Saturday, April 25, 2009

The Not So Obvious

I briefly mentioned that I suffer from depression, anxiety and OCD; I am obsessive not compulsive. I don't have a phobia of germs or practice rituals like checking that doors are locked, etc. I tend to ruminate about situations I feel are problematic thus creating a bigger and more overwhelming problem in my brain than really exists. Rational thinking dissipates and is replaced with overwhelming worry and self hatred. The obsessing becomes out of control, therefore sending me into a deeper depression. It is hard to determine which disease comes first. Is it the OCD that causes the depression and anxiety or the other way around? It is very common for people to have 1 or more mental illness combined to make up their diagnosis. Once this is discovered, the treatments options get narrowed down and the patient, if they are willing can become well again. A huge problem with mental illness is not only to do many people elect not to seek help, but when they take medication and feel well again, they think they are cured and cease taking their medicine. Eventually this will prove to be a mistake and the cycle of depression continues all over again.

This is another parallel to infertility. It often takes months or years of trial and error with blood test, surgeries, and ART to determine exactly what is the reason for not conceiving or having recurring miscarriages. Hopefully the full diagnosis is discovered and will allow the woman to have a successful pregnancy.

I have thought many times of revealing my mental illness challenges but have been afraid of the reaction. Mental illness is very similar to infertility because it too is a disease that people cannot "see." The effects of the illnesses are internal and the grief and pain associated with them are not obvious. Both of these diseases often are not accepted by the general public as being justifiable or "real." There is a huge stigma placed on people who are mentally ill, and there is also a complete disregard for those suffering from infertility. Both conditions can be perceived as a choice; they are not like cancer, MS or diabetes- all life threatening illnesses. The difference lies in the legitimacy placed on mental illness and infertility as being actual diseases where one absolutely needs to seek medical treatment.

Some of the things people say to infertiles and people with mental illness are so completely insensitive and ignorant. I don't think anyone would consider telling someone diagnosed with Leukemia to just take a vacation and the cancer cells will disappear on their own. There would be a steadfast reaction by family and friends to help the patient receive the best care possible in order to save their life. While infertility may not kill you. It can definitely kill your spirit and take a once happy and fulfilled life and turn it around completely. And, there are conditions like endo, ovarian cysts, and PCOS that can cause great health concerns if not properly diagnosed and treated. Mental illness can kill someone if gone untreated by a medical doctor- suicide is sometimes seen as the only way out for very sick patients. The sad fact is that these deaths can be prevented if a patient is cognoscente and able to seek treatments and is willing to succumb to their illness and accept that they need help. Depression, bi-polar disorder, OCD, eating disorders should be treated with the same serious reactions as many other life threatening conditions.

I am no stranger to suffering in silence because the ailments that are a part of my life are not easily explained or understood by most people. I have been as open as I can be with many people in my life about my mental illnesses, but I know that I am misunderstood. I know that unless you have depression or bipolar disorder or OCD, you cannot possibly comprehend what it feels like. I feel as though mental illness is even harder for the average person to understand. It is such an abstract disease and those with the illness have many different ways of reacting.

As for infertility it is hard for people to really "get" the grief involved because it is not accepted as an actual disease but rather pegged as something couples have to get over and "fix" and then there will be a baby. We have all heard the reactions by many people when hearing that TTC has resulted in infertility issues. "You're young, you're not doing it right, have you tried this? It'll be fine." They are all dismissive and hurtful.

Thankfully there are people out there who do understand how difficult it must be not to have a child to love because the child is a tangible thing to help support understanding for the physical loss and grief that is lacking in an infertile's life. Many people can understand the pain of not being able to have children when all the people around them are moving on with life and becoming parents.

Mental illness and all the conditions and side effects that go along with it ultimately reflect nothing concrete for people to grasp onto to allow a deeper level of understanding. They don't comprehend how debilitating these diseases can be. They may observe someone as being lazy, anti-social, a poor worker if they cannot hold a job or complaining about a problem that they should be able to "snap out of. "

I guess I don't know which is harder to try and explain to people-infertility or mental illness. All I know is that they have both filled my life with many challenges. I have fought what seemed like a no-win situation for myself and I sunk deeper and deeper into depression. Things would get better, but then inevitably I would find myself in a silent, lonely black hole.
My diagnosis of depression and anxiety came a couple of years before TTC. I sank unknowingly into a very deep depression at the age of 23. After receiving therapy I realized that I have had depression and general social anxiety since I was very young. I was always extremely shy and sensitive and my feelings and social challenges of acne, body changes, and trying to fit in were explained as normal feelings for a teenager. College was challenging for me, and I was very depressed all 4 years, but I never understood it to be more than my personality and introverted personality; therefore I never sought any help. I thought my mood swings, lack of self confidence, and anxiety in social situations were just part of my personality. I have what is called dysthmia. I was not bound to my bed or having break downs; the average day is a more manageable depression but a serious condition nonetheless because it can turn into a more grave episode. I was a highly functioning depressive and masked my problems and internalized my heartache. That is was most depressed people do (especially women); they beat themselves up for feeling the way they do thus creating a never ending cycle of feeling bad about oneself and sinking further into depression.

The habit is broken for many people by a combination of talk therapy and medication. That is how I have gotten through the past 8 years. But, it wasn't until 2 years ago that I self diagnosesd my OCD- Obsessive Compulsive Disorder, which completed the puzzle of why I continued to struggle withmy day to day life. My depression did not get worse due to the strain of infertility. I had been getting help for a couple of years before we hit the really hard times of TTC. I had my moments, believe me, but they were more manageable because I was talking to a therapist and taking meds. I knew I needed to continue with my health plan because of the stress and strain of IF.

One of the ironic parts of my TTC journey is how things began for us. When I told my doc that I was going off the pill six months into marriage, she advised that she didn't think it was a good idea. I wasn't well enough to become a mother. I needed more time to work on myself and get past some of the issues that had been fueling my depression. I didn't listen to her because who wants to be told they can't try and have a baby? We talked about the effect of taking medications while pregnant and studies show that it is okay for the babies health. She explained that many women take the meds until the last tri-mester when the baby is more developed. You don't want the baby,who will have some of the drugs in their system to go through withdrawal symptoms after being born. Some women elect to stop taking their medications completely. There is risk involved with their mental well being while being pregnant, but if closely monitored it may be a better alternative. Every case is different. In order to combat post-partum depression, women immediately go back on their medication after the baby is born. It can takes two weeks or more for the medications to build up in the blood levels and begin to work. Anyway, my point is that I thought my biggest challenges when TTC would be battling my depression. I was told that I would not be able to breastfeed my babies because I had to be on meds. This was very disappointing. I was also warned that if I had a difficult pregnancy due to depression, I may only be able to have one child. This too was devastating news. Now I can't help but chuckle at how naive I was at the time. The amount of different challenges that came my way made these first conflicts seem miniscule. Who knew that the baby would never come, thus making worries about depression and breastfeeding completely irrelevant?

Most likely I will post more about my experiences with depression. It is a part of my life and maybe this will help some other women and men. I can only hope that readers of this post will not judge me because they do not understand mental illness. I am a highly functioning and generally happy person that needs help coping with a challenging mental condition. These things do not define me just as infertility does not define me. They just happen to be one part of who I am and where my life has taken me.

This is an important issue to discuss as it pertains to the life crisis of infertility and loss. Many infertiles experience situational depression, and the positive outcome of finding a therapist or support group to let out emotions is something I have experienced personally and cannot endorse enough. There are some things in life that we simply cannot deal with on our own.


Beautiful Mess said...

I know all to well how you would feel about posting this and hoping you wouldn't be judged. I did struggle with depression while I was pregnant and after and then again when my mom passed. I didn't go the medication route, but If I often wish I had. I think I would have coped better with both situations. Thank you for posting this. I think you're a brave woman.

Just Caz said...

Thank you for sharing your story..
I was feeling we had something in common with the comments you left on my blog.
And I guess now I know why.
Like you, I am a high functioning person who suffers from depression.
It's terrible sometimes the lack of understanding people have for the gravity of the situation that others are going through...

After I was first diganosed and medicated.. I wonder how I ever made it through those first dark days when I just thought there was something wrong with me.. but didnt know what it was.

I think by sharing what you have and will experience with your mental health issues, you are being brave enough to risk judgement in order to educate others.
For that you should be so proud of yourself. Because as a fellow sufferer, and as a fellow human being.
I am proud of you.



Heather and Jase said...

I feel your anxiety, hun. My children and I suffer from ADD and ADHD. This opens a huge can of worms with a lot of people. Other mothers and an ex-hubby who don't believe these conditions are real and who judge me for seeking treatment for all of us. I suffered from depression for years because of my ADD. What's wrong with me? Why can't I seem do get simple tasks done? Why am I so darn forgetful? Am I just completely lazy?! The thought of having to concentrate and focus would give me a panic attack because I wasn't sure I could!
Once I got diagnosed a huge weight lifted because I had an answer and I could spare my children from feeling the same way.
Most people suffer from some form of mental illness even if they are in denial. Thank you for being so very brave and sharing!
There is never shame in realizing a problem and taking steps to get help. NEVER!

tracy said...

I do know how you feel. Really, I do. I take several medications, daily. Invisible disabilities are very painful. Not just from the disability but from all the things you talked about.

Yaya said...

It's true. I often feel like people don't accept the amount of grief I have over infertility AND they don't realize the magnitude of depression. I'm clinically diagnosed with severe OCD, thanks goodness for lexapro....

Nina said...

Wow. This post is so spot-on. Thank you.

Ophelia said...

I have Bipolar Disorder. I've discussed it several times on my blog. When I was TTC (unsuccessfully) I went back and forth over whether or not to continue taking my meds - I've been on them for 10+ years! I consulted with many doctors and ultimately decided to come off them after seeing a high risk OB. I felt like I was fighting for my life at times. No one could *see* this struggle, they just thought I was being b*tchy. My doctor told me I wouldn't be able to breastfeed either since I'd have to go right back on my meds right after giving birth had I gotten PG. He was also gravely concerned about my risk for PPD. TTC is hard enough when your infertile, but throwing mental illness into the mix and it's a recipe for disaster! Sheesh!

I get you.

I talk openly about my Bipolar Disorder. I feel like it's my job to do so in order to break down the social stigmas attached to it. So many people have these misconceptions about "us". I'm not some crazy lunatic who cannot function, or who talks to herself while sitting curled up in a dark corner somewhere. Nope! I'm a productive member of society! This disease doesn't control my life. It's a struggle, but with the right medications and right support system, I'm very well balanced. It's taken me so long to get where I am, but I'm here! I want others to know that it's possible for them to get here too and they don't have to be ashamed either. I think if more people discussed it openly, there wouldn't be such a fear surrounding mental illness. Kudos to you for helping to break down the barrier!

I'm here if you ever need to talk!

Mrs. Gamgee said...

Thank you for being courageous enough to post this. There are at least two people in my family who suffer from differing forms of depression. I'm sad to say that even within our family, there are those who don't see it as an illness, but rather something that they can just snap out of.

Kristin said...

Erica...thank you for being brave enough to post this. While I haven't struggled with long term depression, I did go through an extreme depressive stage while battling IF. I also have a few dear friends who have been diagnosed as bipolar and I hate seeing them judged because of it. {{{Hugs}}}

Guera! said...

I hear ya loud and clear. I am dealing with infertility and have dealt with depression and worry my whole life. Your post was refreshing to read. I felt like I was reading my own thoughts but so much better expressed than I could.

Amy said...

I think you have a lot of courage. My husband has similar challenges, and I know how hard it was for him to find adequate help.

RMCarter said...

Having dealt with both depression and infertility, I have never thought about these similarities between the two. Thank you for this post and for your bravery. It really made me think.

Phoebe said...

Thanks for commenting on my blog. It's not often I get a comment from someone who understands. The misconceptions about mental illness are institutionalized. I had many doctors and health care providers miss it when I was pregnant. It was a sad tragedy. Education is the only way to battle this ignorance.


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