Sunday, August 31, 2008

How Did it Sneak Up on Me?

The last day or so I've really been pondering how did this depression sneak up on me? I try to remain in touch with my emotional and mental state. I would say that many times I am hyperaware of how I am doing. So how did I miss it?

But then again almost all the women I've known who have gotten post-partum depression say the same thing. It took them a while to realize it ... it starts slowly and just builds a little. I also have found out that getting PPD is common to happen between 6-8 months.

Looking back over the last month I now know the triggers that probably set this off ... my sleep has been interrupted while Leila was teething. She started waking up several times a night ... meaning I was waking up several times a night. And my biggest sleep issues is I have a hard time falling asleep. So for every time I wake up a night it is between half an hour to an hour before I can fall back to sleep.

Trigger #2 was that my mom and I got in an argument. And the stress from that wasn't healthy for me.

Trigger #3 - Work. I work for myself which can sometimes be very stressful. I was successful at cutting down my workload during my pregnancy and taking on less projects - but I started taking on more than I should have after I hired a part-time nanny last month.

Trigger #4 - Money. Finances have a tendency to stress me out. I currently am one of those lucky people who own two houses. Not because I want to own two houses but because the market in Florida has tanked and I haven't been able to sell one of them. Well, this is only partially true -- until having my daughter I didn't want to sell our other house. I had fantasies about moving back to the east coast of Florida. And because at the time both my husband and my business were doing well there was no urgency to sell. Fast forward a year and my husband's business is slow (he's in construction) and I'm working less because of the baby and now the second house is a huge drain on our finances. I know hindsight is 20/20 - but I should have sold the house 3 years ago when we first moved to the west coast of Florida and the market was still great.

Thursday, August 28, 2008

Is it Postpartum Depression?

I have debated if I would post this on my blog because I have really wanted to maintain a positive feel here so that other bipolar women thinking about having a baby or currently pregnant would be encouraged and know that its possible. In the end I've decided that really this blog is also partially about my real life.

So, here it goes. I am starting to think that I may be starting to suffer from a mild postpartum depression. I know that traditionally it starts within weeks of birth - but they say it can be anywhere in the first year. Currently my daughter is 8 months old. I just got my weekly email from babycenter and saw this:
Which new moms are at greatest risk of suicide? (here's the link). I have some history with that subject so I checked it out. And as suspected the article says women who have previously suffered from depression (checkmark needed) or other psychiatric conditions (checkmark needed) or who have attempted suicide previously (checkmark needed), have been hospitalized in the last five years (checkmark almost - It has been 5 years and 2 months since I was hospitalized) are at a 27 TIMES higher risk than the general population. (Please note I previously wrote 27% and that was not accurate)

At the bottom of the article there was the link to the postpartum depression article. So I checked that out and was surprised to see how much it sounded like me from the past few weeks.

I've known that I've started to feel a little down ... and have been somewhat irritable and am not sleeping as well as I would like, but I hadn't started the crying until the last week and then yesterday I had a brief thought of "why am I here" - which just happened to be my 30th birthday. Do not get me wrong I am not suicidal -- it was a brief moment where I questioned my existence. Witin minutes I realized I am here to raise an amazing little girl - who I know will do great things in her life.

And now my dilemma is do I wait this out for another few weeks, be more diligent about exercise (which I have slacked off on the last two weeks because I've been busy with the baby and work), focus on healthier eating, increase my omegas and maybe go to a support group -- or do I call my psychiatrist and either increase my Lamictal or start an antidepressant.

Ordinarily I would do both. However, I am worried that by getting on something else I will need to stop breastfeeding. And that makes me feel horrible. I really, really wanted to breastfeed for at least a full year since I know that is what is best for my baby. But then again, mommy crying clearly isn't best for baby either.

So I guess I know what I really need to do ... pick up the phone and call the doctor and maybe we will find something that still feels safe for me to continue breastfeeding. I am already having guilty feelings that I'm going to be a bad mom if I have to prematurely wean my daughter ...

The funny thing is until I read the babycenter email I just thought I was a little down due to some stress in my life.

I was so proud of myself for maintaining everything so well ... I have been on a low dose of medicine for so long (I was without all medicine for 3 months and for the last 14 months have been on less than half of my former dose of Lamictal) and only on one medication (no klonpin, ambien, sonata, antidepressants -- nothing) and it felt great to know that I was just healthy. Almost feels like a letdown that I now am feeling like this.

I also wonder if turning 30 has contributed to this ...

Tuesday, August 5, 2008

How Motherhood Has Changed My Outlook

One of the unexpected things of my pregnancy and now motherhood is how it changed my outlook on life and having bipolar disorder. For years (many, many years), I didn't really have acceptance that I was really bipolar. You would think having a mania induced psychosis that landed me involuntarily in a psych ward with hallucinations would have cemented in my mind that I was bipolar. But still somewhere way down deep I wished or hoped that maybe my diagnosis was wrong. And that one day they'd say that really I had something that is "curable."

Deep down I have struggled for the last 15 years with taking antidepressants, tranquilizers, mood stabilizers and anti-psychotics. I secretly worried that by taking the medicines I was changing who I am. I always wondered "where does the line between personality and illness begin or end?" Sometimes when I was depressed I would think that maybe the person that I am is a negative person who was just meant to be suicidal. When I was up ... I thought hey maybe my personality is just meant to be energetic and happy. That's who Rachael is.

Over the last few years I stopped obsessing over whether I was meant to take medicine or not. And started to realize that I may have to take them for the rest of my life. But still I had the lingering thoughts -- what if ... what if it was because of the antidepressants that I became so severely manic in the first place. Maybe the course of my illness isn't really Bipolar 1 -- maybe it is something less. Somewhere in the last year I realized it doesn't matter anymore.

My therapist used to tell me that true acceptance would mean that I wouldn't feel any internal struggle about taking medicine and that I would stop "wishing" for things to be different. That I would accept that this is what is ... I am bipolar and I have to take medication to keep my illness in check. And suddenly now that's OK.

Somewhere during my pregnancy I realized that things could be a lot worse. I'm fortunate that if I eat well, exercise, maintain positive sleep habits and take my medicine I'm fine - I have no symptoms, no bad effects of my illness if I maintain myself. And honestly I could have a lot of diseases that are far worse ...

I also now realize even more how important it is for me to maintain my health because now someone else depends on me being well. As much as possible I don't want my daughter to ever think that she's been given the short stick with a "crazy" mother. I sure when she is a teenager she will think her mother is crazy - but hopefully it won't actually be because of my illness - just one of those things that happens between mothers and daughters during adolescence.