the beginning beginning

Monday, 11/30/15, 9:58am

I didn't always have depression. I had a bout of it as a pre-teen, but I didn't share it with anyone for many years until after it came back.

I had a really happy high school and college experience. The couple years after college, I thrived. I was independent, working as an engineer in the field I wanted, and I met Nasser. We clicked from the start but were long distance so we became friends. We emailed so regularly though, we quickly became more than friends. I was in southern California at the time and we decided he would come out for a visit which then led to an official relationship. After all that, we only got to date 6 months, 3 months in the same city, before finding out we were pregnant.

Obviously, it was life-changing.

Fantastic really, but life-changing.

The depression probably started coming back during the pregnancy. Telling my parents was awful. And traumatic. Then we managed to experience almost every life event the books say to avoid in order to help prevent post-partum depression. We planned a rushed wedding, got married, I had pre-term labor and was put on bedrest, I quit my job, we moved 1000 miles to Colorado to be near my sisters.

Then RG came early.

I got sick, like puking my guts out sick, about half a week after getting taken off bedrest. I recovered, but the dehydration put me into labor. Labor, well, you know, sucked. But the worst moment was when they whisked my baby away to the neonatal intensive care unit, or NICU, as we were soon to become all too familiar with.

They wheeled a hospital grade pump into my room, not an hour after RG was brought to the NICU. They told me to pump every 3 hours for 20 minutes and taught me how to wash the pumping attachments.

He spent 2 weeks in the NICU, but I was discharged 2 days after delivering. We experienced so many ups and downs those 2 weeks. Nasser started working again part-time since there was no paternity leave policy in place at the time at his company (agh seriously??). His boss was "giving him a break" by letting him take vacation time that he hadn't accumulated yet, but he only had 1 week, which we tried to distribute over the first 2.5 weeks or so of RG's life. If Nasser was going in to work for awhile one day, he would drop me off, with several bottles of pumped breastmilk, at the hospital in time for the 6am feeding. I would try to nurse at almost every feed, every 3 hours, sometimes all the way until after the 9pm feed. We weighed RG before and after each nursing attempt so that we knew exactly how many ounces he had taken in. Then we would supplement the rest with previously pumped breastmilk.

I cried the day they ran a tube up his nostril and down into his stomach so that he could be tube-fed some of the milk. This was to allow him some catch up time since the effort to eat, even from a bottle, was too much work for him to get stronger.

I cried out of joy when we had a really successful nursing attempt. But then I left the NICU for awhile to get some snacks in me and call every close family member to share the wonderful news. I cried out of extreme sadness, and guilt, and remorse when I found out that RG had been put back on oxygen because the nursing session took too much out of him and his blood oxygen saturation level had dropped too much.

He came home once he could take in all his nourishment by himself and we didn't need to give him the rest by tube. But he was still on oxygen for another week after coming home.

I tried to nurse for about 2 1/2 months. I saw a few different lactation consultants, we tried to "re-create the birth" in a bath to try and get him to latch, we tried a nipple shield, every different hold position. Nasser would help me try at every feed when he was home. We bottle-fed at night and during the day when Nasser was at work. But I didn't feel confident to try by myself during the day. At the time, people told me "breastfeeding is hard but just takes hard work and determination". Those words haunted me with guilt because I felt like I should have been able to make it work with enough hard work and determination. And I didn't.

I got mastitis in both my breasts after a Friday of being out of the house and using the hand pump in the car caused clogged ducts. I had painful red patches on my chest that whole weekend and Sunday night I spiked a fever. I was too delirious and sleep-deprived to realize what was happening. I woke up every 3 hours to pump, bottle-feeding RG whenever he woke up. I heated up warm compresses to place on my clogged ducts, massaged them, meanwhile never realizing that the chills and aches I was feeling through all of it was the infection my body was fighting. In the morning I finally asked Nasser for help (why did it not occur to me during the night to wake him up and ask for help??), he got me some ibuprofen (why did it not occur to me during the night to take something for my fever??), he called in sick, and took me to the doctor.

I didn't get diagnosed with depression until RG was about 10 months old. This was after I quit trying to nurse, decided to exclusively pump, and got diagnosed with postpartum thyroiditis (when the thyroid goes crazy postpartum and releases all stored hormone pushing you into hyperthyroidism. But then after the hormone has been depleted, it doesn't produce enough additional hormone and you dip into hypothyroidism). The thyroid thing was like the topping on the cake. Really it wasn't so bad and we realized when my body was in the hyper phase, but dipping into the hypo phase made me realize what depression was. The loss of thyroid hormone was, for me, dramatic but luckily I knew what was happening because we expected it. Depression was probably the most notable symptom which made me realize that I had had it when we were going through the NICU and trying to nurse phase. I went onto the synthetic thyroid hormone supplement to even out my levels (which had its own side effects of increasing my metabolism and upping my milk supply which then led to another bout of mastitis), but even then, the depression didn't fully go away. I'm sure it was there the entire postpartum period up until then, but I didn't understand what it was. I just knew I was "stressed".

When I decided I needed help, I couldn't seek it myself. My own personal stigma made me feel that I should be able to handle this myself; I was a strong person and I just needed to be stronger than the depression. I finally begged Nasser to call the OB-GYN for me to get help.

They first put me on Zoloft, which is great for a lot of people out there, but I had the totally useless and upsetting side effect of suicidal thoughts. Perhaps I was already slightly suicidal beforehand, but the medication made it worse. Finally, at about a year postpartum, I found myself a psychiatrist to manage my medication (of course he switched me quickly to a different anti-depressant) and my first therapist.

2 antidepressants later, along with an anti-anxiety medication for when necessary, as well as an anti-psychotic, and several therapists later, I am doing "well". I tried to wean from the medication before getting pregnant with my second, but we realized I needed to stay on it. During my pregnancy with TK, I wanted desperately to wean or to at least lower the dosage because of the potential risks, but we ended up needing to up it. My pre-term labor with RG made me automatically "high risk" for my 2nd pregnancy and they gave me progesterone shots every week between 16 and 36 weeks in order to help prevent pre-term labor. The shot was quite literally a pain in the butt, but after a couple weeks I realized I was getting some side effects. Every week about a day or 2 after my shot, I'd be incredibly lethargic and depressed for about 2-3 days. It was a cycle that lasted for half the pregnancy.

When TK was almost a year old, I spent 72 hours in a mental hospital. Technically I brought myself in for an "evaluation" and to ask questions about their outpatient program, but they ended up keeping me. It was a terrifying and humbling experience.

I have a therapist now, my medication seems good, and I'm doing a lot of the "right" things to prevent bouts of depression. But they still happen, plenty often. And yet, this is me doing "well".

A therapist once wondered if I actually have post-traumatic stress disorder based on all my experiences while pregnant with RG and then postpartum. I think it may be part of it, but it's not the whole story. I used to think it was postpartum depression, but then it never went away and here we are 7 years out with RG. I've accepted my disease though and have hope for a more stable life with fewer bouts of depression, but I no longer have any expectations that I'll ever live depression-free. There's plenty to work towards still, but my depression is worse when I expect that things should go back to the way they were before it. They can't. My life has significantly changed, obviously with the addition of a marriage and 2 children, so of course it can't go back to the way it was before. And I've changed.

I have, in my depressive moments, wondered how things would have been different had I not gotten pregnant. I've wondered if we still would have gotten married, but these wonderings have made me realize that I don't like to think of "what ifs" with regards to my marriage. I love Nasser and I wouldn't trade our marriage for anything. Our relationship has changed and grown through all the stuff we've gone through. It's so different from what it was when we got married. But it's also my rock. Sometimes I hate being so dependent on another person, and maybe it's not healthy, but Nasser helps me remember my independent side. He helps me breathe through the bad moments and appreciate the good moments. We've rode this roller-coaster together and thankfully, we've gotten closer through it all.