Pray…but then get Help

What do you do if you have perinatal depression when you are a Christian?

The reason that this is on my mind recently, is that I’ve been seeing some pieces by people encouraging other women who are suffering with a perinatal mood disorder, to think a lot of positive thoughts and pray.

I am absolutely not criticizing the power of prayer here. I think that prayer should definitely be used in conjunction with medical treatment. But when I see things like the above observation, it makes me very, very nervous.

There already is a stigma against medication as treatment for perinatal mood disorders (and mood disorders in general). There seems to be both a secular and religious perception that mood disorders, depression and anxiety all can be cured through mindfulness, positive thought, etc. I’ve written about this before, when I was exploring whether or not happiness is a choice.

At first I thought, well perhaps this is pure reliance on God because if you suffer from chronic depression or anxiety, then that is how He made you and this is your cross to bear. But that didn’t make sense to me, because you could be born with a weak heart, a weak kidney, cystic fibrosis, an autoimmune disorder, etc. I could be wrong, but generally we all seek medication for those conditions that we were born with. Otherwise, we would have heard more stories in the news about Christians rejecting heart implants or treatment for cystic fibrosis and so forth. It’s true that Jehovah Witnesses reject blood transfusions, but they do seek out medical treatment for most of their ailments, after all in accordance with Luke 5:31, “Jesus answered them, ‘It is not the healthy who need a doctor, but the sick'”.

I’ve read comments or blogs that imply or evenly overtly state that if you don’t pray to God to help you through your perinatal mood disorder, that you then don’t truly believe in the power of God, the power of prayer and aren’t in fact a true believer. Perhaps this is more of a fundamental mindset, but let’s pull on that thread a bit.

I find this to be a strange place to draw the line on what can make one a Christian or a believer in God. Why stop and draw the line there? Why not reject all medical intervention and turn purely to prayer for all ailments?

There seems to be a weariness among the non-religious, other faith-devout and Christians, toward medication for mental ailments. Is it because you can’t see the mood disorder? Of course that doesn’t make sense, because you can’t see leukemia, either. Or is it because of a perception that mental health medication will ease your life in a way that God didn’t intend?*

Perhaps it is a misunderstanding of how both mood disorders work and how medication works. Of course this idea is not exclusive to Christians; people of other faiths or no faith have trouble with this too. I find it interesting how often I see women of all walks of life, writing about how they are struggling with postpartum depression and need help and that they are open to anything…except medication.

Having dealt with perinatal depression, perinatal anxiety and post-traumatic stress disorder (PTSD) firsthand, I think there are a couple of things to discuss.

The symptoms of any of these mood disorders are not strictly ‘feeling unhappy’. The symptoms involve crippling depression, constant crying, irrational anger, hopelessness, debilitating fatigue, physical side effects, etc. Postpartum anxiety involves your mind constantly tying itself in knots and worrying about anything and everything, to the point of physical and mental exhaustion.

These symptoms are crippling. They are not just opting out of life’s struggles and setbacks. They’re not just being unhappy or choosing to be unhappy.

They are real mental and physical limitations brought on by the body’s chemicals acting out of control. In studies with people who have chronic depression, research suggests that these individuals were born with malfunctioning neurotransmitters. That means that just like someone who is born with a physical defect, research suggests that sufferers of chronic depression are also born with different neurological traits that create a state of persistent chronic depression and/or anxiety.

pet scan of depressed brain chemistry
Courtesy of WebMD

That certainly doesn’t mean that every single person needs medication. Plus, there are many different types of depression. But it means that a lot of people do need medication…and not just temporarily. It means that they need medication to bring them up to the same starting line that everyone else is at. But that’s a very, very basic explanation of mood disorders – as I’ve mentioned before, I am not a doctor or licensed care provider, just a critical reader.

So let’s talk about what medicine does.

Taking medicine isn’t just a prescription for “happy pills”. It’s not going to make you immune to sadness, disappointment or the challenges of life. It just is regulating you to get to where everyone else is. Even with the right amounts of medication, many people with chronic depression still struggle in a way that the non-chronically depressed person simply can’t fathom.

So now let’s talk about what’s going on with perinatal mood disorders. You’ve got chemicals rising and falling…crashing in some cases. Your body has changed; in some cases permanently. If you don’t believe that can wreak havoc on your mind, your rationality and your sanity, then you’ve never experienced PMS before (which if you aren’t a woman, this is a harder example to relate to). It truly can be an out of body experience; you feel like you’re watching yourself do things that you can’t understand or relate to. Such are the effects of hormones.

This of course is not to absolve people of responsibility, but we must be both empathetic and intellectually honest in our analyses. We must admit and understand when people aren’t able to make rational choices for themselves. We must be nuanced in our approach to mental health treatment and save our judgment when we can’t actually relate to what someone is going through.

I get it. Hearing the words that you should reserve judgment when you can’t relate feels like a slippery slope to nihilism. Extreme cultural relativism and nihilism drive me crazy. I definitely think that C.S. Lewis’ plea for objectivism has its place in our society. But none of this has to be a slippery slope and we don’t have to over rotate on personal responsibility to avoid nihilism. Rather this is just nuanced…much like most of life.

But getting back to what we were talking about, with no disrespect intended here, I truly mean you don’t understand if you’ve never been through a major depressive disorder.

If you’ve suffered from anxiety or depression that you can treat with exercises (both physical and mental)…you maybe have a better than average idea of what the chronically depressed and sufferers of perinatal mood disorder go through, but you still don’t understand.

Let me demonstrate why I’m saying repeating this so firmly. I’m not trying to be disrespectful or unkind, but I want to be clear.

I for one, always was an advocate of mental health treatment. But I really just didn’t understand how much your body holds your mind hostage during depression. I didn’t even really get it when I was going through it, I just knew that I was miserable and suicidal. Your body creates this alternate world, where 2 + 2 = 17 and you think it’s totally normal and real. I didn’t understand how irrational and out of whack I was until I got better. When I got treatment and recovered, I didn’t feel happy…I felt like myself. I felt equipped to handle the highs and the lows of life. Most importantly, I was blown away by how real the lies feel during depression.

Your body’s just trying to survive during a major depressive episode. It knows things are out of whack, but it has to work with what it’s got. So your hormones and chemicals create a new baseline to survive. Isn’t it amazing how resilient God made us?

Your body is telling you that everything is normal. But while your body is fighting to maintain some type of equilibrium, your new baseline for normal erodes…so slowly that abject hopelessness seems normal too. Things have gotten worse at such a slow rate, that by the time they’re wildly out of control and you’re doing the bare minimum to function, you think that this abject hopelessness is permanent and real. That hopelessness can kick start a slide into suicide ideation. That’s why we should take advantage of God’s gift of physicians, science, research and good health options.

No matter how hard I try to explain this, you will not understand what people go through and why they need medication until you go through a major depressive episode or disorder. You can’t. And I pray to God that you never do understand it, because I never, ever want anyone to experience what I did. That’s why I blog.

So that’s where grace comes in.

Seeking medication isn’t an indication that someone has given up on God. It means that they’re doing everything in the power that God has given them to get healthy so that you can face life’s challenges and hurdles. They’re treating their illness.

Any Christian knows that just because we don’t see something doesn’t mean it’s not there.

So I challenge all of you, whether your background is secular or religious: be full of grace and empathy to our fellow brother and sister’s struggle. Encourage them to seek the treatment that they need, and if you are a Christian, pray for them and help them. After all, that’s the Christian thing to do.

Postpartum World_ICON_4C_Green Rattle

*I’m truly asking. Please feel free to comment. I would love to hear from you.

 

Tips for Coping During the “In-Between”

Those who are familiar with anti-depressants know that it can be a frustrating treatment at times. Typically it takes 3 – 6  weeks to kick in. For many folks, if the pill is the right prescription, they may feel gradually better over time. For others, they can bottom out before feeling better or even feel numb until all of a sudden: BAM! and they’re back to themselves. That’s assuming of course the prescription is the right one.

There are many different treatment options and they all have different side effects. But one thing is common: none of them work immediately, unless you add a supplemental “as needed” type of medication such as Ativan.

So how do you get through those three weeks or so until the medication starts to set in?

  1. Exercise with a buddy: Exercise is frequently touted as something that can help people with depression. However, note that I’ve outlined this step as exercise WITH a buddy. The problem with depression is that there is an underlying level of fatigue that makes it very difficult to get out of the house. A buddy can help hold a struggling mother accountable and push her to get out the door. This may not always work if the depression is particularly bad (this happened often during the worst parts of my postpartum depression). However, having someone to help push a struggling depressed mother can increase the likelihood that the mother will get out and move around. Exercise is a temporary fix during postpartum depression but it can help a depressed mother get through the afternoon or at least provide a few hours of reprieve.
  2. Talk therapy: Talk therapy is a must. First of all, having a licensed expert who can monitor how the drug is working is critical to assessing treatment. The talk therapist can help identify if perhaps an alternate treatment is good or can provide unbiased opinion as to whether the depressed mother seems to be improving. Often the depressed mother may not see improvement initially. Secondly, the therapist is an unbiased third party who can help a struggling mother with perspective and mindfulness. Like exercise, this is a temporary fix, but it can help the struggling mother get through those tough weeks while waiting for the medication to sink in.
  3. Support Groups: Along the vein of talk therapy, support groups create a space where mothers can talk about their struggles in an unfiltered environment. Sometimes just the recognition that other women are going through the same struggle is calming and provides comfort. This can also provide temporary relief.
  4. Working Towards a Plan: The act of working on a plan, assessing your progress and reevaluating your plan to recovery can often bring a sense of peace. It may help to outline a plan of attack; it gives a sense of productivity and direction that can help combat the helplessness that the struggling mother feels during the throws of postpartum depression.
  5. Find That Cheerleader: The struggling mother will need someone to help her push through the pain. Depression has the unfortunate consequence of many women drawing away from other people. This is why a cheerleader is necessary. I can not stress how incredibly important this was. This is why support groups are often critical. The struggling mother needs to find a friend through the support groups or find someone online that they can trade stories and lean on each other when things get really low.
  6. Work on Losing Guilt: It’s critical for the struggling  mother to rely on her partner, her family and anyone who will help her out. This is obviously much easier to say than do, but there’s a couple of things to tell the struggling mother during this time:
    1. “This period of time does not reflect on you as a mother”
    2.  “You carried the baby and gave birth. It’s OK to lean on your partner to get you through this.”
    3. “This is fleeting. It will pass. It will change and become different in ways that you can’t even understand.”
    4. “You have plenty of time to bond and build a relationship with your baby – when you’re better.”

Please note that these are not intended to be treatment options for postpartum depression. They are only to help struggling mothers get through that waiting period before the treatment begins to work.

Also note: be aware that if you are dealing with postpartum depression, you should never settle. Don’t settle for, “I feel better but am still dealing with anxiety, etc.”. The goal for a treatment plan should be to get back to feeling like yourself. If you still don’t feel like yourself and your doctors aren’t listening to you – you need to see another doctor. Motherhood is amazing when you have the energy to do it. The biggest thing I hear from women who have conquered postpartum depression is:

I wish I had sought treatment earlier and not lost this time.

Postpartum World_ICON_4C_Green Rattle

Pregnancy Changes the Brain

Recently the Washington Post published an article about the changes that pregnancy has on the brain. It’s important to note that this study was small and hasn’t been replicated yet. But it does go a long way in soothing concerns that I hear from many postpartum women.

As I’ve written about before, actually many times, medication is a tough subject. We have a certain degree of control over our thoughts, feelings and logical deductions. But that control only goes so far. So people naturally think that when you’re in the midst of some type of depression, that you should be able to control how you feel and treat it with your own thoughts.

But as I’ve pointed out before, mental health is not that simple. We are trained to think that happiness is a choice, for all. We view everything from our own perspective, so we think that if we can use herbs and positive thinking that everyone can.

To be honest, I never fully understood how wrong this thinking was – the thought that we truly can control our depression with disciplined thinking – until I went through my own postpartum depression. Now I understand that it’s a very chemical and hormonal process and when your chemicals are off, your brain plays some pretty strange tricks on you.

But I digress.

One of the other concerns that women have about starting a postpartum depression treatment involving medication is that they’ll be on the medication forever. People, I’ve found, can deal with the idea of taking antidepressants a little better if they believe it’s a temporary thing. While I still think this isn’t exactly the healthiest approach to mental health issues, as far as it relates to postpartum depression, I guess I can deal with that approach.

If you think about it, pregnancy is only a finite period, but it would seem logical that the effects would linger. For example, during pregnancy your estrogen is at incredibly high levels. For many women, this acts as a natural antidepressant. For me, it was quite the opposite. My body doesn’t handle hormonal fluctuations very well. But getting back to the point, that’s 9 – 10 months that your body is operating at a different hormonal cocktail.

Then you give birth. Your estrogen immediately crashes. That’s why a lot of women report “baby blues” or crying, emotional highs and lows in short periods and so forth. For many women, those hormones start to level off, but it’s important to note that if you’re breastfeeding, your estrogen levels – which were formerly crazy high – are now in the toilet. Your body has to make room for the prolactin to produce milk…and estrogen is the first hormone to get kicked out. So then for however long you breastfeed, your body is yet again taken through the ringer with abnormally low estrogen levels. For months. Or for some women – FOR YEARS!

Then, is it any wonder that our bodies need time to recover once they go back to their normal hormonal equilibrium? Our bodies spent years fine tuning themselves at that specific chemical frequency and then they basically get jerked around for about two years surrounding pregnancy and childbirth.

So ladies – if you find yourself in a position where you’ve got to take some medication to get back to normal – be patient. Your body’s been through the ringer. Your life has changed. Nothing lasts forever. You might be on the medication for awhile, you might not. But by getting treatment, you’ve taken the first step to getting better and being the mom you always wanted to be. So be kind to yourself. You deserve it. Put the days ahead of you where they belong…in the future.

Postpartum World_ICON_4C_Green Rattle

Do you Need to Save your Life?

Photography Credit: eKate Photography

WARNING

TRIGGER ALERT: In depth discussion of suicidal thoughts and plans

Note: I am not a licensed mental health provider or doctor; this post is strictly based on my experiences and these tips are based on what worked for me. 

As part of my therapy, I talk to a lot of different women about their postpartum depression/anxiety experiences. So the word ‘suicide’ gets quite a bit more use in my day to day vocabulary now.

In going through my own struggle with suicide ideation, it’s taught me a lot about the human body, the mind and what suicide really is. Before I had perinatal depression, I had heard phrases such as “suicide is selfish” and “suicide is a cry for help”. I didn’t think much about it. I knew of people who had died by suicide, but I didn’t know anyone personally. Since I’ve experienced the pull of suicide during the throws of depression, both of those statements seem trite and hollow…if not just a complete misunderstanding of what drives people to take this very permanent path.

Continue reading “Do you Need to Save your Life?”

The Medication Conundrum

Recently, Postpartum Progress posted an article that was originally posted on Scary Mommy. The article was about a woman who has suffered from treatment resistant depression for years. Her depression was naturally exacerbated with childbirth and the postpartum period. She expressed her frustration with well-meaning family, friends and strangers when they would advise her on how to treat her depression.

The full article is here.

Continue reading “The Medication Conundrum”