Double Standard - or why I want to talk about postpartum depression and ankylosing spondilitis

Hi there.

So there’s something I’ve been needing to talk about here because it feels like this elephant in the room, or at least in my room. With this whole kick about me being honest and authentic, this elephant’s growing like one of those freaky rubber animals Seth got for Christmas that expand in water. I’ve spent more hours than I care to admit trying to write, and more importantly live, like the elephant isn’t here or at very least is small-ish enough that I can skirt around it on my way to the kitchen. I also have realized anytime I try to get all writer-y and think more about appearing insightful and ‘deep’ to anyone who is reading this blog, my ability to write anything cogent gets sucked out the window…I can almost feel it leaving. So before I think the better of it and  stop writing here I go.

I am ill. I have one illness that I have no problem discussing. It’s ankylosing spondilitis and while you may have a hard time pronouncing or spelling it (don’t worry – happens all the time) I can easily talk about it most of the time. I don’t like that I have it; being an auto-immune disease means it acts all weird sometimes and I have relapses (boo – I’m a cripple) and remissions (YEAH – triathlon here we come). It’s influenced my life dramatically and I can usually say, that as whole person, I am better for having it. It’s a constant teacher in my life. I’m not ashamed that I have it. But there’s another illness that I don’t talk about much. It’s the thing that prevents me being honest with myself, and that is something I’m trying to change because I know I need to – for myself and others.

My other illness is depression. I don’t mean I’m depressed; it’s not ‘I’m lonely, in physical pain, just went to a brutally sad funeral and am justifiably sad’. I mean depression in the DSM-IV kind of way; the mental illness kind of way. It’s a lot like ankylosing spondilitis. It has ups and downs, it has remissions and relapses. There are things that make it  better, things that make it worse. If I let it, it also can be a powerful teacher. In all likelihood, it’s also something I will deal with for the rest of my life. I have resisted admitting to myself that I have a mental illness. I feel much more okay with admitting I was sick after having Silas, that the postpartum depression was devastating, that I’m just recovering from  that still – but that wouldn’t be honest. A lot of what has lingered after that Terribly Awful Time was messing about before I ever had kids. It was just so familiar that I couldn’t distinguish it from myself, or wouldn’t.

I don’t know if I’m currently depressed. I feel sad a lot of the time, but winter does that to me. I’m sad for my cousin, my AS is acting up, and I miss my friends and family a lot. ‘Normal’ people would feel sad too. I am still on antidepressants. Also, I’m weaning off anti-anxiety medications  prescribed five days after Silas was born; when I ended up in an emergency room entirely lost and unrecognizable. I left there with a lot of medication. A lot a lot. These anti-anxiety medications are notoriously difficult to wean off of. They cause nasty withdrawal, particularly if you accidentally decrease by 55% instead of 95% (funny story for later). This past year has been fraught with trying out new medication and ending others, decreasing some, increasing others. Essentially a lot of trial and error with mood altering substances….of the prescribed kind. Sounds fun right? Its’ been scary, exhausting, damaging, and sometimes really funny – later, always later. It’s been something that, for the most part I’ve hidden away. I’m more than willing to talk to you about my physical illness, but not my mental illness – and I think we all know why. There is stigma – so much of it that sometimes when I visit a shrink, or fill my prescriptions and I see the pharmacist’s eyes widen just as he looks at my prescription, back at me, then at my kids, that I feel like I was made wrong, like there was a mistake.

Mental illness is hard to face, for so many reasons which I promise I’ll talk about more. I’ve been wanting to bring it all up before now. Really I have. Some of you know lots, some of you know bits and pieces, and some of you know nothing all this. Please understand I just couldn’t for a long time. And then to go back and say, so, about all those dr’s appt’s, about all that time Ryan was home after Silas was born….ya, it was, well, it was something entirely differently and we kind of lied and I’m sorry but I just couldn’t talk about it. But I have to. It is so healing for me to do so, but what compels me right now is the fact that as some you read this, you’re saying to yourself ‘I had no idea’. When I’ve told people about my illness, especially the bits I manage to squeak out about after Silas was born, I get that response often. Truthfully I find it shocking because I feel so transparent and obvious, but I’m not calling you dull…it just always comes as a surprise.

It’s because of that response, the fact that so many of you would have no idea, that I realized I needed to speak up now.

This week one of Ryan’s colleagues – an experienced RN, great to work with, kind, friendly, and well liked – came into her workplace on a stretcher. She had overdosed on medications that only someone with her experience would know to take.  She knew exactly what she was doing. It was a completely sure-fire way to end things, and she would have seen a lot of failed attempts in her time. There is not a resuscitation team on the planet that could have saved her.

All anyone at work has said is they had no idea. 

Don’t freak out now, I’m not suicidal. This is not a cry for help (besides, crying was so yesterday, I’m totally over that now).

But I have been suicidal, and I will be again…because that’s part of this illness. During university I wished every Feb-ish that I would stop existing. It took looking through old journals to start to see the trend. Sunlight decreases and so does my will to live. I’ve never planned anything, never ever. Never wanted to die, just wanted to stop existing. Those are two very different things in my mind. Also, it will happen again. Winter keeps coming, even here in the Promised Land.

Suicidal thoughts are also ironically, part of the treatment. In what can only be described as a sick irony, the side effect of nearly all common antidepressants is suicidal ideation (thoughts). It just so happens that I’m taking these drugs to be less depressed and not for their wonderful weight enhancing properties, so for me that particular side effect is troublesome. When I increased my dose of Effexor recently as prescribed – I suddenly realized that for days now, I was finding, very rationally, talking myself into why my family needed me. But then grotesque images started to flood my mind (again). And that felt weird and not me, even the ill me. So I checked our handy drug guide and turns out when you increase Effexor, one of the big risks is a very sudden increase in suicidal thoughts.

Phewf.

But I still needed to manage those thoughts. Those thoughts, and the many others that are horribly damaging, are some of my symptoms, and some of the side effects. They can alert me, like the increasing pain in my back is telling me now, that something is awry. That I need to check my dose, check with a pharmacist, or like now, finish things up and lie down so the pain doesn’t get worse. They can do that, but thoughts are much more difficult to manage than back pain.

So that is all. I have two illnesses. They are a part of me, they have defined so much of me, but I don’t want to let either one of them define or consume me. I need to manage them. And when I can’t write or talk about something then I tend to lose perspective. And when I can’t objectively assess those scary ass thoughts as symptoms, and objectively treat them, I tend to implode or explode. I don’t want to do either. I want to live well. I want to embrace and love all the parts of me; taking the time I need to tend to my sick spine, or thoughts, or behaviours, taking the time I need to talk about them, to manage them.

If I don’t, then others won’t know. And people, there are many, many others that need to know. Unless the ones that ‘no one would ever suspect’  speak honestly, there will be needless others that think, that know, they are made wrong. And then, like Ryan’s former colleague, they will do what they feel is the right thing to do for all involved. How will I be reminded when I need to be, that I am not made wrong? Those of us who feel strong and can speak up need to, when we can, how we can.

I worked in psych for years ironically. The illness I saw broke my heart. But not enough to do much about it. Now it really breaks my heart and I want to do something about it. So I’m writing about my postpartum depression when I feel strong enough. And I’m going to write more about it here. And I’ll keeping writing for myself, and waiting for when it feels right, like this does now.

Thanks for listening,

Kerrie

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