Monday, November 28, 2005

Baby's First Thanksgiving

The cats are thrown out while I'm in the hospital, then one gets run over. The other one is brought back in and Christmas decorating is cancelled because of the cat.

Oh yeah, and the baby's sick, too.

Monday, October 24, 2005

The Oreck Challenge

Life sucks, then it gets marginally better, then something happens and it sucks again. Maybe in a few weeks it'll get better. Maybe my intelligence and some semblance of normal emotional behavior will return when my milk comes in....

Then again, maybe the sky really is falling and there's a giant oreck out there to clean up the mess. Wouldn't that be nice? Just suck up all the little shards of abnormality in the world? Of course, the next logical question would be: would there be anything left after the clean-up, and who determines what qualifies as normal and abnormal? There's a question for the Hitchhiker's Guide. Where is that little don't panic book, anyway? I seem to have lost mine somewhere in the transom of chaos known as my life.

I miss intelligent conversation...I miss any conversation that doesn't center around pregnancy or kids. And I think I forgot what logic is, since it's an abstract and foreign concept to my kids...see how any topic can become a kidversation? I'm sure I could attempt a conversation with someone tomorrow about the mathematics of space or Imperialist Russia or the Ming Dynasty and it would somehow turn into a kidversation. Is a pregnant belly a billboard to the world that reads "I can only understand dialog about humans under the age of 18 and the bodily functions thereof"? I miss my brain. I wonder if I could solve a crossword anymore? I don't even know where my crossword books are - but I can pinpoint no less than 5 books on pregnancy, childbirth, breastfeeding, or children at this exact moment. Where is the law that says reproduction and intelligence are mutually exclusive? And who wrote it? Can I lodge a complaint? Oh wait, nevermind, I'd have to read the forms and everybody knows pregnant women can't read.

To borrow a sentiment from a young, intelligent, childless friend:

barf.

Thursday, October 13, 2005

Fear and Loathing

I feel abandoned and I can't tell anybody. I feel like a fool for having yet another kid to just get yelled and cussed at and to take to church alone. I hate sitting there husbandless with my two kids and big belly. I hate the pitying looks and questions, and I hate telling my daughter that Daddy's not coming to church for the umpteenth time.

I hate the eye-rolling and disgusted sighs I get when I mention it. I hate the pregnant comments that inevitably come with every tear. I hate feeling....ugh!!! I just hate it.

I hate being taken repeatedly. I hate calling over and over and over and being told the same thing time and again, then nothing being fixed. I hate being blown off because I'm a woman, or I'm pregnant, or I'm poor.

I hate being disobeyed. I hate not having more control of my kids. I hate being depressed. I hate being on medication. I hate not being able to get off of it. I hate not being able to afford it.

I hate listening to other moms talk about the things they do and trying to come up with some noble, higher reason for not doing it other than the fact that I can't afford food, let alone anything else. I hate worrying if the toilet paper will last 'till payday, and who I can put off to get it when payday comes.

I hate that I want to get away from my daughter on some days and I just can't stand her. I hate that I feel like sixty dollars a month has to be spent on me taking her to kids day out once a week just so I can get a break from her. I hate that I still end up calling Misty and scrounging money from somewhere, anywhere just to get her out of my hair.

I hate that I lost her at school. I hate that she's not potty trained. I hate that he's not completely trained, either. I hate that he rarely gets green dots at school. I hate that he throws fits. I hate that he gets so crazy and rambunctious. I hate that they terrorize the cats.

I hate that I'm not normal, or at least a little closer to the normal that everyone else is. I hate depression. I hate my family life. I hate that I don't really have a family life to hate. We all just happen to live in the same house. I hate all the yelling. I hate all the swearing. I hate all the bickering and arguing and aggravating. I hate, hate, hate the absolute disobedience and disrespect and daily spankings. I hate not knowing what to do and that what I am doing isn't working. I hate feeling like a failure as a wife, mother, person, human being. I hate being incompetent. I hate being impatient. I hate being emotional. I hate crying. I hate screaming.

I hate pretending. I hate pretending that I'm okay, that I'm happy, that I'm positive, that I'm optimistic, smart, talented. I hate trying to be worthwhile to anyone for anything, but knowing that I'm not and never will be. I hate ... I just hate.

You know, sometimes life just sucks.

Monday, October 3, 2005

Closer but Not Yet

My appointment went well and the doctor reiterated that as long as I can make it until October 10, the baby will be fine. Of course, we'll aim for at least November 1. The cramps are considered normal and more of the round ligament pain. The contractions are not to be worried about unless I have 6 within an hour. The swings were explained as part of the pregnancy and are expected to slow back down within a month of delivery. I just have to keep taking the meds and the B vitamins.

I can tell it's getting close - I'm exhausted. It feels like a different exhaustion than what I had a few weeks ago. It's like my body is trying to rest up for the delivery. I need to pack a bag for the hospital. Funny, with the last two, it was already packed and in the car by now.

Part of me wants to get to it, but part of me dreads when she's actually here and I'll be caring for her and Sarah full time. I'm hoping beyond hope that the church family will rally around me and help out a lot. Of course, there's still been no mention of planning the shower. I think with everything going on, it's not going to happen. Maybe that's why I'm so apprehensive. I've been counting on that for diapers. I'm not really angry or hurt about it, though. The ladies that will be planning it have had so many things going on that I can't be upset with them. I just wish I could help them somehow.

Tuesday, September 27, 2005

Dire Thoughts

Pray for me. I was having thoughts last night during a fit of moroseness that I don't dare speak or even write.

I got up and took my meds since I realized I hadn't taken them. I did take two of the B vitamins since it says to take one twice a day and I was feeling so bad, but I resisted the urge to double the Prozac. I need to try to make sure I take them everyday.

Sarah is staying with Misty today and I'm going to sleep so I don't have to think. They want me at the school to help iron on transfers, but I'm not in the mood. I just want to avoid thinking so I don't have to face the demons in my brain.

God used me to encourage another woman in her marriage trials this morning, and she responded that she was really grateful and needed to hear what I had written. That makes me feel a little better. Maybe it's enough for now to keep you-know-who at bay. Good thing tomorrow night is prayer meeting - I'm going to need it.

Friday, September 23, 2005

Sigh of Relief

We've decided to postpone Sarah's party because of the hurricane. We're supposed to get very heavy rain on Sunday and we decided it's just not worth it to ask people to drive in that for a piece of cake. So I have two more weeks to clean - yay!

I've been sleeping upright, but at least in bed with my husband, which has a nice effect. I didn't realize how much I missed sleeping next to him. The bad side is that I've been waking up hurting. I think it's a fair trade-off for limiting the heartburn. I'm still pretty tired this week, though, because it's hard to be comfortable in that position. Maybe I'll get a nice long nap tomorrow afternoon.

Learning about some of the other families in the school has made me realize that I don't have it so bad. One's dealing with an absent mother, another with autism...so many stories and hardships.

I watched a movie about the Holocaust the other night then went and bawled in the shower. What audacity for me to be depressed! How could I bemoan my life when I look at what the Jews went through? It was convicting, both that I am too self-pitying and that my faith is not where it needs to be. I have tried to keep it in mind since then to remember the blessings that God has so mercifully bestowed upon me. I still struggle, though.

I'm not really in a high, but not in a low low either. Just kind of lower-even-keel, if that makes sense. For me, though, that's good.

Tuesday, September 20, 2005

Better But Not

The inhuman phase has passed, but has been replaced with the exhausted phase again. I can't wait 'till Friday. I think I'll just come home and go to sleep as soon as I drop Sarah off at Kids Day Out. I'm struggling to keep my eyes open now.

I am so not looking forward to Sarah's party on Sunday. I still have tons of laundry and dishes to do and Michael is in his own funk, so I've got to figure out a way to get over myself and get to work. Otherwise the party will be one big "please excuse my mess." I'm broke so I can't offer to pay anyone to help me and I can't bring myself to ask someone to do it for free.

Bethany has been a royal pain for the last several days - restless and all over the place. Part of me wants to hurry up and have her, but I know it'll only be harder once she's here. Plus, I want her to be as healthy as possible which means staying inside as long as possible. I just wish she'd stop kicking so hard!

Sarah's in a snit this week and refuses to obey or leave the cats alone. I need to figure out what's going on in her little brain so I can address it. I miss my good girl.

Brandon is doing well in school and comes and goes at home. I never know from one day to the next if he's going to be in a good mood or a rotten one.

I'm going to try to actually cook a good dinner tonight and clean the house a little more today and see if the calmer surroundings will help calm the people around here. Wish me luck.

Thursday, September 15, 2005

Down again

I made the mistake of thinking I was a worthwhile human and got cussed out because I went out to lunch with Sarah and the Parent Teacher Partnership moms that I had a meeting with this morning.

I made $80 yesterday that wasn't planned on, so I thought spending 8 would be okay. How foolish was I? Well, at least I felt human for a few hours. That should give me some satisfaction...but somehow it doesn't since now I feel like a dog that got out of its cage. I feel trapped in my house and that I can't get out. The car is just a cruel trick to make me think I have some freedom. I have to ask permission for every trip and every penny spent. If I spend money without asking permission first, I have to report it immediately upon my return and justify it all. "How much did you spend?" is a common question around here. Permission is usually denied unless I beg and cry, and then it's given grudgingly and I'm reminded of what a privileged wife I am for days afterward. I feel so stinking trapped, like I'm not worth being let out. What have I done that my humanity has been taken away? Why am I not allowed to be around other people? Is it because someone might let it slip that I'm valuable in some small way...that someone might actually appreciate me? I was told "thank you so much" today - I feel like that's not allowed to be said to me...I might get a big head or something. Couldn't I at least have it in porportion to my body? If I'm so smart and know so much, how come nobody can know? Why am I not even allowed to remember it for myself?

God forbid I feel an iota of worth.

Sunday, September 11, 2005

Improvement

I missed my appointment Friday because of stupidity - I thought it was later than it actually was. So I was disappointed that I didn't get to go sell purses. I'll be going in Wednesday morning. At least it gives me an opportunity to make more purses to sell...

I woke up every hour on the hour last night then woke up at 4 and couldn't get back to sleep. Sarah got up at 6 and Brandon at 6:30. Thankfully, my darling husband took them outside and then for an outing this morning so I could sleep. I'm still tired, but not near as bad as I was.

I started to take a B vitamin, which I think is helping. I've actually sat in church (and sang!) the last two weeks. We had a seminar on the 5 love languages this weekend that I enjoyed, so something is working better.

I've also gotten some typing work this week and there's a woman considering having me sew two dress and pantaloons sets apiece for her two daughters to the tune of $40 a set - so I'm excited about the work that has come in and anxious for the possibility of more work to come. I finally put up a website for my sewing work, which seems to be getting tons of traffic, so maybe even more orders will come through.

The secretary of the Parent Teacher Partnership at Brandon's school called me yesterday afternoon and asked if I'd be willing to create a newsletter for the PTP. I'll be meeting with them Thursday morning. They and the principal are also anxious to get me working on the school's website. It's amazing how feeling needed by others outside your family boosts your confidence and self-esteem. To think that people that don't even know me find me useful and are actually seeking me out to help them! It brings a grin and a sigh of happiness from realizing that maybe I'm not invisible to the world after all.

We also got two kittens this past week. They're not more than 5 weeks old and absolutely adorable. Both are lovable and like to purr in our ears. It's made a wonderful difference in Michael - I've seen him smile more since Wednesday night that I think I've seen in 6 months. That might be an exaggeration, but honestly, he's rarely smiled recently. I'm finally getting the lovin' I've been longing for and find it euphoric to lounge around with a kitten happily sleeping on my neck, shoulder, etc.

Here's hoping for a long up spell...

Tuesday, September 6, 2005

Insomnia

Last week ended with three green dots in a row - hurrah!! Once he got home, it was another story - the fits, etc were in full force. We'll see how this week goes. Yesterday was a school holiday, so I'm wondering how he'll do with the longer break between classes.

I've developed monstrous heartburn that nothing relieves, and I'm out of the heartburn pills that were helping minimally. I'm going to talk to the doctor Friday about getting on Nexium. It's the only thing that worked while I was pregnant with Sarah, and it worked like a charm - oh to drink orange juice and eat tomato sauce without the dragon lurking!

As if peeing and heartburn all night weren't enough to keep me sleep deprived, I've got some sort of sinus thing going on that's giving me headaches and making me fuzzy. I went to bed at 11:30 last night, woke at 1:00 with Michael and Brandon, 2:15 with Michael and Sarah, then 4:00 on my own. The last time I tossed and turned for 45 minutes before I gave in and got up. I did get four purses cut out, though. I even got one made before I took Brandon to school. I'm going to try to get as many made as I can before Friday so I can take them with me to my appointment and maybe sell one or two. That would be lovely.

I hope this apparent insomnia is short-lived, if not non-existent. Maybe it was just my brain going about selling purses combined with the sinus medicine wearing off. Maybe it's preparation for Bethany being here...maybe it's hell on earth....hmmm - that must be it.

Friday, September 2, 2005

Partial Antidote

Brandon has gotten two yellow dots and two green dots this week - a cure! Almost... It's amazing how your child improving his behavior can improve your depression.

I still haven't sewn all week, but at least I have washed a few loads of laundry and I did some dishes yesteray. I'm almost human.

The Braxtons are getting more frequent now - not just when I have to raise my voice to get the kids to hear me. I got a whistle, but it doesn't have the effectiveness I was hoping it would have. I woke up this morning with back pain that feels like what I had during my period. I wonder if it's just how I was sleeping, or if I should worry. I'll mention it at my appointment next Friday.

Bethany has really started moving around a lot. Last night Michael and I actually saw my stomach move. Michael's face was a pretty cool sight.

I still miss the cats, and I'm still exhausted and want to sleep all the time. At least the crying jag seems to be in remission for the moment. We'll see how long it lasts.

Tuesday, August 30, 2005

Floating

We went to parent night last night, which helped to alleviate our fears somewhat. We did learn that Brandon is the problem child in the class, but that he's also one of the youngest (if not the youngest). The teacher seems a little more human to me now. We'll meet with her tomorrow morning for a one-on-one conference. I still had a crying fit last night, partially regretting my decision to send him to school instead of homeschooling, and wondering if I've forced myself into a permanent decision because of his excitement over school.

I stayed up late Saturday night and haven't been able to recoup my sleeping pattern (what little it was), so I'm fighting to keep my eyes open. I haven't sewn since last week because I'm so tired and I'm scared that I'm letting it slip. I just can't force myself to the sewing table right now.

I need desperately to do dishes and laundry - Brandon is running out of school clothes and we've begun to eat cereal out of take-along containers since the bowls are all dirty. The living room floor is beginning to look like a confetti pattern from all the lint and crumbs that need to be vacuumed up, and I can't remember the last time I made the bed. At least you don't have to make a path through the living room yet. Maybe I'll perk back up before it gets that bad.

To make matters worse, the mother cat has apparently taken the kittens away. I haven't seen them in days. I was so hoping to befriend them and have pets again. I miss having pets. I haven't had a pet in almost 8 years. I grew up with cats and haven't had one in over 10 years. I'd love to cuddle a cat and hear it purring right now. It would be so wonderful.

Sunday, August 28, 2005

The Abyss

Brandon has continued to get worse at school. We're going to meet with the teacher on Tuesday morning. I worry all day what he's doing and how the teacher is treating him. I'm beginning to wonder how this woman's mind works. Of course, that's probably the overprotective mother in me going nuts.

I've spiraled into a slump worse than any I remember. I either want to cry or sleep all the time. I'm exhausted and withdrawn. When I do go to bed, I can't get comfortable, and can't fall asleep. Then when I do manage to fall asleep, I toss and turn and wake up all night. I've been waking up at 5 every morning. What's the point of being exhausted if I get no rest? I go to bed between 9 and 10 and get up at 6:30, but feel like I never slept.

I didn't want to go to church yesterday...I never not want to go to church. I can't sing in worship, and I end up going to the mother's room and rocking in the rocking chair because I can't stand to be in a room of people. I'm trying to force myself to participate in things because in the past that has made me feel better. It doesn't seem to be working, though. Part of me wants to give up and withdraw completely, but I know that will just make it worse. I'm just not into it, though.

The only time I approach anything resembling contentment or happiness is when I'm sewing. I've got to figure out something else to make, though, or Sarah and Bethany will have so many dresses they'll never wear them all. I'm scared to try anything else, though. I'm too afraid I'll screw it up.

My depression has become the "trump card" in arguments now. Once I say anything about being depressed, Michael declares, "you've trumped me" and stops talking. I feel like this depression is taking away my life, and he seems to view it as some sort of excuse I use to get out of accountability. I view it as a straight jacket that nobody has the key to.

Someone mentioned B vitamins yesterday. I'd think that the Prozac and my prenates would have what I need, but I'm going to look into getting a B vitamin complex to start taking. I've known that they are very helpful in depression, but like I said, I figured my prenate had enough in it. I'm getting desparate now, though, so I'm going to try to find some.

I don't know when I'll post again. I had to force myself to do this one.

Monday, August 22, 2005

Abhorrent Behavior

Brandon was atrocious today. He got no less than five spankings, after time-outs. Michael told him he got a black dot for today. There was yelling, backtalk, sticking out his tongue, slamming doors...you name it. I can only hope tomorrow will be okay at school. He's already grounded from DVDs; I guess next will be VHS.

Again, if you're reading this, be praying tomorrow.

Sunday, August 21, 2005

Finally!

Brandon got a green dot yesterday! We took away all DVD's and spending the night with Grandma until he got a green dot. We'll see how it goes next week.

The van died Thursday afternoon. We think the motor is shot. I ended up borrowing my mom's truck to take the kids to school and Kids Day Out, and to go to my doctor's appointment. What fun - all day in a gargantuan pickup with no air! My appointment went well, though, and my second glucose screen was fine. I'm considered at high risk for gestational diabetes because my mother has developed Type II diabetes since my last pregnancy. I'm also overweight and my paternal grandmother has had diabetes since childhood. I go back in three weeks - it's getting closer!

We're thinking it's time to give up on the van and try to trade it in. A lady from church is going to talk to the board tomorrow morning and ask if the church will help us with a down payment on something. Isn't that sweet?

We're not sure yet if we're going to try to get it fixed or just trade it in. Michael's taking it to a shop Monday to have it looked at. If it's definitely that the motor needs to be completely replaced, we're going to trade it in. Otherwise, we don't know what we'll do yet.

The past couple of days I've been feeling a little better - not as withdrawn as I have been. Of course, I've also been making a concerted effort to take my medicine everyday, so I'm sure that's helped somewhat. I also picked up $125 dollars worth of sewing work yesterday and then found a Moses basket for $15 dollars at a resale shop - that would make anyone happy!

Thursday, August 18, 2005

Not so bad

Misty's mother-in-law brought Amber and Courtney over a little after 12. They brought homemade supper with them, then stayed until 4 o'clock. While they were here, Courtney played with the kids, Amber folded and put away all my laundry, and Pearlene did the dishes, cleaned the kitchen, and cleaned the living room. I felt so spoiled - I even got to take a nap!

Sarah never got sick again, and the last time Brandon got sick was around 11 or 11:30. The wonderful people at the doctor's office called in a prescription for prometh gel and pedialyte for Brandon without making us come in. I gave him one dose of gel at 1:00 to make sure he kept everything down, but apparently he didn't need it. We took him to school this morning. Sarah still has some diarrhea, but not as bad as it was, so I think everybody's on the mend or better.

It's amazing how a little tlc from some friends can make you feel better - and all because I just called and asked for Amber to come watch the kids while I slept. I still feel so undeserving, but as I've been reading (and slowly learning), God loves me and wants to show me how much He does. Often, we just have to reach out so that we can grasp the love He offers us.

All in all, yesterday and today so far have been much better. I try not to get too excited, though, because I realize one good day doesn't mean the slump is over. I'll hold on to the good I've got and use it as an impetus to take care of myself in the hopes that I will continue to improve.

Wednesday, August 17, 2005

Dreading Today

Brandon and Sarah (3) both got sick around 1am and have been sick all night so Brandon's staying home from school today. I'm exhausted and trying to think of someone to come and help me, but I don't know who. Janet lives too far away at these gas prices, and Misty has her 5 still. Maybe she can bring Amber over.

I'm dreading how today will go if I don't find someone to come over. I'm extrememly cranky when I'm so tired, and I have trouble staying awake to care for the kids. If anybody's reading this, please pray for me today.

A Worse Day

Brandon (5) got in trouble today - his second day of kindergarten. Again, the day seemed to be going fine until he got home. Just getting him home today was a nightmare because of the bus and the transportation director not telling me the right information.

I feel like a failure as a mother, and that Brandon is a failure as a student. All this time I thought I was doing the right thing by staying home with him and keeping him out of day care and the like. Only now he doesn't know how to sit still in class and got in trouble not once, but twice today.

The teacher's note says that he "needs to learn control." How do I teach that, and how long is she going to give me? How much trouble is he going to get into while we're trying to teach him? The vagueness of her statement is frustrating...what does she want me to do? I've never done this before and I need direction.

It helped to call my friend and cry to her, but I can't spend my life crying to someone about everything. Sometimes I think my depression stems from my apparent inability to parent my children and that I'd be fine if I'd never had them. But have them I do, so I have to figure this out somehow. I keep thinking if I could get this parenting stuff down, I'd be fine. If only life were that simple...

Tuesday, August 16, 2005

Child Development Study Following Fetal Expoure to Fluoxetine (Prozac)

Am J Psychiatry. 2002 Nov;159(11):1889-95. : Child development following exposure to tricyclic antidepressants or fluoxetine throughout fetal life: a prospective, controlled study.Nulman I, Rovet J, Stewart DE, Wolpin J, Pace-Asciak P, Shuhaiber S, Koren G.Motherisk Program, Division of Pediatrics and Psychology and the Reseaarch Institute, The Hospital for Sick Children, Toronta, Ont. Canada.

OBJECTIVE: Previous work suggested that first-trimester exposure to tricyclic antidepressants or fluoxetine does not affect adversely child IQ and language development. However, many women need antidepressants throughout pregnancy to avoid morbidity and suicide attempts. Little is known about the fetal safety of tricyclic antidepressants and fluoxetine when taken throughout pregnancy. The goal of this study was to assess the effects of tricyclic antidepressants and fluoxetine used throughout gestation on child IQ, language, and behavior.

METHOD: In a prospective study, mother-child pairs exposed throughout gestation to tricyclic antidepressants (N=46) or fluoxetine (N=40) and an unexposed, not depressed comparison group (N=36) were blindly assessed. The three groups were compared in terms of the children's IQ, language, behavior, and temperament between ages 15 and 71 months. The authors adjusted for independent variables such as duration and severity of maternal depression, duration of pharmacological treatment, number of depression episodes after delivery, maternal IQ, socioeconomic status, cigarette smoking, and alcohol use.

RESULTS: Neither tricyclic antidepressants nor fluoxetine adversely affected the child's global IQ, language development, or behavior. IQ was significantly and negatively associated with duration of depression, whereas language was negatively associated with number of depression episodes after delivery.

CONCLUSIONS: Exposure to tricyclic antidepressants or fluoxetine throughout gestation does not appear to adversely affect cognition, language development, or the temperament of preschool and early-school children. In contrast, mothers' depression is associated with less cognitive and language achievement by their children. When needed, adequate antidepressant therapy should be instituted and maintained during pregnancy and postpartum

Full study details found at http://ajp.psychiatryonline.org/cgi/content/full/159/11/1889

Identifying Prenatal Depression & Treatment Options

Depression During Pregnancy
A Public Health Risk & What To Do About It

Pregnant women and their loved ones are becoming more aware of the negative consequences of non-psychotic postpartum depression on infant and child well-being, on the mother's and father's subsequent mental health, and on the quality of their relationship. However, expectant mothers may not be well informed about the negative effects of depression during pregnancy on fetal and newborn development and on their own mental health after the baby is born. A series of studies have shown, for example, that depression during pregnancy is associated with higher anxiety or stress levels that, in turn, predict low birth weight and prematurity.

Further, depression during pregnancy is likely to lead to postpartum depression in the mother. A large number of studies have demonstrated that prenatal depression is one of the strongest predictors of postpartum depression. Once a woman has postpartum depression, she continues to be vulnerable to depression in her childbearing years. Maternal postpartum depression has been found to pose serious risks for the quality of mother-child interaction, interfering with the ability of the mother to bond with the infant and for the infant to form a secure attachment with the mother.

What are the signs of depression during pregnancy? Fleeting moments of feeling sad and blue or depressed are part of the human condition. These mood changes are normal and tell you that something is not quite right in your life and they usually pass. Clinical depression is different. It is persistent, impairing and includes a range of symptoms such as sadness, disturbance in sleep and appetite, changes in weight, agitation or feeling sluggish, a decrease in energy, feelings of worthlessness and guilt, having trouble concentrating or thinking, thoughts of death, feeling life is not worth living, and loss of interest or pleasure in usual activities or things you used to enjoy such as food, sex, work, your family and friends. In addition, depression during pregnancy is usually associated with a great deal of stress.

Evidence suggests that approximately 10% - 26% of women have been found to be depressed during their pregnancy and as poverty increases, so does the rate of depression during this time. Pregnancy is also known to be an opportune time for suggesting health interventions and pregnant women may be unusually open to making changes to improve their mental health before their baby is born. In order to alleviate depression during pregnancy and prevent postpartum depression, it is imperative that patients, doctors, nurse clinicians, and social workers be provided with evidence regarding the effective treatments for depression during pregnancy. The good news is that depression during pregnancy is a treatable medical illness for which there are a number of effective treatments. Depression is not the pregnant woman's fault, but there is something she can do about it, if she seeks help.Antidepressant medications (mainly selective serotonin uptake inhibitors or SSRIs) have been found to be effective for reducing non-psychotic, unipolar depression during pregnancy and have demonstrated relative safety during pregnancy and the postpartum period. On the other hand, many pregnant or breastfeeding women are reluctant to take and doctors are reluctant to prescribe antidepressants because absolute safety (e.g., low risk of birth defects) cannot be assured. Thus, pregnant women may prefer treatment for depression with psychotherapy.

Recent evidence suggests that two types of psychotherapy may be effective for alleviating depression during pregnancy. The first type of psychotherapy, interpersonal psychotherapy, helps the depressed woman feel better by addressing and better managing the interpersonal difficulties most connected to her depression, including 1) learning to identify and take care of her own needs, 2) learning to rely less on an unsupportive boyfriend, 3) increasing her social support from available, reliable people in her network, 4) resolving a dispute with a person important to her, 5) enabling her to talk about her negative (and positive) feelings about the pregnancy without fear of judgment, 6) adjusting to and planning for the upcoming birth.

The second type of psychotherapy, cognitive behavioral therapy, helps the depressed woman feel better by encouraging her 1) to increase pleasurable activities weekly, 2) to give herself credit for her accomplishments, 3) to develop more realistic and helpful thinking, 4) to address and resolve step-by step the problems most currently linked with her depression, and 5) to adjust to and plan for the upcoming birth.
You can feel better before your baby is born! To seek help for depression during pregnancy, talk to your nurse, social worker or your physician, or call your local community mental health center.

Editorial provided by Nancy K. Grote, Ph.D., MSW, Director, Promoting Healthy Families Program, School of Social Work, University of Pittsburgh, Pittsburgh PA.

References: Grote, N.K., Swartz, H.A., Bledsoe, S.E., & Frank, E. (in press). Feasibility of providing culturally relevant, brief interpersonal psychotherapy for antenatal depression in an obstetrics clinic: A pilot study. Research on Social Work Practice.

Article found at http://www.expectantmothersguide.com/library/pittsburgh/depression.htm

Blog Day 1

Today seemed to go well until the kids and I got home this afternoon. I found myself in the usual "get away from me; don't touch me" mood that accompanies my lows. It's during these times that I feel the worst. Generally I am very sanguine, but in my slumps I retreat completely. I don't want anyone near me, and I find it virtually impossible to process information or interactions. People usually get a dazed look from me during these times and have to repeat themselves.

I realized a few days ago that I hadn't been taking my meds regularly. My lows often follow several days of skipping meds. I find that happens when I'm not eating well, since I have to take them in the middle of a meal. When I'm not enticed by the pantry stock, I tend to snack rather than dine and I feel like I'm not eating enough to keep from getting sick if I take them. As a result, I end up going through the day not taking them because by dinner when I actually eat a meal I've forgotten all about it. I need to discipline myself to eat meals, both for my mental health and for Bethany's sake.

Monday, August 15, 2005

Introduction


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Why is This Here?
As I have struggled with depression throughout my adult life, I've often wondered if what was going on in my head was familiar to anyone else in the world. Well, technology has once again offered a balm for our vanity, so here I am.

I don't know if anyone will ever read any of this. I don't know that if anyone does read it, it will sound familiar...or at least not completely crazy. Regardless of the outcome, this is here for me to share my life.

Hopefully it will help someone somewhere to know that she is not alone. Maybe it will help a husband better understand what his wife is going through. Maybe a family member or friend.

"Case History"
I am currently pregnant with my third child. This is my first pregnancy to also be on antidepresants. I take 40 mg of fluoxetine (Prozac) daily. Just before I got pregnant, I had begun to wonder if I needed to up my dosage because I seemed to be struggling even more than usual. I've been on the same dosage and medication for almost 3 years.

For me, depression exhibits itself in anger and fatigue - not good when you have a 3 year old and a 5 year old. I am a stay at home mother with a very small business doing website design and graphics design.

Plan of Action
My plan is to try to post each day to journal my experiences with depression during pregnancy. I will share articles, facts, and links that may also benefit.

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