How I Knew
/For the record, I was never a Tom Cruise enthusiast, but I never in my life thought taking antidepressants would be for me.
For starts, I never suffered from depression. Sure, I had the teenage angst years where I boo hoo'd over the boyfriend who dumped me, and the "what do I really want to do with my life" mindfuck when my graduate department admitted they had erred when they let in too many students ahead of me and there was to be no financial or professional assistance in the form of grants or jobs in my future. Sure, I wrote overly-emotive poetry and listened to Pink Floyd's "The Wall." I had a solid six-hour cry 18 months into my trying-to-conceive misadventure which was odd enough that my husband came home from work early to sit with me. But I always felt a solid foundation going through these moments -- a sense that there was more to me than that. I watched a friend crumble after failing her pre-lims, and realized she had wrapped her entire life -- her entire identity -- into this potential profession. It hit me (as I passed the kleenex) that I was rather lucky: I liked this profession enough, but I had other stuff too. I liked to cook, I liked to run, I liked to travel. I had super friends, a fabulous boyfriend (who became my husband) and I figured if I had my wits about me, I could probably make money somehow. Oh, and someday, I wanted a family.
Furthermore, and this is rather embarrassing, but I was never into mind-altering substances. I thought smoking was gross, and never even had the experimental attempt -- of either flavor. Wouldn't know what drugs to take or where to get them, and I was not remotely interested, anyway. I didn't realize beer tasted good until I moved to the midwest for grad school, and didn't like wine until I could afford something that didn't come in a box or with a black and white generic "Wine" label on it.
Finally, I liked having ultimate control of my body. From very early on my life, I was a violinist and a soccer player. So at a young age I figured out that if I practiced something for literally months on end, suddenly one day my fingers would click and lo, I could play the fingered octaves at the start of the Winiawski Violin Concerto. I liked that if I did wind sprints around my block (two driveways on, two driveways rest) that come game time, I could throw my internal gear shift and move around someone. I liked the way I could make my body do things, and there was no interest (no way, really) in allowing something to alter my mind that would mess this up. I liked the control, not the fuzz. I had no interest in being numb.
What I failed to perceive, probably because of my immaturity, was that on some level my brain actually wanted to do these things. That I liked doing these things. It just seemed too easy that if I set my mind to a marathon, I could eventually make my legs follow. And I did. It all worked perfectly.
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My husband and I joked (in the macabre way that you do, what with the terminal child in your arms) with each other during Maddy's brief week that we were going to need therapy. But I think it really hit us, a week later without her, that we did indeed need something. So we dutifully marched in, sat on the couch, and ground our way through the first awful few weeks of having so much to say and not wanting to say a word.
But I still didn't think I needed antidepressants. Sure, I was depressed all right, my baby died! Who wouldn't be? This is just grief. Everyone probably wants to crawl in a cave and stay there for 20 years. I wasn't suicidal, I wasn't in denial. I wasn't showering or eating much out of the coffee food group, but I was getting out of bed.
And there was Bella. Two and half, still in diapers. Not in daycare, because, you know, I was going to be home with the baby anyway. She was my job, my responsibility. She was my safety net, my bullet proof vest, and I strongly believe the candle which kept me from wanting to stay in my cave for eternity. And for a good month or so, I could limp from my bed to her room, change a diaper, find her clean clothes, and start a day. Probably one spent indoors, or sequestered in the yard, close to the door. If we were lucky, a weepy trip to the grocery store. Never the playground. Never a playdate. We let her activities lapse.
And one afternoon, Friday, about four weeks after Maddy died, she decided not to nap.
This was a completely unremarkable occurrence for a child who had never really napped in her lifetime, no different than any other day circa 1 p.m. where my tone of voice edges on exasperation. But she would not acquiesce to quiet time, she would not stay in her room, she would not sit still and have me read to her. And I was exhausted. Of it all. Of the grief, the loss, the aching, the trying, the getting up, changing diapers, putting my feet on the floor every morning with the realization that this was my life -- not some nightmare. I collapsed on my bed, and could not get up. I could not open my eyes. I could not deal with my life. I lay there glued to my sheets, with a toddler ambling about my house, and I could not call anyone on the phone, sequester her in the room with me. Immobile. Tired. Comatose.
What stunned me was not so much that I couldn't get up, but that my mind ceased to ask for it. My brain -- instead of screaming at me to lift my eyelids already -- shut down and concluded that this semi-conscious state was acceptable, regardless of the toddler who could possibly tumble down the stairs, walk out the front door, or figure out the safety latch under the kitchen sink. My husband was at work, but I couldn't lift the phone. Two neighbors had offered to come at a moment's notice if I needed a "time out," but I somehow forgot. I could no longer rely on my mental faculties to prod me in the right direction and encourage the rest of me to move. The part of my mind that once compelled me to run 26 miles now couldn't force me to lift my head. It was . . . . frightening. Sorry Tom, if your brain doesn't send the signal to take vitamins or go for a jog, you ain't gonna.
First thing Monday morning, with resignation, I called my doctor for antidepressants.
A few of my friends had tidy little metaphors for exactly how ADs made them feel: a tufted cushion to stand on; a buoy to keep their head above water. I'm not really sure what my reigning metaphor was, but I can tell you this: it slowed my brain way the hell down. I went from racing from one deadbaby thought to another to actually being able to catch my breath between sobs. It allowed me to sleep without tossing for two hours. It allowed me to drive without breaking down in a (hazardous) blinding torrent of tears and shudders. It also diverted my attention from sticking on one ugly thought for too long: going through the life support removal replay? Mind quietly segues to lunch.
It allowed me to function. I dare say, it helped me grieve. I had a job to do, and it helped me do my job. Although my brain never went to the place of endangering myself or Bella with weapons or whatnot, by having my body do nothing, it was in fact endangering us both. The antidepressant did not make me numb, it did not make me miss Maddy any less. It by no means made me happy. It made me get up, it made me move when I needed to, it helped me pay attention.
After a few months, it became readily apparent to me that I had lost my short-term memory -- most likely from the shock of Maddy's death, but possibly abetted by the ADs. I also noticed when I went to play the ABC -game ("Your name? Gah. Lessee: A, Alice, Allison, Angie, B, Barbara, Betty . . . ") that my mind would not stay on task and focus long enough to get through the C's. I'm guessing the ADs saw this as anxious fretting and tried to shut my brain down and think about puppies or daisies or something, but it became increasingly frustrating to the point that it made me overwhelmingly anxious. Heart-racing, short-of-breath anxious. Given that I felt a bit better all around anyway, I quit taking them at six months. I haven't felt like I needed them since.
It probably bears repeating that I didn't feel I needed them until a good 4-5 weeks after Maddy died. If I were to search around in med journals, I bet I might find some reason for this. I don't think it's unreasonable to think that our body produces hormones and adrenaline after childbirth in order to get us through the first grueling sleepless weeks of our babies' lives. I know the act of breastfeeding produces oxytocin, and I'm willing to bet letting down does a bit too. All this conspires to both give us an amount of energy and simultaneously relax and think, perhaps, that we can do this just fine, thanks. The first month or so many of us are also gently supported by the onslaught of cards, flowers, donations, email, phone calls, meals, and friends and family. They too dry up about 4-6 weeks later. I've seen a number of women here on the 'net crash weeks to months after the event. It's not unusual. And don't think if you haven't sought help by that point that somehow it's embarrassing if you do now. It's not sliding backward, it's just what's happening now.
ADs are not to be taken lightly, in either direction: you may not need them, but grow to rely on them. Conversely, you may need them, but fear or not understand them. Either scenario is dangerous in my estimation. I can't tell you exactly when and if you need them, or when or if you should go off. In my mind, it was crystal clear: the day not only my body, but my mind stopped responding was the day I felt I needed them. The day my mind began to rebel against their function I got off. To quote every big-pharm commercial: see a doctor, but please see one, if you think you might need additional help, or need a different dosage or flavor with less side effects, or or if you're ready to leave them behind.
I never, ever thought I'd need ADs. I had seen them work for others, so I wasn't opposed to them as a rule, but just didn't think I was the type. I had a foundation! I was more than this death! I had a life to live! I've run a marathon, for Pete's sake! But all that meant nothing when I realized I -- my mind -- had neglected Bella for an afternoon. And not cared. And there was no way I was going to let it do that to either of us again.