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.

"Taking care of your personal appearance can make you feel better about yourself, give you more confidence...a spring in your step, a readiness for anything." Women's magazines (yes, I am going to criticise them in general, even though it is a cheap shot), advice from advertising, marketing, that silly shallow voice in your head. If you just dress nicely and put on a bit of makeup, you'll feel better. Hands up if you've heard it all before.

Well, my hand is thrust skyward like a teacher's pet's. And sometimes, this advice is true. Feel better, look better; look better, feel better. The bone of contention today is this: when you become a mumma, your appearance is not personal anymore. For a while, at least.

My personal appearance? I do beg your pardon, but I'm left barely a moment to myself to even visit the toilet, let alone have a shower, dress in anything resembling an 'outfit', or do any cosmetic-waving whatsoever. Also, these things cost money. Having given up paid work to herd cats raise kids, I don't have quite enough to splash around on this season's faux-minky-doo-blinky-whatsit. I do, however, have this charming (black) long-sleeved t-shirt with snot on it, which I would be quite happy to wear over my jeans that don't quite fit anymore, if I just give it a sponge touch-up. Go shopping? Well, thank you so very much for that sparklingly generous suggestion. Shall I go on a Saturday so that I don't have to drag two or three reluctant maningerers with me? (Yes I did make that word up: it's an amalgam of 'whingers' and 'malingerers', for those with an etymological bent.)

Ok. I'll stop it. I'm just stroppy today because my snotty almost-two-year-old will not nap, and my seven-year-old is home from school early (also snotty) The five-year-old better not get snotty or I'll have conniptions.

Sometimes, a mother's appearance is actually 'corporate' as opposed to 'personal'. Her man has loved her into a different shape. Her babies have changed her boobies, her toddlers have used her as a climbing-frame. Her older kids have run her a little bit ragged. So let her relax and dag-it-up for a season if she needs to. Soon, those charcoal bags under her eyes will be replaced with crinkles, and she'll be sporting a charcoal handbag instead. (O, gosh, no. Not 'sporting'. Erk.) Ok, she'll be carrying it, with a picnic-face on. (O, no, not 'picnic-face'. That chocolate bar add from a few years ago called the picnic bar 'ugly'; it makes her sound ugly instead of sunny-faced happy.) Ok. She will be looking ALL NICE and with SOMETHING NEW TO WEAR. (That will have to do.)

Right, the advicey-bit is here: if your friend/self/significant other is looking shabbier than usual, remember, in interior decorating: Shabby Chic is great.

"Shabby Chic is a form of interior design where furniture and furnishings are either chosen for their age and signs of wear and tear or new items are distressed to achieve the appearance of an antique. At the same time, a soft, minimalistic, and feminine feel is emphasized to differentiate it from regular vintage decor; hence the "chic" in the name." 

(Yes, I Wikied it. Four years of Uni and now most of the time I use Wikipedia and Google for research.) 


Note the key-words above: age, signs of wear and tear, distressed combined with soft, minimalistic, feminine, chic. And the most important word: chosen. Yes. Chosen. 


I now consider my changed-bits and tired-lines to be 'badges of honour', thanks to a smart suggestion from a friend a few years ago. I'd rather be chosen than selected, soft than hard, distressed than cosseted. If there is one thing I have learnt recently, it is that when things are easy, cooshy, I don't learn very much at all. 

How can you not notice you are depressed? It's fairly easy, for a time.

When you have two children under two, life is very, very tiring. All of the time. For the first year or so. When you're in the thick of that, you don't see the end. You don't know whether things will ever settle down again. The 'now' becomes your life, and you might just lose the ability to believe that things will ever change.

After the birth of my second daughter, I was on a complete high for two weeks. I didn't get the usual baby-blues. The labour and birth had gone quite well, really. My recovery was quick. The baby was gorgeous. We had bonded. That seemed to me to be a crucial indicator of how things were going. If you were going to get post-natal depression, you were going to be one of those mothers with a) a difficult baby, b) no support, c) a traumatic delivery to recover from, or d) an inability to form a bond with your baby. None of those boxes was ticked for me. I had: a) a fairly easy-going baby, b) very good support - my husband James took about 5 weeks off work, c) smooth delivery, and d) instantaneous bonding. Even the breastfeeding was going well. (And breastfeeding is NOT a piece of cake.)

I was, however, tired. I'd been mildly anaemic during the pregnancy, and also extremely nauseous. My beloved grandmother had also died very early in the pregnancy. I had had to telephone my parents, who were in Alaska at the time, to tell them. It was 4am their time. It was the most terrible phone call I have ever had to make. Although I went to the funeral, I think the grieving was somewhat muted; my mind and body were busy dealing with the next generation. I did miss my Nana terribly. I still do. But I was comforted by knowing that my lovely Dad had seen her before flying to Alaska, and had told her about the baby I was carrying.

And now that the baby was here, I was tired. Have I mentioned tired? And exhausted? Ok. So I was very tired.

One night my husband put his hands on my shoulders, hoping a hug might ease some of my burden of weariness. I jumped and shrugged him off with terrifying rapidity. It was an unconscious reaction, and one which shocked both of us. For James, it confirmed some suspicions. He brought me a large book, and opened it to the Post-Natal Depression pages. He gently said that he thought I might have PND. I looked at him blankly, furious at I-didn't-know-what. Then I determinedly read the pages he had referred to.

I had read these pages before. Kaz Cooke's KidWrangling is an amusing and enjoyable read. Like all well-prepared mothers, I had read the PND material so that I could be ready to spot any warning signs. But that had been months ago. Now, when I read the checklist, I cried.

Only two tears squeezed themselves out and landed on my cheeks. They didn't even have the momentum to roll downwards. They just stopped there in their tracks. Inside, it felt like I was sobbing. But nothing much was coming out. There was a dam wall of anger and confusion blocking it. James knew, though. The lack of protest on my part was disconcerting for him.

One of the things I'm grateful for is that Kaz Cooke's book had a wide range of possible symptoms of PND in it. It actually made me feel a bit better to realise that there could be something deeper going on than just being desperately tired all the time, and quite possibly a terrible person - or worse: a bad mother. Because, for me, the single biggest symptom of depression was anger. I don't mean hormonal grumpiness, either. I mean full-on rage. Mostly inside my head, but sometimes, dangerously, leaking out into my dealings with my beautiful daughters. And making me shrug off the love of my life.

to be continued...