Electroconvulsive Therapy: what I wish I’d known

Not this bad.

So. When I was in the psych ward last year and my doctors approached me with the idea of electric shock treatment (aka ECT: electroconvulsive therapy), my first reaction was, “that still exists?!” It turns out it’s not the torture treatment it used to be. It’s safe, quick, easy, and very effective. But my hospital wasn’t very good at giving me the full picture, so here’s what I’d like you to know if you’re considering ECT. (Please note, these explanations are in my own words. I’m don’t know if they are 100% accurate, and I’m sure they’re not technically correct. Double-check with a good doctor!)

1. It’s an option for people who are already using the conventional means of therapy and/or medication, and aren’t getting better; and for people who need to get better in a hurry. As a postpartum mother of 4 with suicidal depression, who’d already been on medication and therapy for years, I needed something to change, quick.
2. It re-sets your brain. My husband did a lot of research and found out that ECT kind of erases some of the thought patterns that have built up in your head. If you head back home after your treatments into a situation that hasn’t changed, with all the same stressors and problems, your mind will fall back into its old patterns again. You need to take advantage of the time after ECT to work hard and establish good new patterns for your brain: coping strategies, positive thinking, relaxation techniques, etc. I found Cognitive Behavioral Therapy extremely helpful for this.
3. That means that you’re going to have a long recovery period. You’ll probably need to take time off work, or lessen your other responsibilities. You’ll need people nearby to cover for you and help you out. You’ll need someone to drive you to your treatments and stay in the hospital the whole time, and you’ll need someone to check in on you while you’re recovering. Obviously this is a tall order. But apparently, unless you take these precautions, your ECT may not have much effect and you may end up back where you started.
4. My side effects were short-lived irritability and confusion, and some fairly significant memory loss. I was told that I would lose the memory of the morning before the treatment, and that was it; but in my case, that wasn’t true. I’ve lost memories from the last few years of my life, mostly the last year. I can’t remember places we went, things the kids did, books I’ve read, people I visited. I can’t remember what my friends’ youngest kids are named, or what they’ve told me about recent developments in their lives. It hasn’t really affected my life that much, but it makes me sad. I feel like I’ve lost part of my identity. I think it was worth it, though. I’m not sure how much of my recovery was due to the ECT, and how much was due to medication, therapy, and changes in my situation; but I’ve talked to people for whom ECT was an unequivocal success, even a life-saver.
5. Get somebody you trust to help you research and make the decision, especially if you’re in the hospital or in the middle of a crisis. I was scared, uninformed, panicky, and generally not in any state to make important decisions. I was so lucky to have my persevering husband to depend on. This is something you shouldn’t do alone.

Please write to me if you’d like to talk about it! My email is preverized@aol.com

Dear Me:

1. Dear 14-year-old me: spending every lunch period sitting in the chapel and crying is not normal. Tell someone, for heaven’s sake. This is called “depression.”
2. Dear 18-year-old me: why would you even date a guy who’s mean to people, inconsiderate to you, and doesn’t really care much about you or anything else? I don’t get it.
3. Dear 20-year-old me: learn NFP before you get married, you dummy. Don’t just say “oh, we’ll learn it when we need it.” Trust me, you’ll need it.
4. Dear 21-year-old me: just give the baby a bottle. You will never regret it.
5. Dear 22-year-old me: anti-depressants are wonderful. It’s about time.
6. Dear 23-year-old me: I know you don’t really believe it when people say this, but it really will get easier as your kids get older. Really!
7. Dear me for the last five years: just go to bed. There are very, very few things you could be doing that will make you happier than more sleep.

Come see the rest of the 7 Quick Takes at Kelly’s!

Make your own happiness

There were a lot of inspiring plaques in the behavioral health wing at Dartmouth-Hitchcock hospital, most of them the usual vague “live, laugh, love” type of thing. But one of them really spoke to me. It was actually in the scheduling office, and it said “the time to be happy is now.”

The first part that struck me was the “now.” I often get stuck in the trap of depending on the future and my specific plans for it: when we get a house, then I’ll be happy. When the kids are older, then I’ll be happy. When my husband gets a good job, then I’ll be happy. And guess what happens? I get what I was hoping for, and I still find something to be unhappy about. Or worse, I don’t get what I wanted, and I feel justified in remaining unhappy. The sign reminded me not to pin my happiness on something that might happen in the future.

But here’s something I’m just realizing recently: if you want to find happiness now, rather than in the future, you need to be able to make your own happiness. Is it possible that happiness is a choice? I’m not sure if this is true for someone in the midst of true clinical depression, and I hope I’m not sounding like those clueless people who tell you to just snap out of it and cheer up. But for those of us struggling with mild depression, or maybe just the ups and downs of everyday life, I think it’s possible to choose happiness. When I’m feeling down, I have two choices: I can do the thing that feels good initially, like holing up in my room and watching reality TV, and dwelling on everything that’s bothering me at the moment; or I can do the thing that will make me feel better in the long run, like taking a walk, or putting down the book I’m trying to read and giving the kids my full attention, or putting on some cheerful music and dancing around.

This isn’t easy! It takes so much effort. But each day I’m learning more and more that I have control over my mood, and I don’t have to be a slave to my emotions. Try to be happy! It doesn’t work every time, but I never regret trying.

I published! Baby Jesus and Electro-shocks

My dear readers, I miss you. There’s been a lot going on lately and I haven’t been able to write. I’m hoping to get back to it soon. In the meantime, here is an article I wrote for Aleteia.org about my experience with Electro-Convulsive Therapy, and how they are helping me slowly learn to give up control and put my life in God’s hands. Merry Christmas to all of you!

Keep Moving

“Cliffhanger” by Sam Purtill, via Flickr

A few days ago I came upon a quote from St. Bernard that really struck me:

You must either ascend or descend; if you try to remain in one position, you are sure to fall.

This might sound like a challenge or a threat at first; but I find it helpful because it sounds more like advice to me. When you’re fighting depression, or temptation, trying to stay in one place out of sheer force of will is not likely to work. Getting up and doing something is the only way to make some progress.

Imagine you’re sitting at home in front of your computer, and you’re attacked with a strong temptation to watch pornography. White-knuckling it is not going to work. Instead of doing your best to stay in your current position–in the near occasion of sin, but not sinning–you’d do much better to get moving. Go out of the room, call a friend, go outside, read a book, anything to distract your mind.

If your toddler keeps getting into the sugar bowl, you’re probably going to be disappointed if you keep admonishing him and putting the sugar back, hoping that his self-control will kick in. Do something! Put that sugar bowl on a higher shelf!

This doesn’t just apply to sin, either. When I was studying abroad in college, I fell suddenly into one of the deepest depressions of my life. I caught myself stopping in the middle of the staircase, trying to come up with a reason to take the next step. What finally brought me out of it was happening upon a quote similar to the one above, which reminded me that sitting there, being depressed, was never going to improve things. I had an impulse to pick up my homework, which was a reading from St. Thomas Aquinas, just to give myself something to do other than focus on my despair. To my surprise, I got completely caught up in the reading, and I was out of the depression when I finished. (Thank you, St. Thomas!) The chapter I read wasn’t particularly relevant to my situation or anything I was particularly interested in; it was just the act of doing something normal, something to take me out of myself, that rescued me.

When you’re stuck in a rut, don’t worry about finding the absolute best thing to do with yourself–just do something! You’ll be moving forward.

Linkup! How to Tell if You’re Depressed

The last time I wrote about postpartum depression, I shared the fact that my struggle was made worse by guilt: motherhood was what I had always wanted, so why wasn’t I thriving? Another mother wrote in to say that she had the opposite problem: she felt guilty because being a stay-at-home mother was not something she had always wanted, and so she blamed her depression on her unpreparedness. My first thought was “oh, my post must not have helped her very much, because she couldn’t relate.” But instead, she found it helpful, because it showed that the fault was not hers; if both of us could be depressed for opposite reasons, the depression must have some origin besides our failings. So true! Your mind can find a reason to make you feel guilty no matter what. Depression can be connected to objective situations, of course; but in the end, it comes on its own and you can never be completely sure why.

I often find comfort in something my mother used to say: If you’re feeling guilty about not being a good enough mother, that means you are a good mother. A bad mother wouldn’t be worrying about it!

I’ve written several times about depression, therapy, and medication (links at the bottom–Wordpress is quirky today), so today I’d just like to focus on how to tell if you’re depressed or just sad, stressed, or have the “baby blues.” These are a few things I’ve noticed through the last few years as indicators of depression; but before all, check with your husband or someone who knows you well! When you’re in the thick of a pregnant, postpartum, breastfeeding, or sleep-deprived state, it can be hard to think straight and realize that you’re not normal. An objective viewpoint is critical.

• Do you still have a sense of humor? If you’re just having a bad day, you can laugh at things going wrong–maybe not that minute, but at least later on. When you’re depressed, nothing seems funny. Your life is awful and there’s nothing funny about it. Humor doesn’t ease the situation at all.
• Likewise, when you’re depressed, nothing is cute, not even your kids. Even when they’re acting normally, you’re constantly aggravated and upset by them. You can’t enjoy them at all because you’re sick of them, they’re just things that make your life harder.
• When you’re having a bad day, you can stop and say to yourself “okay, this day just stinks. Tomorrow will be better. It won’t be like this forever.” When you’re depressed, you don’t have that perspective. You can’t remember things being good before, and you can’t imagine them getting better in the future.
• When it’s just a bad day, simple pick-me-ups can really help: a change of scenery, a snack, exercise, 5 minutes alone, getting distracted with a project, calling a friend, and so on. When you’re depressed, nothing works. You can do all the right things and still feel lousy. Again, that’s because depression doesn’t necessarily come from external circumstances. Sometimes it just comes. That means that you can’t always chase it away without external help.

My computer is freezing up when I try to insert links, so bear with me:

• My original maternal depression post, which includes some helpful guidelines for considering therapy, medication, and self-help books:  https://checkoutthatsunset.wordpress.com/2015/05/27/bloghop-good-catholic-moms-and-maternal-depression/
• My post about making peace with medication, which I was very reluctant to try: https://checkoutthatsunset.wordpress.com/2015/03/09/i-dont-want-to-be-on-a-pill-for-the-rest-of-my-life/
• My post about some things that helped during rough periods postpartum, mostly suggested by various therapists:  https://checkoutthatsunset.wordpress.com/2016/04/22/7qt-things-that-help/
• My post about why prayer or spiritual counselling may not be enough to cure mental problems, and how God wants you to take advantage of any help you can get, spiritual, secular, or medical:  https://checkoutthatsunset.wordpress.com/2016/05/13/why-schools-need-real-counselors/

Please click over to Flourish in Hope (http://www.flourishinhope.com/2016/05/30/my-ppd-story/), a wonderful site I’m just discovering, for other moms’ stories, and thank you so much to them and to Katherine at Half Kindled (http://halfkindled.com/) for organizing this! Let’s all keep each other in our prayers.

 

Why Schools Need Real Counselors

Here’s a wonderful story about St. Benedict’s, a boys’ preparatory school in New Jersey where the students–most of them from low-income black or Latino families–have a 98% graduation rate. The monks attribute their success to the fact that they have real counseling services–not just career counselors or academic counselors, but actual psychologists–who help the boys deal with anger management, depression, and lack of a father in their lives.

“The counseling center is critical,” said Father Edwin Leahy, a monk and the school’s headmaster, to the Huffington Post on Tuesday. “I don’t know how people do this work without attending to the kids spirits, psyche and heart. It’s very rare that cognition is the reason for poor academic performance in our experience — frequently it’s emotional distress.”

 

What a Catholic approach! They’re educating and healing the whole person–not just the mind or the soul, but the brain, the psyche, the emotions. They’re not just assuming that a good education and a good spiritual life will solve all problems. As I have written many times, Catholics often fail to understand that psychological problems can be different than spiritual ones. Prayer can heal, for sure, but we’re more than just souls, and sometimes our minds need healing too. You wouldn’t rely on prayer alone to fix a physical problem; God doesn’t want you to leave your mental problems untreated either. I have seen firsthand, in college, what happens when you take young people with depression or an unhealthy past, expose them to heady ideas and philosophies, and offer nothing but hard academic work and daily Mass to deal with their psychological problems. They go off the deep end.

I recently received a fundraising letter from my alma mater, which emphasized the way that the college defied the trend of hypersensitive “safe spaces” and “microagressions” and instead formed independent and strong men and women. So far so good; but the president of the college lost me when he listed, under the heading of emasculating demands that the ivy league made, “free mental health support.” Opposed to this he listed “daily Mass and sacraments,” as if the two were mutually exclusive. Now, it may be mostly the “free” part that the president was balking at; but the fact remains that he considers mental health support a symptom of the entitlement society, rather than a crucial part of care for the whole person. This is a dangerous and foolish way to treat the education of young men and women. May more schools follow the example of St. Benedict’s, and show their students God’s loving care for us–mind, body, and soul.

 

Photo: Boy carrying brother by wyammadison on Flickr (license)

7QT–Things That Help

I’m back! Welcome to visitors from This Ain’t the Lyceum. I’m hoping to begin blogging regularly again this week, at least until baby #4 comes along in August. I hadn’t really intended to write mainly about mental health, but I guess that’s the biggest thing occupying my mind these days. So here are a few practical things I have figured out, read about, or learned from therapists that have helped significantly with my depression and anxiety.

1.  Mood charting. I’m sure there’s an app for this, but I do best with pen on paper, so here’s a handy chart you can print out. This particular one includes categories for depression, anxiety, irritability, sleep duration, weight and medication. I alter mine to include whether or not I’ve had a nap (see #5), and specifically how much trouble I’ve had being patient with the kids. I found it very helpful to have the different categories separated, rather then under one big “was I depressed today” box to check. When I differentiated between anxiety and depression, I discovered that anxiety was a bigger problem than I thought, and began working on that. Another chart to help you identify trends in your routine: The Well Mom Checklist asks some basic questions to help you take control of your day, like “have I eaten nutritious food today? Have I let others help me today?” It’s aimed at postpartum moms, but you can easily alter it to fit your situation.

2. Self-esteem exercises. I know, it sounds awful. But it works. I’ve written about these before, but it bears repeating: you believe it more if you say it in so many words, especially out loud. I’m also supposed to be starting each morning by saying “yippee!  Another day with Rosie!” but I confess that I haven’t worked my way up to that yet.

It helps when you have a nice brother who adds his own note at the bottom.

3. Make a list of everything you accomplished today–and don’t forget the little details! For example, don’t just write “took care of the kids;” write “fed the kids breakfast, changed their clothes, read books to them, brought M. to school, made sure he had his backpack and lunch, put the baby down for a nap, washed her face, said night prayers with them.” This is a really wonderful exercise to do at the end of a long day when you feel like you’ve accomplished nothing.

4. Make a little list of small tasks you can do in your spare minutes throughout the day, to give you little boosts of satisfaction in your accomplishments. With 3 small kids, I found that my free time comes in 5-minute portions, which I generally spent (a) wasting on Facebook, (b) running around thinking “what should I do? Should I cook? Should I pray? Should I clean? Should I nap?” until the kids demanded my attention, or (c) starting some big project, and then inevitably being frustrated when I had to stop it two minutes later to take care of the kids. My therapist suggested a way to make the best of these moments without stressing out:

•  Do something small, something you know you can get done in a few minutes, so you can feel like you accomplished something. Make a phone call, sort the socks, take the meat out of the freezer, answer a quick email, hang up all the jackets, etc.
• Do something big, but start out with the understanding that you’ll do it one step at a time, so you won’t get frustrated when the interruptions start.. First I’ll take out my dinner recipe. Next time I have five minutes, I’ll get the ingredients out. Next time, I’ll chop the vegetables. Next time, I’ll grate the cheese….
• Just sit and be present. Give yourself permission to rest for a couple of minutes, and focus your mind on the information your senses present to you, without judgement or analysis. This takes a little practice, but it works.

5. Naps. At various times in my life, a daily nap has been a necessity, not a luxury. I sleep for about two hours every day while the baby and the 3-year-old nap, and guess what? I don’t feel guilty about it! I used to, but that was before I started paying attention and noticing that every day I didn’t take a nap was a day I was cranky, mean, weepy, and depressed to the point of despair by the end of the day. When I started thinking of a nap as a mental health necessity, it became easier to make it part of my daily routine. Now I take a nap even when I don’t feel particularly tired, or when there’s something else I’d rather be doing, because I know it’s not being lazy, it’s essential self-care.

6. Bare Minimum Mode. I got this idea from the wonderful Jennifer Fulwiler. The idea is that you’re not just sliding into chaos, but purposefully choosing to cut out some non-essentials during certain seasons of your life. As Jen says,

I found it helpful to articulate those activities that were just too much for me right now, cut them out, and embrace that as a proactive strategy, rather than walking around feeling stressed about what wasn’t getting done.

Here’s a post she did with some more details. My version of Bare Minimum Mode includes using paper plates and plastic cups, and not worrying too much about having three, distinct balanced meals–as long as we’ve eaten something healthy today, and no one’s hungry, we’ll call it good.

7. A nightly routine. Every night for the last week, as soon as the kids are in bed, I go through this routine:

• chart my mood for the day
• check the “Well Mom Checklist”
• take five minutes for quiet mindfulness/being present

This has surprised me in two ways: (1) it feels wonderful and really helps me relax, and yet (2) each successive day it becomes harder to do. So many excuses!

Bonus: don’t skip your nightly routine in favor of staying up past midnight to argue about gay marriage on Facebook. That would be bad.

Please see Kelly at http://www.thisaintthelyceum.org for the rest of the Seven Quick Takes! I missed you, and I’m going to do my best to begin blogging regularly again.

Only Heaven

I like to sing hymns to my babies at night: they make nice lullabies, and they’re a good shot in the arm for an exhausted mama.  Tonight I was singing “…and I will raise you up, and I will raise you up, and I will raise you up on the last day,” and I thought sure–on the very last possible day.  I’m not trying to be funny here.  Sometimes it feels like God waits until the last minute.

My mother’s Alzheimer’s is progressing terrifyingly fast, and every morning she suffers through an attack of spiritual doubt and misery.  This morning she told me “everyone keeps talking about mercy…all about mercy….”  She couldn’t finish her sentence, but I thought I caught the implication: where’s the mercy for me?  I didn’t know what to tell her.  I believe in God’s mercy on the last day, but I don’t know why, for some people, He doesn’t send it earlier.  Where is the mercy in my brilliant, wise, eloquent mother spending the last ten years of her life in confusion and humiliation?

I know I’m missing something here.  I know–I believe–that a life of hardship can have more joy and peace than just the promise of heaven.  But I don’t see it right now.

Sometimes a crumb falls
from the tables of joy,
sometimes a bone
is flung.

To some people
love is given,
to others
only heaven

–“Luck” by Langston Hughes

Bloghop! Good Catholic Moms and Maternal Depression

“This is what I’ve always wanted!  So why am I unhappy?”

This was my dominant thought when I was postpartum with my first child.  My husband and I both came from large families, and we had joyfully planned for a life like our parents’: lots of kids, starting right away, and a stay-at-home mom.  I felt shocked, angry, guilty, and disillusioned when my first year at home with my baby was horrible.

To begin with, I was bored.  I didn’t really know what to do with a newborn besides nurse him, and I didn’t know how to keep busy while I was holding him, and I felt guilty whenever I put him down.  And I do mean every time.  He would be sitting there happily, staring at the pictures on the wall, and I would look at him and think, “I’m a bad mother.”  Looking back, these were two tell-tale signs of depression: irrational guilt, and uncontrollable negative thoughts flooding my mind.  And always in the background there was the meta-guilt of my inability to enjoy motherhood the way I had pictured.

Two years later, my dread of another postpartum like that one outweighed my fear of pills, and I agreed to try antidepressants a few days after I gave birth to my second baby.  I clearly remember my ten-day checkup at the midwives’, when they asked me about my depression and I realized that I hadn’t cried AT ALL since giving birth.  Even for someone not prone to depression, that’s practically a miracle!  (I’m not trying to recommend antidepressants as a cure-all for everyone, but I do hope that anyone in this situation will consider them as a real option.)  The second step, in my case, was therapy.  The greatest gift my therapist gave me was to help sort out an identity for myself, separate from that of a wife or mother.  This allowed me to invest some energy into finding fulfillment outside of the sphere of motherhood, which is crucial.  If you’re at all prone to depression, anxiety, guilt, self-comparison, or low self-esteem (that covers just about everyone, right?), investing your self-worth entirely into some ideal of motherhood is guaranteed to invite depression.

Not everyone’s experience will be like mine, and therapy and antidepressants may not be the right course for everyone; but the important thing is to realize that something external must be done about your depression.  You can not pray or will your depression away, because its origin is not in your failings.  Maternal depression can feel like it’s your fault, because motherhood seems like something that should come naturally and easily; but this is a fallen world, and what’s natural is not always easy.  Even if motherhood is what you’ve always wanted, there is nothing wrong with needing help.

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Thank you so much to Katherine at Half Kindled for hosting this much-needed conversation!  I’m really thrilled to be a part of this.  Please read what my fellow bloggers have contributed at A Knotted Life, Call Her Happy, Half Kindled, This Felicitous Life, and Mama Needs Coffee.

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A few resources I have found helpful:

• therapy: ask your midwife or OB/GYN for a recommendation.  They may be able to give you the name of a therapist who’s been recommended by other patients in their practice.
• self-help books: I really appreciated Gregory Popcak’s book, God Help Me! This Stress Is Driving Me Crazy!, which is an extremely helpful and practical mix of tried-and-true psychotherapy techniques and spiritual advice and encouragement.  (I have a few reviews of Popcak’s books in the works.)  I haven’t read Aaron Kheriaty’s Catholic Guide to Depression yet, but it’s been recommended to me by so many trusted friends that I feel comfortable passing it on to you.  I hope to tackle it soon and review it for you.  I find this blurb extremely encouraging: “…the confessional can’t cure neuroses, nor can the couch forgive sins.  Healing comes only when we integrate the legitimate discoveries of modern psychology and pharmacology with spiritual direction and the sacraments….”
• NaPro technology.  I know many people who have been helped by NaPro, which specializes in helping women overcome infertility, postpartum depression, and other reproductive problems through natural and morally permissible means, specifically through the Creighton method of natural family planning.  I know a few people whose postpartum depression was linked to low progesterone, and NaPro doctors were able to prescribe progesterone supplements that changed their lives. Here is a website for locating NaPro doctors in your area.
• For those of you who are nervous about antidepressants during pregnancy or breastfeeding, I found these studies from Mass. General Hospital, which were given to me by my midwife, extremely comforting.