I wanted to not be here any more. I wanted to drive, very fast, into that train, right there. And my foot actually hesitated over the brake pedal before applying it.

That was my first deathly thought. Not my last. There are many things that have kept me from acting out any of these thoughts. My kids are three of them, and my husband is another. God has held me. Pulled me back. Kept me safe.

Anti-depressants have been a part of that. It took me a few weeks to adjust. There were minor side-effects (an upset stomach, tooth-grinding - but only for the first two days or so). It took the best part of a month to start feeling the effects. But they built steadily after that, reaching full efficacy a couple of months into treatment. I can say, without exaggeration, that anti-depressant medication has made the biggest difference in my treatment. I am embarrassed about that, still. I would like to say that something less clinical was my 'breakthrough'. But I cannot. Biggest difference. Which leads me to think that my depression is heavily brain-chemistry-related.

I'm one of the blessed ones, for whom medication worked, with few side-effects. First time around, my GP hit the nail on the head and prescribed a drug that worked well for me. It just happened that way. I'm glad it did, because having waited six months to start that sort of treatment, I was fairly desperate for something to make the difference. I'd had all sorts of fears lurking around in my head; what if anti-depressants don't do anything? What if they make things worse? (Some anti-depressants can make things worse initially, before they get better.) Have I been hanging out all this time only to find out that drugs don't really make much difference, that this is as good as it's going to get?

Time. You need to take time to get your medication right, with the help of the prescribing doctor. You need to give it time to work. If you manage to get it right, it will make such a difference.

So that's how my journey-on-anties began. And that, too is ongoing.

I'm not cheating. I'm living.

4 comments:

  1. I just read your blog and I mean what I said on my wall. Thank you for sharing so honestly. To hear from the horse's mouth so-to-speak..well there's nothing quite like it. Many can say - "it won't always feel like this", or "medication will help", or "those thoughts just aren't true".. but your words which come from being there, have an unforced authenticity & truth about them.

    Your writing brings so many falsities to light - not just mis-conceptions in regards to depression & it's treatment, but how skewed our thinking can become while in the midst of it. How a beautiful, gifted, loved and redeemed person as yourself could find yourself in s place so void of hope and joy and pleasure..well it just doesn't seem right does it. But I guess that's because it is not. I think I am starting to see depression is sneaky, like a snake.. Getting in where other's can't see it. Sinking it's fangs into that which is good and leaving us wounded & sick.

    Which often times calls for medication. It is hard though, when others didn't see the snake, and often don't see the effects of the venom. Trying to point it out seems self-seeking and in comparrison, the puncture marks seem small.

    But hearing the tale of an eye-witness, infact a fellow sufferer..well that is different. You still have the marks to show, but you speak not just of the way you suffer, but advocate for others who do too.

    Thank you for keeping on living. Your story gives hope and life to me & I'm sure many others. 

    A xox

    ReplyDelete
  2. Thank you, A, for your comment. Your snake analogy is excellent; very apt.

    My hope and prayer is that you, and all fellow-sufferers, will find the way through. In the meantime, there are the learnings. They may not appear right now, but later.

    ReplyDelete
  3. Hi Sally

    I really enjoyed reading your post. I don't have much to say, but I just wanted to let you know that your post had an impact on me and made me reflect on a topic that has been close to me in my family. Thank you.

    ReplyDelete
  4. Hey Sal

    Your blog is excellent. Your openness and honesty is compelling. I'm sure this will be useful for many people who may or have gone through depression.

    Keep it up!

    ReplyDelete

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