oakleythoughtso

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.

O yes, stuck in the mud.

Having got a little distracted of late, I thought I'd get back to my own story.

So, I had sorted out my counselling. That took a while, but was worth getting right. Then there was the referral to the PND support group. The best thing about that group was the free childcare. Which sounds bizarre. Ok, well it wasn't the best thing. But it was the easiest. I really appreciated the fact that they thought of that. It made it possible for so many of us to attend, when we otherwise would have been completely distracted looking after very young babies/children. Because we really needed to be able to concentrate. This group ran for eight weeks. There were about ten women, and their children. We met at a local community centre, once a week. Two women organised the group; a social worker and a psychologist. They were warm and personable women, but they also knew how to facilitate a group with perspicacity. (I love that word.) They needed to be able to rein people in when they began to use the sessions for personal counselling. (Believe me, we could tell who was seeing a counsellor and who was not.) They also needed to be able to draw people out (the subject matter didn't always lend itself to immediate gut-spilling), and to keep us to our allotted time. I can imagine groups like this having the potential to be an utter disaster. This group was not. I learnt a lot about myself, and about PND.

At the first group session, we did the predictable: go around the circle, introduce yourself, tell your story. For all of us, I'm sure, that was daunting. But I found it particularly hard because my story didn't sound very bad. That probably indicates a terribly competitive streak in me. But honestly, what the others had to deal with sounded much worse than my life, even though I was struggling. I very nearly went straight home after the first few stories. Awful home situations, dud partners, traumatic birth stories, colicky babies, unhelpful in-laws, downright destructive or completely absent support networks. Classic PND cases.

And there was me. Stable home, awesome (and observant) husband. Good birth stories, 'normal' babies, helpful family, good friends. What was I doing there?

Well, I did match some criteria. Here is a list of 'risk factors' for PND that Beyond Blue has posted:

• a past history of depression and/or anxiety
• a stressful pregnancy
• depression during the current pregnancy
• a family history of mental disorders
• experiencing severe 'baby blues'
• a prolonged labour and/or delivery complications
• problems with the baby's health
• difficulty breastfeeding.
• a lack of practical, financial and/or emotional support
• past history of abuse
• difficulties in close relationships
• being a single parent
• having an unsettled baby (i.e. difficulties with feeding and sleeping)
• having unrealistic expectations about motherhood including:
  • mothers bond with their babies straight away
  • mothers know instinctively what to do
  • motherhood is a time of joy
• moving house
• making work adjustments (e.g. stopping or re-starting work).
• sleep deprivation

I put that last one in underlined and bold. Because it's just about impossible to overestimate the effect of sleep deprivation. (It has oft been mentioned to me that sleep deprivation is used as a form of torture.)

I was not an extremely convincing match-up, though. You can imagine why self-doubt, and doubt-of-diagnosis might occur. Not being on medication at that point also made me feel a bit of a 'sham'; if the other women in the group were feeling this bad ON the meds, how bad were they feeling OFF their medication?!

At a certain point, I actually needed to be away from other sufferers of PND. I naturally tend to 'take on' others' pain and anguish, and I had my own to deal with at that point; I couldn't absorb any more. So, when the group finished, I didn't really keep in touch with the others.

A few years later I bumped into a couple of them. One was doing really well. She had worked very, very hard on her strategies to combat the effects of depression. She was off her medication and enjoying being a mum. I was so happy for her. The other was not doing so well. She remained pretty much where she had been in 2005: reliant on medication alone (refusing counselling), struggling to do too much (working as well as trying to complete post-graduate studies), with too little help from an unsupportive husband. It was really hard to watch.

I also caught up with one of the group facilitators in 2009, when I was pregnant with my third bub. She and I set up a Mental Wellness display at a local neighbourhood centre, with information for anyone who might need it. Not just stuff that was available online, either. We tried to make it as local in focus as possible. Tangible help close by. We ran a briefing session so that the volunteers at the centre would be able to point people in the right directions, if they needed help. I really have no idea if it was ever useful to anyone! But it was a tough time in my life, and it was an act of defiance against depression to make the effort to do that display.

The choices we make, the choices that other people support us in, affect our minds, our bodies, our hearts.

I struggled on, fought hard, for six months. Counselling, journaling, the PND group, weekly childcare spots for my eldest (then aged two). These all helped. But then my eldest began to give up her daytime nap, and the added exhaustion sent me down deeper. By this time I had realised how bad things were for me, and I twigged that other people's apparently more difficult realities did not lessen my own struggles.

With Christmas interstate coming up, I knew I needed some extra help. I went back to my GP and asked for anti-depressants.