Electroconvulsive Therapy: what I wish I’d known

electric shock.jpg

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

Wonderful things that happened after my crisis

Long story short: after my fourth baby, I went into a tailspin. I tried a couple different medications, and Wellbutrin made me suicidal, so I checked into the hospital. I spent ten very good days in the psychiatric ward and had electroconvulsive therapy. (See my article about the spiritual effects of it here). After that I was supposed to remove stress and responsibility from my life for a while, so that my brain would have time to build on the changes from the shock therapy and establish a more positive thought pattern. So we attempted to free me up from some of the stress of living with a 6-year-old, 4-year-old, 2-year-old, and newborn, in my parents’ house, with my mother who has Alzheimer’s. Ha ha! That didn’t work. Instead my brother and sister-in-law took the three big kids into their home, and I moved into my sister’s house with my husband and newborn to recover.

What a mess! Except it wasn’t. Here are some wonderful things that God did in my family’s life as a result of this crisis.

  1. My family came together. They have always been loving and supportive, but my breakdown provided an opportunity for them to get even closer. There were several family meetings, in which my parents and all 7 of my siblings got together to help us figure out what to do, and how they could help. Everyone gave what they could: babysitting, money, shelter, driving, prayer, and help figuring out logistics and planning. And afterwards, when things were a bit more stable, they kept up the group conversation, to keep us all in touch and within reach for mutual help.
  2. I got wonderful one-on-one time with the baby. Instead of being the littlest of four, always set down so I could feed the big kids, or carried like a football while I did the laundry, she got to have that only-child experience of being the center of my universe. I think she’d be fine either way,  but it was nice for me! I had similar experiences with the other kids; my family’s help made it possible for me to spend a glorious hour outside with my two year old,  enjoying the wind and the shadows and the trees and the mud, and give my other kids their heart’s desires: my undivided attention to their very favorite Legos and ponies, respectively.
  3. We experienced life with my sister’s family, who are called to a special charism of poverty and generosity. We learned to live with less stuff, waste less, and pay special attention to the liturgical seasons. We learned to live in a sort of community, everyone contributing to the household and accepting anyone who showed up.
  4. We lived out of our suitcases for three months. It actually helped me appreciate what I had, and appreciate what it would be like to be dirt poor–using both sides of every paper, saving boxes to keep my clothes in, piecing together my sewing scraps to make a wall hanging because I had no pictures. And I missed very little of the massive pile of stuff I left at my parents’ house. We’ll see how quickly I can keep this new-found minimalism, but so far in our new apartment we’ve managed to get rid of a lot of junk and live with less than we’ve ever done.
  5. My family’s generous actions had good results for them, too. My sister, whose kids are almost all grown, got to have a baby around the house again; my other sister, who did a heroic amount of babysitting for me, told me that she’d been helped out a lot at another stage in her life, and it was nice to have the opportunity to pay it forward and help someone else. Driving us and our kids back and forth for visits and moving gave my siblings opportunities for long-awaited visits with each other. Siblings got to catch up, aunts and uncles got to know nieces and nephews, cousins got to play together. Yup, one big long crisis-fueled family reunion!
  6. My children had the experience of living at my brother and sister-in-law’s house. They came back home with all sorts of wonderful habits, like brushing their teeth and following along at Mass and clearing their plates after dinner, and all sorts of other things that I totally would have taught them, any day now. They learned to play with kids of different ages and how to adjust to a different family’s schedule.
  7.  _I_ learned how resilient and grounded they are. My kids’ maturity and patience in dealing with all the changes (along with my sister-in-law’s kind updates on their little triumphs and achievements) was really encouraging to me as a parent.

There was no avoiding this huge disruption, and I thought my family and I would barely survive it. God had plans to bring a lot of unexpected good out of it. Thank you, God.

Find the rest of the 7 Quick Takes here.

Renoir onions

“Onions” by Pierre-Auguste Renoir, 1881

 

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.

Making Peace with the Minimum

Barbie, Pregnancy, Doll, Education, Child, Childbirth

Remember the “Best Odds Diet” in What to Expect When You’re Expecting? As I recall from my anxious first-pregnancy reading, the idea was that you could eat junk food or you could eat healthy food, but if you really wanted to do everything you could for your baby, you would eat as healthily as possible. If you had a choice between a piece of whole-wheat bread and a piece of organic, whole-wheat, whole-grain, homemade, all-natural bread, why would you choose something with less nutritional benefit for your baby? Why eat something good when you could be eating something perfect? Didn’t you want to give your baby the best chance at perfection that you could?

I think I threw the book out when it suggested that it was okay to treat yourself once a month or so, but you should really try to make your indulgence something like homemade, fruit-sweetened carrot cake or a bran muffin. Sometimes this mindset is so obviously ridiculous that it’s easy to dismiss. But sometimes, it’s so subtle and logical-sounding that it can really get a hold on you. Do any of these sound familiar?

I just checked her diaper and it’s only a tiny bit wet, so I really don’t want to change it now. But now that I know, it would be wrong to wait–I’d be knowingly letting her tender skin come in contact with pee, and maybe she’ll get a rash! I better change it right now.

Maybe he has this inexplicable diarrhea because he drank water from that mud puddle! I could have stopped him but I didn’t. I figured “usually I stop him, but one time won’t be a big deal.” But what if this happens to be the one time that really mattered?

I’m sure I buckled her into her carseat correctly. But what if I didn’t, and she dies in a crash? I should go double-check, or triple-check. That would be the best thing for my baby. After all, I want to give her the best odds at survival.

Maybe you’re a normal person, and this doesn’t sound familiar. Or maybe you’re someone prone to worry, scruples, or obsession, and this is your life. But here’s a third option–maybe you’re normally pretty balanced, but right now you’re pregnant, or postpartum, or breastfeeding, and you’re not thinking logically. This is no way to live your life. It only ends in despair and self-loathing.

I recently saw a meme that rejected the mantra “fed is best.” Fed with formula is minimum, it argued, but breast is still best. Why would you want to give your baby the minimum when you could give her the maximum? Now, how you feed your baby is a lot more important that the little things I mentioned above, and breastfeeding is certainly best in itself; but even so, things get bent out of proportion when you elevate the feeding decision above everything else. If you look at it simply as a choice between what’s okay (formula) and what’s best (breastmilk), the choice is obvious. But that keeps you from weighing other considerations, like whether your mental health is up to the challenge, or whether your physical health is up to the loss of sleep. It’s very unlikely that you’ll be able to make a choice that’s optimal for every single aspect! Life just doesn’t work like that. Don’t let your mind bully you into thinking you have to make the best possible choice, every time. Don’t let the perfect be the enemy of the good.

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.”

 

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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

Seven Quick Takes
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.

Dont Panic, Panic, Button, Stress, Worry, Fear, Stop

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.

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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.

listofaccomplishments

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.

Self Esteem and Scripts

Self Doubt, Depression, Confidence, Psychology, Esteem

If you had told me 10 years ago that I’d end up doing “self esteem exercises” every morning, I would have laughed.  I grew up convinced that anyone who advocated for raising self esteem in children was trying to do away with the hierarchy of natural talent, and would end up trapping students on a feel-good plateau of mediocrity.  This way of thinking wasn’t entirely wrong: recent studies have shown that children are more successful when they are praised for trying hard, rather than for being smart.  But somehow it ended up, at least in my experience, with parents denying or ignoring the need to praise their children at all.  I was lucky enough to have supportive and appreciative parents; but a dear friend of mine grew up thinking that he was stupid, because he received nothing but criticism at home.  As an adult, he discovered that many of his difficulties were due to an undiagnosed and untreated disability, and that many of the talents and skills he took for granted were actually in high demand and esteem outside of his family.  He has found out that his parents were actually very proud of him but never got around to telling him that.  He is doing well, but still struggles against the self-doubt and feelings of deficiency that have been programmed into his brain.

This is why, at the risk of giving my children big heads, I work hard to praise their efforts and natural talents alike, to notice and point out their achievements, to be encouraging about their failures, and to tell them point-blank that I am proud of them, and that I love them.

This last point–explicitly telling the kids how I feel about them–brings me back to the self-esteem exercises, which were recommended by my counselor.  Like Gottman’s scripts, they sound awkward at first, because they’re so obvious and cliche (my personal version is “I am good.  I am a daughter of God.  I deserve to be loved and respected”); but that doesn’t make them unnecessary.  Yes, I know that God loves me, just like a child knows that his parent loves him; but it is so much easier to believe it when you hear it out loud!  In the same way, I know that my husband cares about me and is listening; but it helps so much if he makes sure to express it with a script like “how was your day?” or “yeah, that sounds rough” or “poor baby” or just “uh-huh.”  Silence can be misinterpreted; saying something, even if sounds unnatural, clears things up.  Whether you suffer from the criticism of your family and peers, or just the lifelong crushing weight of original sin, it’s important to be reminded, out loud, that you are loved.