oakleythoughtso: counselling

Wednesday, August 24, 2011

Now, Where Was I?

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.

Wednesday, July 6, 2011

Thinking Through Mud: Talking

Depression is hard to get a handle on. It's difficult enough for people who are living through it. It's even harder to understand if you've never had a chemical imbalance of the brain. I've lived with it for half a decade now, and I've learnt a lot. But there are still times when it amazes and humbles me; when I feel like a rookie. That's life in all its richness.

The other thing that makes depressive illness a little difficult to understand is that it affects people so differently. And there is no true way to quantify it. Yes, there are surveys, and scores, and all that. But many practitioners in the field of mental health are wary of those, and so they are not always utilised.

So it was with some trepidation that I made an appointment to see my GP. She was wonderful, and offered to put me straight onto anti-depressants. I was concerned on a number of fronts, and asked about other options. I argued that I wanted to continue breastfeeding, and that I didn't want the drugs to be anywhere near my baby. I was under-informed at this point, but my GP recognised a brick wall when she saw one. She referred me for some counselling [and later linked me up with a PND group called "Moving Forward"].

Counselling. I was actually quite looking forward to it. Having a chance to air my thoughts with a professional. I went to see one of the Maternity Support Workers who was based at the hospital where I had given birth. She was a former psychiatric nurse. Problem number one: I believe she had seen so many people in terrible psychological states that anyone who could string a sentence together was perceived by her to be 'fine'. She was, therefore, a minimiser. Lesson number one: it doesn't help to downplay the situation, to point out that it's 'not really all that bad'. That just makes a depressed person feel that they are being a malingerer, and should really just pull their socks up and get on with things. (The truth is that they actually can't. If they could 'shake it off' or 'snap out of it', don't you think they would?)

Problem number two: I just didn't like her. Now, I know that sounds petty, but it's actually a key factor in determining how successful counselling will be. Lesson number two: find a counsellor that you respect, and can easily talk to. You don't always need to agree. You don't have to feel an affinity for them as you would a friend. You do need to be able to spill your mind's inner workings. And you do need to be able to stomach what they might say. Some of what a good counsellor will say will be tremendously encouraging and affirming. Some of it will be tough to hear, and even harder to implement. But a good counsellor is paramount to good management of depression. I would go out on a limb and suggest that you cannot reach a good level of mental 'wellness' without some counselling, even if you have no significant traumas to re-hash. The reason I say this is that, especially during early parenthood, it is well nigh impossible to find the time to commit to thinking about all the dross you need to work through, let alone making any sense of it.

Problem number three: my first counsellor was not all that sure I had depression. She cast doubt after doubt on the diagnosis, which left me feeling confused and even more angry. If it wasn't depression, what was it? Go down that thought-path for too long and all you're left with is the conclusion that there is something very wrong with you. This is a particularly common experience for depressed mothers: "I'm a terrible mum" is a regular self-accusation.

Lesson number three: high-functioning does not necessarily mean that everything is alright. People who have a high capacity to push through immense pain can really look fine, when inwardly they are far from it. Just as people have differing pain thresholds in the realm of physical pain, some people are better at holding things together in the arena of mental anguish. I might venture to add that this is particularly the case with mothers of small children. They are physically forced to attend to their children's needs. They must function. It takes a greater crisis to knock them flat. If they have a breakdown, they appear like a car driving along the road on a couple of blown-out tyres, rather than a smoking, stationery vehicle with its hazard lights blinking.

Lesson number four: if you see someone struggling, it's quite possibly worse than it looks. Offer help. What is the worst that could happen? That you'll be knocked back? Well, then the ball is in their court. That you'll be asked to do too much? Well, then set some sensible boundaries around what you're willing to do. People - especially mothers of small kids - do need help, and don't like to ask for it. Accepting help is easier. And you know what the best thing is? Offering something specific. Handing over a lasagne is much more helpful than asking, "Is there anything I can do to help?" People who are struggling to survive depression have trouble thinking. It's just so much effort. For me, it was as though my mind was filled with mud. Thinking through this mud was slow, difficult, and required more effort sometimes than I could find the energy for.

I was blessed, again, with a wonderful GP who took me seriously when I said the counsellor wasn't helpful. She referred me to a fantastic counsellor with a good deal of experience with female mental illness. She became an important helper in my recovery process.

My final note today is an example of what NOT to look for in a counsellor.

the story is ongoing

oakleythoughtso

Wednesday, August 24, 2011

Now, Where Was I?

Wednesday, July 6, 2011

Thinking Through Mud: Talking

Pages

Followers