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

It Is What It Is

Here’s a thought that attacks me all the time: I’m not doing enough. I should be spending more time with my mother; I should spend more one-on-one time with the kids; I should be praying better, and more often; I should be able to handle a long day without losing it; I should be able to manage without having my husband step in and rescue me all the time.

At first, I tried to counter this thought by arguing against it. I would tell myself that I really was doing enough; or I would say that yes, it wasn’t enough, but I had good excuses, and I would do better later. Neither of these worked; I couldn’t convince myself that I was giving my all, but I couldn’t realistically see myself doing more, either. I used to torture myself with the thought that I was not actually trying my best, because there were some moments–a lot or a few, it didn’t matter–when I was not trying as hard as I could have. This led to a vicious cycle of self-pity and self-accusation: I knew I could theoretically try harder, but even with my current minimum of effort I was a mess; so what was I supposed to do?

Here’s the answer: it is what it is. The fact is, you are not doing all you could possibly do. It could always be better. But here’s an equally important fact: just because you should, ideally, be doing something, doesn’t mean that it’s possible. Yes, I should be spending more time with my mother; but the fact is, I just can’t. For so many reasons, I can’t. This means that, given the situation, thinking about what I should or could be doing is irrelevant. It is what it is. Give yourself a break: this isn’t an excuse, it’s just reality. There are enough things to worry about without wasting your energy on things you can’t change.

(I had this insight while I was in therapy, not so much from my therapists, but from the thought processes they helped me start. I’ve found that this is the best thing about a good therapist; she doesn’t give you the answers so much as ask the right questions, and guide you to answer them yourself. I know, this sounds like a cop-out; but if you’ve ever tried sitting down by yourself and thinking about why you do a certain thing, or what part of your life needs to change, I bet you didn’t get very far. Having to do it out loud, in front of someone, really helps you kickstart the process!)

Linkup! How to Tell if You’re Depressed

Hope for the future.2

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.”

 

8580811313_69def23188_z.jpg

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.

self-esteem

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.

Virtue, Luck, Mental Health, and Pedophilia

Marble, Feet, Legs, Hands, Limbs, Art, Sculpture, Stone

In All the King’s Men, there is a tender scene where teenage Jack Burden and Anne Stanton find themselves alone in the house after a rainstorm and almost, but not quite, make love for the first time.  For some reason he can’t explain, Jack can’t go through with it, because it doesn’t seem right somehow.  Then his mother comes home unexpectedly, and he doesn’t get a chance to change his mind.  In retrospect, though, Jack decides that it was his great virtue that prevented them from sleeping together:

I suddenly had the feeling of great wisdom: I had acted rightly and wisely….And so my luck became my wisdom…and then later my wisdom became my nobility, for in the end, a long time after, I got the notion that I had acted out of nobility….and frequently, late at night or after a few drinks, thought better of myself for remembering my behavior on that occasion.  (p. 447)

This really hit home for me; how many actions or decisions do I pride myself on, thinking they were a result of virtue, when actually they were just a result of luck, or my natural inclination, or my particular psychology?

It is only at the end of the book, when Jack has come to forgive his father for betraying the trust everyone had in his spotless virtue, that he realizes the corollary to this principle: not only can virtue really just be luck or disinclination, but vice can actually be the result of an excess or perversion of virtuous intentions.  “A man’s virtue may be but the defect of his desire, as his crime may be but a function of his virtue.” (p. 660)

I’ve always loved this quote, and recently I realized that it’s very similar to something C.S. Lewis says in the preface of Mere Christianity:

No man, I suppose, is tempted to every sin.  It so happens that the impulse which makes men gamble has been left out of my make-up; and, no doubt, I pay for this by lacking some good impulse of which it is the excess or perversion.

He goes on to point out that God judges us, not by our outward nature–our inclination either to “niceness” or “nastiness” of character–but by what we freely choose to do with the personality we’ve been given:

If you have sound nerves and intelligence and health and popularity and a good upbringing, you are quite likely to be satisfied with your character as it is….You are not one of those wretched creatures who are always being tripped up by sex, or dipsomania, or nervousness, or bad temper….You are quite likely to believe that all this niceness is your own doing….it is hard for those who are ‘rich’ in this sense to enter the Kingdom….But if you are a poor creature–poisoned by a wretched upbringing in some house full of vulgar jealousies and senseless quarrels–saddled, by no choice of your own, with some loathsome sexual perversion–nagged day in and day out by an inferiority complex  that makes you snap at your best friends–do not despair.  [God] knows all about it.  You are one of the poor whom He blessed.  He knows what a wretched machine you are trying to drive.  Keep on.  Do what you can.” (Book 4, Ch. 10)

Let’s talk about “those wretched creatures” who have to deal with something much more seriously consuming than an inclination to anger or vanity: sexual disorders.  It’s really upsetting to see how many Christians don’t realize that same-sex attraction is an inclination, not a sin in itself; that God (and the Church) does not judge anyone for bad inclinations, but only for acting on those inclinations.  Same-sex attraction is like any other inclination or temptation; something you did not choose for yourself, but which you have the responsibility to conquer.  And here is something I’ve only realized recently: the same is true of pedophilia.  I recently came across a heartbreaking website called Virtuous Pedophiles, which functions as a support group for people with pedophiliac inclinations who find themselves alone in their struggle to stay chaste.  The intention of the website is not only to function as a support group, but to spread awareness of this horrible struggle; to teach non-pedophiles that pedophiliac urges themselves are not sins or crimes, because, like other temptations, they are beyond our control.  Understanding this is the key to helping pedophiles resist temptation and keep children safe; because only if we understand that there is such a thing as a “virtuous pedophile” will we be motivated to give him the help he needs.  As it stands now, most people would recoil if someone confessed pedophiliac urges to them, and many therapists would feel obligated to report them to the police as potential molesters.  How can pedophiles get the moral support and psychological help they need, if we act as if temptations and urges that appear unwanted in their minds are just as bad as actual molestation?

God help those of us who were blessed with healthy psyches, to not attribute our luck to virtue; and God help those who, as my husband pointed out, were saddled with bad self-esteem and attribute their bad luck to moral shortcomings.  Most of all, God help those of us with really “wretched machines” to work with, who need help and prayer more than anyone.

P.S. As I was writing this, I discovered a wonderful post about “Virtue Privilege,” where the author discusses the ways in which virtue without empathy can lead to a lack of mercy.  Here is my favorite part:

Only when we learn to differentiate between the accidents of our birth and upbringing and the truly universal will we find grounds for communion with one another. While I may not be tempted to the things that tempt you, I know what it is to be tempted. While my suffering has different causes and effects than yours, I do know what it is to suffer. Whatever our advantages, we know, or should know, all too well how easily we fall prey to our own pet vices. We need not be able to imagine how a woman could believe herself to be doing good while working in an abortion clinic—we need only be able to remember how often we ourselves have been tempted to ignore or deny a “lesser evil” out of disordered but sincere love for something or someone.

Preventative Maintenance for your Marriage

Speaking of marriage and therapy, how do you feel about couples therapy?  I used to think therapy of any kind was only for people with serious problems–marriage on the brink of divorce, bipolar disorder, death of a child, etc.  I discovered that therapy can not only help you with “smaller” problems, which aren’t as dramatic but can do plenty of harm on their own, but it can be wonderful preventative maintenance.  There’s nothing wrong with making sure that things are running smoothly, and bringing little problems out in the open before they turn into trouble.  I really loved this article (shut up, I read it in the waiting room) about Dax Shepard and Kristen Bell’s marriage:

Kristen: You do better in the gym with a trainer; you don’t figure out how to cook without reading a recipe. Therapy is not something to be embarrassed about.

Dax: I noticed an actor and her husband on [a recent cover of a celebrity tabloid] that said, “In Couples’ Therapy!” The clear message is, “Oh, their marriage is ending.” There’s such a negative connotation. In my previous relationship, we went to couples’ therapy at the end, and that’s often too late.

What a great point–nobody expects you to know how to parent, how to eat right, how to exercise, or just about anything else, without learning how.  Why is marriage any different?  Why do we expect people to know everything they need to know about marriage on their wedding day?

My husband and I were lucky enough to find a good counselor through a recommendation from my midwives, but ran into some problems with her after a while because her secular worldview was really starting to clash with ours.  Then we learned about counseling services from Catholic Charities.  Not only are you receiving counselling from a trained professional, but he’s a Catholic, too!  (Our counselor isn’t 100% orthodox, but it is SO helpful just to have someone who’s on the same page with you, so you don’t waste all your time explaining that no, birth control isn’t an option, and no, you’re not being oppressed by the Catholic patriarchy.)  And they have a sliding scale payment system–we only pay $20 a session.  What a gift.  Anyone else have tips for finding a good counselor?