Wednesday, February 29, 2012

Get mommy a Valium.....

When I wrote the title to this blog, I got a correction for not capitalizing "Valium". HAHA! I guess when mommy's little helper is such a big help, it's gotta be capitalized. (Disclaimer: I have never taken Valium. Lorazepam, yes, but never Valium!)

It's been a long couple of weeks. The two demons we battle in our household, depression and anxiety, both reared their ugly heads and threw everything off balance, as they are inclined to do. These two monsters can really throw everyone and everything for a loop, and, worse, they are difficult to get under control. Sure, there are myriad medications to treat both afflictions, but unlike many other illnesses, these also benefit from the help of a great counselor. One would think getting help would be easy, especially in progressive Seattle, but what I've learned in the past week has not only shocked me, but made me realize how little we, as a society, are doing to help those who suffer from mental illness.

Now, let me say, I HATE that term. Mental illness. Mostly because it conjures up images of a homeless old bag lady feeding pigeons in a park. She must be mentally ill......but the truth is, one in four adults and one in ten children have some form of mental illness (National Alliance on Mental Illness). There's a funny saying "Mental illness affects one in four adults...look at your three best friends. If they seem fine, it's you!" But the truth is, that's a LOT of people. And that includes a lot of disorders, not just depression and anxiety, but bipolar disorder, ADHD, eating disorders, OCD, schizophrenia and more. Scared yet? You should be, because it's a bigger problem than most realize. And you shouldn't be because, with the right care, many mental illnesses are treatable and most people seem "normal". I hate that term, too. Normal. What is normal?

I can tell you, as someone who suffers from anxiety, normal is when you feel "balanced" every day. When, through a combination of diet, medications, exercise, counseling, or whatever works for you, you feel steady and even-keeled every day and can handle what life throws at you without falling apart, that's your normal. Looking back, I realize I've suffered from anxiety from as long as I can remember. I can't count the number of "stomach aches" I've had that prevented me from partaking in an activity, trying something new, or having an otherwise fun experience. I moved a lot growing up and every first day of school was fraught with anxiety, tummy aches and tears. I vividly remember fifth grade, starting another new school, when I became acutely aware that it would not be "cool" to cry in front of my new class. I held it together and from that point on, I managed to get through it, but that first day of school was always the hardest.

In high school one memory that stands out for me was a planned trip to a theme park with my friends. I got ready, was picked up by my friend who was driving, and we swung around the block to pick up another friend. In that amount of time, I had sealed my fate....the stomach ache was starting, my heart was racing, and I asked her to please take me back home because I was "sick". I ended up missing a really fun day and I was kicking myself before they even pulled out of the driveway after dropping me off, but I was also relieved and "safe".

As an adult, I once was invited on a hike with several women friends. I didn't know most of them well, and I had the usual anxieties about being in a group of people I didn't know, but the thing that made me cancel the trip at the last minute was the irrational fear that I would not be able to "keep up" with them on the hike and what might they think?

A lot of things changed after I had my first child. Suddenly I was the mother bear protecting my cub, so many of my usual daily anxieties were replaced by caring for my baby, and the general busy-ness of being a mother.  I felt a lot more secure, and a lot more outgoing, as I formed a group of friends with new babies. Things seemed to be going along swimmingly until.....

I had my second child. And somehow, having two children seemed a lot "harder" for me than for my friends. Everything just seemed to take so much effort and I was exhausted all the time. Some days, I would hand the baby off to her dad for no other reason than that my arms were so tired, I thought I'd drop her. I knew something was wrong and so I went to the doctor. And thus my medical nightmare began.

It took two years to get properly diagnosed with a thyroid disorder. In that time, I had 25 different appointments, numerous procedures, and a lot of worry and stress. Once I was diagnosed and properly treated, I started to feel better but still "off". As that "off" feeling dragged on, I realized it might be something more but I didn't know enough about anxiety to realize that might be my problem. Also, all I ever heard about was "depression and anxiety" as the two often go hand-in-hand. And I didn't feel depressed at all!

After a couple of especially bad episodes of anxiety, I ended up in the ER one night. I couldn't breathe, my arms and legs were numb and I felt like my chest might explode. After checking my heart and vital signs, the doctors said I was "fine" and brought in a social worker to talk to me. She asked if I had a good support system at home and discussed postpartum depression (which we both agreed was not the issue, even though it likely could have been since my baby was just several weeks old). I laughed at the "support" comment, because, at the time, I was teaching parent/baby classes at the same hospital, and providing support to groups of 50 or more moms every week. I could stand confidently in front of a crowd and facilitate discussions about diapering and sleep problems, but I still could not recognize anxiety in myself.

Ironically, I left with a prescription for Lorazepam, which I loved more than life itself. But I also knew it was an addictive drug, so I took it so sparingly, and would even break the tiny tablets in half, which resulted in a pile of dust in my palm that I would gobble up in the vain hope that a few crumbs of anti-anxiety drug would get me through a particularly rough patch. At one of my annual physical exams, my nurse listened patiently as I explained my relationship with my beloved Lorazepam, and she suggested that I take one whole pill a day for a week. ONE WHOLE PILL? Not a tiny pile of pill dust? Well, ok, then. I'm not embarrassed to say it was the best week of my life, as far as my physical self felt. I actually felt "normal" for the first time in YEARS. I remember this tiny feeling of hope creeping back; optimism, enthusiasm, excitement for life. Addicting drug? Bring it on!

But of course my pragmatic nature prevented me from continuing to take it every day, because it was bad enough I was Anxious Mommy, I didn't also want to be Rehab Mommy. So, I went back to the pill dust once in a blue moon and prayed for my stupid anxiety to just END already.

And so things went along "normally" punctuated by episodes of anxiety, which I was often certain were medical emergencies, yet nothing ever panned out. My labs were normal, I had great blood pressure, I was healthy and "normal". But I wasn't.

Finally, after realizing how much of life I was missing due to all the physical symptoms I was having, I decided to see my doctor (again!). By this time I had learned a lot more about mental illness and knew I was probably suffering from anxiety. And I was DONE with it. Taking medication, which I was resistant to for YEARS seemed like the most sensible option, although, ironically, my anxiety about side effects was what prevented me from embracing this option. Swallowing that first pill was, for me, a huge victory, because I was taking a CHANCE on something without knowing the outcome. And the heavens parted and choirs of angels began to sing....ok, maybe it wasn't THAT dramatic of a change, but, then again, it WAS!

I could finally just "be". I still looked like the normal mommy I had been pretending to be (except, maybe, for the 40 plus pounds I gained on the first medication I took. Which totally sucks. But honestly, the trade off was worth it.) Most of my friends had no idea the extent to which I suffered every day with the heavy cloak of anxiety that dragged me down while I struggled to maintain the appearances of "normal". So, perhaps my transformation wasn't as life-changing to them as it was to me (duh) but I have never second-guessed my decision.

Ok, that's a lie. I decided after a couple of years on meds that I could try to wean off. My doctor agreed so I started the gradual wean. At first I noticed I was more irritable than normal. As in, my child's breathing irritated me. And if they interrupted me to bring me an "I love you" picture they had drawn while I was doing something else, I might explode in a rage. In fact, I often raged at my kids while knowing in my head the offense did not warrant the punishment. And yet, I couldn't make my body stop overreacting, stop feeling irritable, stop.....everything. I would lay in bed at night and actually FEEL my adrenaline, as though a slight vibration was coursing through my veins (I once described this to a doctor as my body "buzzing like there's a motor running"). In short, I felt horrible, so I went back on the meds.

Another time I tried to wean off my meds, it was only a matter of days when I felt that old familiar irritability creeping over me, and one day I just felt completely hopeless. I remember having a good long talk (and a cry) with my husband. He encouraged me to just keep taking the meds - as long as I needed to, and maybe forever. I cried "You mean I have to take a pill to be nice? I have to take drugs so I'm not a bitch?"

But that's when I really took to heart what my doctor said: if you had diabetes or cancer or any other life-threatening illness, you wouldn't hesitate to take medication to treat it. And yet, we resist medication for mental illness because it seems "weak". Well, I take medication and I am anything but weak. I'm stronger than anyone or anything. Because I faced my illness head-on and I'm fighting it.

I tell this story to illustrate how common and prevalent this problem is. Everyone in my family experiences some form of depression and/or anxiety and we all fight it in different ways. Sometimes, it requires a total and complete break from the regular routines of daily life to step back and figure out a new way. Other times, it might be a few months of counseling. We talk about it a lot, and nothing is taboo. I truly believe that one of the biggest reasons we still have a stigma about mental illness in our society is because we don't talk about it enough. When I recently attempted to find a group for adolescents experiencing depression, I came up empty. Not ONE group in this whole state that isn't focused on drug and alcohol issues as well. Which isn't surprising since nearly everyone who suffers from depression and/or anxiety will eventually self-medicate - if not with drugs or alcohol, with self-harm or destructive behaviors. When you hurt inside, you will do anything to stop it.

But how wonderful would it be if we talked about mental illness in parenting classes, and in schools where parents could become educated to see the signs early and intervene? My kids and I watched a show on TV last night about bipolar children. It was eye-opening for sure - and heartbreaking. No one wants to deal with mental illness, just like no one wants to get cancer. It just happens and it sucks. When your child suffers, you feel some guilt about "passing on the gene". What if someone told you that if you have a diagnosed mental illness, your child has a higher percentage of having one too? For instance, if a parent has bipolar disorder, the chances that their child might inherit the disorder can be up to 30%. If both parents have it, the chances increase to up to 75%. And if you have one child with bipolar disorder, chances are up to 25% that your subsequent child will have it, too (McGuffin, P. et al, Arch. Gen. Psychiatry).

If someone told you these statistics before you had children, would you choose not to give birth knowing you might pass mental illness on to your children? Likely not, but if someone told you your child had a 75% chance of having cystic fibrosis because you and your husband both carried a recessive gene, would you choose to have children? My point is, mental illness is a serious disease and though there are treatments, there is no cure. If you think mental illness is not as "dangerous" as other diseases, think of this: intentional self-harm (suicide) is in the top ten causes of death in the world (Centers for Disease Control, based on data from 2009). So, which scares you more - heart disease or suicide?

I truly wish there were support groups in EVERY single middle and high school where kids could go to get help for depression and anxiety. But there are two big problems with that: one, most kids don't understand or recognize their pain as mental illness and most parents don't want to accept it as a possible explanation for their child's problems. And sadly, some parents are just too busy to see the signs. Even the most diligent and connected parents can miss the signs. Adolescents are not just mini-adults and depression can manifest very differently in them. Unlike adults, teens can often seemingly go "in" and "out" of depressive episodes. Adults tend to become depressed and stay there, sinking deeper and deeper if they are not seeking help. Teens can waver back and forth. They might complain of lots of physical symptoms ("my stomach hurts," "I have a headache"), sleep a lot, and lose interest in anything. Their grades might slip, but that's not always the hallmark of teen depression. And a child with anxiety might act out, have tantrums, and develop repetitive behaviors that are self-soothing. Because children go through "stages", parents often chalk these changes up to something that will pass in time.

I work in a special education classroom, and it's heartbreaking to see a child who suffers from ADHD who simply cannot control his body. I remember a particular boy I worked with once who was rude and belligerent to me. I did not like working with this boy and would "pass" him off to the other teachers whenever possible. The following year, I worked with him again and he was completely different. Polite, funny, sweet. The difference? He went back on ADHD meds after being off for a year. It was like night and day. His "real" self seemed to emerge and he was a creative, smart and kind person.

There is another side to meds, of course. Many children are being diagnosed way too quickly and easily and doctors are dispensing ADHD meds like candy. As a parent, I have to decide whether or not to medicate my child. When my kids were babies, I didn't even give them infant Tylenol unless they were running a fever. Give Benadryl on a plane trip so the baby can sleep? You might as well have asked me to give them crack. No way was I going to drug my child. My son was once prescribed infant antacid medication for reflux. When I opened the bottle, it smelled like alcohol and when I read on the label that it did contain a high percentage of alcohol, I freaked out and refused to give it to him. I was very anti-meds and it wasn't until I accepted them for myself that I could even consider giving them to my kids. I once read an article that said if we'd had meds years ago there never would have been the paintings of Picasso, or the prose of Shakespeare, but I don't believe mental illness is a precursor to genius. I also don't think taking meds changes the soul of a being and we are who we are meant to be, regardless of our medications. My kids are creative, smart, funny, thoughtful, beautiful souls, who take medicine for an illness.

And here's a dirty little secret.....if you're still reading this and think "thank goodness I don't have to deal with THOSE problems," know that prescriptions for antidepressants have more than doubled in the past decade. Most of my adult female friends are on an antidepressant. Many people are taking them without a diagnosis of depression or anxiety, and there are risks and side effects that should be carefully weighed, especially before taking these drugs without a diagnosis (and trying other methods for treating symptoms). But if you are truly experiencing symptoms of depression and anxiety, the healthy thing to do is to see a qualified doctor, and make a careful decision about taking medications. And count your blessings - we have evolved enough as a society that we can now freely talk to our doctors about mental illness without the taboo that used to prevail, though we still have a long way to go. Before antidepressants, alcohol and drugs were often self-prescribed "medications".

So, when my child wants to find a group of people to talk to who are "just like me", and I know they are all around her, but there's no organized group, it makes ME sad that I can't provide that for her. And maybe by talking about the prevalence of depression and anxiety (and other mental illness) we will open up more to the option of having more support groups and more education and more help for people who are SICK, not crazy. But not talking about it? Not being comfortable, wishing it would just "go away", or thinking it's a problem that affects someone else? THAT'S crazy.

(Footnote: If you are having feelings of prevailing sadness, worthlessness, hopelessness, feeling constantly "on edge", being overwhelmed, having unexplained physical symptoms, acting out in ways you never have before, feel scared or alone, PLEASE talk to your doctor and get help. There IS help and there IS hope.)


jeff said...

Great article! - you should get this one published in Family:)

Anonymous said...

I came across your post because I was going to use the word Valium in something I was typing and I wanted to know if it should be capitalized or not! LOL I'm so glad I did! Thank you for this article! It has definitely turned on a light bulb! :)